Fragrance in Nursing Homes: A Life-and-Death Matter


An asthma attack can kill. We all know that. It’s also been well documented that fragrances can trigger an asthma attack in a large percentage of asthmatics.

In a November 3, 2015, editorial in the Canadian Medical Association Journal titled “Artificial Scents Have No Place in Our Hospitals,” editor Dr. Ken Flegel stated “There is emerging evidence that asthma in some cases is primarily aggravated by artificial scents.”

Asthma attacks are not the only way that air fresheners, fragrances worn by staff, and scented cleaning products can affect patients and staff in health care facilities. As the American Lung Association notes in its sample fragrance-free policy for workplaces, “Fragrances from personal care products, air fresheners, candles and cleaning products have been associated with adversely affecting a person’s health including headaches, upper respiratory symptoms, shortness of breath, and difficulty with concentration.”

Tara Batista, who joined the Army at age 18 to fight in the 1991 Gulf War, developed multiple chemical sensitivity as the result of her exposure to a myriad of toxic chemicals. She struggled through her chronic illness to get an R.N. degree and ended up working in the VA Hospital in Bedford, Massachusetts. To her dismay, some fellow nurses ignored her requests that they not wear perfume or cologne, and as a result she had to work many days while having a migraine headache.

In its 2009 Indoor Environmental Quality Policy, the CDC stated:

Scented or fragranced products are prohibited at all times in all interior space owned, rented, or leased by CDC.  This includes the use of: incense, candles, or reed diffusers, fragrance-emitting devices of any kind  .  .  .  plug-in or spray air fresheners.

In addition, CDC encourages employees to be as fragrance-free as possible when they arrive in the workplace.  Fragrance is not appropriate for a professional work environment, and the use of some products with fragrance may be detrimental to the health of workers with chemical sensitivities, allergies, asthma, and chronic headaches/migraines.

Employees should avoid using scented detergents and fabric softeners on clothes worn to the office.

It’s hard to understand why a policy that the CDC says is essential to protect the workers in all its buildings isn’t instituted in hospitals and nursing homes, where the patients are more far more vulnerable than the workers in CDC buildings.

In my film Fragrance-Free Workplaces, the director of an assisted-living home in Maine describes the fragrance-free policy that her facility maintains for the benefit of patients, staff, and visitors. One peripheral advantage of that policy is that eliminating the use of air fresheners makes it much easier for some people to visit a friend or relative in a nursing home, as is evident in the following two reports:

My wife and I have a dear friend who suffered a severe brain aneurysm that landed him in a nursing home for over two years. Of course we wanted to visit often, but we soon discovered that the citrus-scented air freshener was so intense that we reacted to it very strongly. The result was that we didn’t visit as often as we liked. Finally we told the staff that the so-called air freshener was preventing us from visiting or staying very long. We aren’t very reactive to chemicals, but that air freshener was an instant headache-maker and it affected our relationship with a dear friend who really needed us.“-Richard Startzman, Filmmaker


Several years ago, my 90-year old father-in-law was admitted to a nursing home after a one-week stay in a hospital for pneumonia. He was sent there for rehabilitation as he had lost a great deal of strength while he was sick. As is common in many facilities taking care of the elderly, the smell of air fresheners was quite strong and you could smell it as soon as you walked in the door. I needed to spend a lot of time there because my father-in-law was weak and he needed a patient advocate—and that was me. But, the odor from the air fresheners was so strong that I felt light-headed and could not think. I felt as though my brain was swelling. I was simply not able to be there to sit by his bedside and help communicate with his caregivers. As I struggled to endure my own symptoms, I wondered about the effect these strong odors were having on other patients in the facility who were trying to recover from respiratory ailments.-Karen McDonell, former paralegal

It is unconscionable for nursing homes and other medical facilities to unnecessarily exposure patients to toxic chemicals. Such practices risk drawing a lawsuit when an asthmatic patient dies from a severe attack in a facility where the air reeks of air fresheners.

Lawsuits brought by the surviving spouse or children of people who died from lung cancer eventually brought the tobacco industry to its knees and motivated the states to join the legal battle. According to the Tobacco Control Legal Consortium page of the Public Health Law Center website, lawsuits brought by the attorneys general of 46 states resulted in the signature in 1998 of what is called the Master Settlement Agreement (MSA). The tobacco companies that signed the MSA “agreed to make annual payments in perpetuity to the Settling States to compensate them for taxpayer money spent for health-care costs connected to tobacco-related illness.” The minimum to be paid was $206 billion over the next twenty-five years.