Fragrance materials in asthma: a pilot study using a surrogate aerosol product

Abstract

Objective: Many household products contain fragrances. Little is known about exposure to fragrances on human health, particularly within the airways. This study aimed to evaluate how common household fragrance products (i.e. air fresheners, cleaning products) affect people with asthma, who frequently report sensitivity to these products. Many of these products have volatile organic compounds