Fragrances and work-related asthma-California surveillance data, 1993-2012.
OBJECTIVE
Fragrance chemicals are used in a large array of products. Workers may be exposed to these chemicals in the workplace directly when used as air fresheners, or indirectly in personal care products used by coworkers or others. This study characterizes work-related asthma (WRA) cases associated with fragrance exposures in California workplaces from 1993 through 2012.


METHODS
We used the California Work-Related Asthma Prevention Program's surveillance database to identify individuals with physician-diagnosed WRA associated with the use of air fresheners and scented personal care products (perfumes, colognes, etc.). Cases were classified using previously published, standardized surveillance methods.


RESULTS
Perfume was the ninth most common exposure identified from 1993 through 2012. A total of 270 WRA cases associated with fragrance exposure were reported during this period, representing 3.8% of all confirmed cases. These 270 cases included 242 associated with perfume or cologne, 32 associated with air freshener, and 4 associated with both. Similar to non-fragrance cases, nearly a quarter of fragrance-associated cases were classified as new-onset asthma. Fragrance-associated cases were significantly more likely to be in office, health, and education jobs than non-fragrance-associated cases. When compared to non-fragrance cases, fragrance cases were significantly more likely to be female (94% vs 62%) and be classified as having work-aggravated asthma (38% vs 20%), yet had similar outcomes compared with cases associated with other exposures.


CONCLUSIONS
Our surveillance data show that fragrance use in the workplace is associated with WRA. Prevention methods include employee education, enforced fragrance-free policies, well-designed ventilation systems, and good building maintenance.
a Public Health Institute , Contractors to the California Department of Public Health , Richmond , CA , USA.
Justine Lew
JL
Weinberg
b California Department of Public Health , Richmond , CA , USA.
Jennifer
J
Flattery
b California Department of Public Health , Richmond , CA , USA.
Robert
R
Harrison
D000328:Adult; D000368:Aged; D001249:Asthma / Q000139:chemically induced / Q000453:epidemiology*; D002140:California / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009784:Occupational Diseases / Q000139:chemically induced / Q000453:epidemiology*; D016273:Occupational Exposure / Q000009:adverse effects; D009790:Occupations; D010476:Perfume / Q000009:adverse effects*; D044469:Racial Groups; D055815:Young Adult
D010476:Perfume
Air freshener; asthmagens; cologne; perfume; terpenes