You can turn away more than a few noses trying to establish a scent-free workplace. Here's how a Nova Scotia hospital developed and enforced a policy.

You can well imagine how difficult it would be to inform your workers they are not allowed to wear any personal scented products — and that can include perfume, cologne, lotions, shampoos and scented deodorant. But at Queen Elizabeth II Health Sciences Centre (QEII HSC) in Halifax, N.S., we did just that. We started with a policy in 1991 at the Camp Hill Medical Centre; by 1993 every site at the QEII HSC (including adjacent buildings, the Scotia Rehabilitation Centre, and the Victoria General Hospital) had a scent-free policy.

In 1996, the policies at each site were standardized. The resulting QEII policy is entitled "Smoking, Scents and Air Quality". It has had a major impact on the workplace environment and specifies enforcement in a manner that is consistent with the internal responsibility system to provide a healthy and safe workplace.

It all began in the late 1980s when a large number of odour-related complaints came to our attention. About 600 QEII employees had recorded complaints of symptoms seemingly related to poor indoor air quality over a four year period at the Camp Hill Medical Centre. Discomfort experienced by staff and patients included headaches, nausea, eye irritation, allergic rhinitis and bronchial hyper-reactivity. After recognizing there was a problem, we set to work on developing the first scent-free workplace.

At the scratchboard

Based on our experience, below are some general recommendations to consider when developing a policy:

* conduct a needs assessment of employees affected by scents;
* search for literature that offers evidence and support for a policy;
* look into local legislative requirements such as those in OH&S acts, WCB acts, and human rights legislation;
* ensure joint occupational health and safety committee involvement and executive support;
* ensure there is a discipline process in place before implementation;
and
* evaluate the policy for effectiveness in its initial implementation stages, as well as constantly identify issues for improvement.

The first step at QEII was to have our OH&S Services department conduct extensive research into the effects of personal scented products, including olfactory fatigue. Our research found a number of scented products have components classified as volatile organic compounds (VOCs) which have been suspected as possible contributing factor in the sick building syndrome. There is some research available on scented products and their affects on people — especially asthmatics.

Our health services department also determined that some scent-free industrial products may have higher VOCs (to mask their naturally bad smells) than unscented products. We hired an occupational hygienist who reviewed all existing chemical products at the centre, particularly those which were identified as potential problems for indoor air quality. Also, we requested MSDSs on all new products to be reviewed by the hygienist and trials to be done in selected areas before approval for purchase.

A representative from every department was involved with the process of product assessment and substitution. And many of our product suppliers developed low-scent or scent-free products for us, which our hygienist approved. For example, our housekeeping director met with the company responsible for the fragrant cleaner used throughout the centre. The company, which was used to requests for nicely scented cleaners, did formulate a low-scent, less toxic cleaner for our use. Many of our other suppliers later came forward with newly designed competitive products for our use.

Cooperation from involved parties was critical to the success of the initial policy. The housekeeping department placed notices in work units one week before each area was to shampooed, stripped or waxed. Engineering services notified managers before doing preventive maintenance in their areas, and had their paints and any other products approved by OH&S before use.

Input was forthcoming from management, OH&S Services and the four unions at QEII. The vice-president of human resources worked with Nova Scotia Nurses Union to develop and distribute information and promotional material, including a poster which has shown up in various areas of Canada. 'Scent-free workplace' signage was posted on all building entrances. A scent-free policy statement was typed on all appointment cards, hospital stationery, requisitions, room booking notices for external group users, and employment postings. Our public affairs department communicated the policy to the public, and provided a list of suggested unscented products available locally which would be acceptable for use.

The policy now includes a statement to eliminate, wherever possible, the use of hospital products where scent or other properties are known to cause health problems for patients, staff, volunteers or visitors. Written information is provided to patients, and residents of our long-term care facility have the policy outlined for them.

Enforcement

In the stages of the initial policy implementation and enforcement, there was much resistance. In a nutshell: The first policy was broad brush, difficult to enforce, and too restrictive for some and insufficient for others. Concerns and questions included the following:

* Where is the scientific data to backup the policy?
* Where is the legislative backup?
* This violates my freedom under the Human Rights Act.
* This policy is a joke. Enforcement doesn't and can't occur.
* Employees wearing scented products denied wearing them and couldn't smell the scents themselves.
* Some employees, managers and physicians felt if they didn't apply perfume or cologne, then it satisfied the policy, although many wore personal care products with scents added.
* It was difficult to find personal scent-free products at that time, especially with reasonable prices.
* Those affected negatively by scented products complained that things other than personal scented products were problems, and were not being addressed.
* The policy was difficult to enforce as it didn't apply at first to patients, contractors, vendors and physicians.
* Alternative-therapy practitioners lobbied us regarding aroma therapy and its benefits — their platform: The policy was not fair.

Managers were called to task by unions for confronting employees who wore scented products. Employees confronted each other arguing about personal rights to wear scented products, which ended in conflict. There were conflicts over staff using prescription scented ointments, or applying them to patients. Discipline and enforcement was almost impossible. However, most employees slowly began to comply with the scent-free policy — just to avoid the conflicts.

Enforcement of our latest policy is prescriptive, putting the onus of communicating and enforcing the policy on anyone using scented products. A worker who notices a problem is required to address the violator "in a cordial and respectful manner". Before this, usually employees and managers would call the OH&S department regarding the offender and asked the department to discipline the violator. But third-party witnessing was not sufficient to carry out enforcement, so the OH&S staff could only respond by trying to educate the alleged offender about the policy. Now, the policy outlines a strict and clear line of command for reporting incidents.

One of the most common questions that came up was "Where is your legislative backing?" When developing and enforcing a scent-free workplace, make sure to check on provincial legislation regarding indoor air quality.

The remaining difficulty with compliance to the policy remains mostly with the public, including patients, visitors, vendors and contractors. Sometimes, given that we are a health care institution, enforcement is not practical. Health care givers can't refuse to care for a patient who is wearing a scented product — although, in some cases, the product does make some of the staff very ill. Patients do receive notice in the admitting handbook about our policy, and patient representatives have been able to help out with awareness and education.

Scented products cause health problems which can lead to lost productivity and increased costs both to the individuals, the organization which employs them, the health care system, and affected individuals. Developing and enforcing our scent-free policy raised awareness of a new kind of prevention, and changed our understanding of indoor air quality and its impact on health.

Brenda Marsh is the former director of OH&S Services at the QEII HSC in Halifax, N.S. She is a working group member at N.S. Department of Labour on a proposed regulation for indoor air quality, and is presently the OH&S consultant for the N.S. Department of Business & Consumer Services.

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REFERENCES AND RESOURCES

* For more information on VOCs and contributing factors in Sick Building Syndrome see Morton Lippmiann's book, Environmental Toxicants — Human Exposure & Their Health Effects, and Dean J. Hauser's book The Work Environment Volume Three — Indoor Health Hazards.

* An employer establishing a scent-free policy may wish to contact organizations such as the following in their own area: The Lung Association of Nova Scotia; The Allergy and Environmental Health Association; The Migraine Foundation; and The Asthma and Allergy Information Association.

* Other institutions that are scent-free may be able to provide advice. Those include the IWK-Grace Health Centre for Children and Women (Halifax); the Nova Scotia Hospital; Highland View Regional Hospital; All Saints Hospital (Spring Hill, N.S.); Dalhousie University; and the Ministry of Highways and Transport in Victoria, B.C.

 

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EFFECTS OF SCENTED PRODUCTS

The following are facts gathered by QEII HSC during their research into scented products and their impact on indoor air quality and workers' health.

1. Scented products can cause a variety of health problems such as, but not limited to, sore throat; runny nose; sinus congestion; wheezing; shortness of breath; headaches; dizziness; anxiety; anger; fatigue; mental confusion; inability to concentrate; irritability; seizures; nausea; and muscle pain.

2. About 15-20 per cent of North Americans have some breathing problems, such as hay fever or asthma, that is adversely affected by strong odours from scented products such as perfumes or aftershaves.

3. Strongly scented products can trigger migraines; 17 per cent of Canadians suffer migraines.

4. About 4,000 chemicals are used to make fragrances and several hundred can be used in a single product.

5. Virtually no testing for neurotoxic effects is done on fragrance chemicals, although research on animals has produced severe health problems.

6. The ventilation systems of many buildings are not able to extract all chemicals from the air, and instead, recirculate them.

From the January/February, 1998, issue of OHS Canada

See also: No Scents Makes Sense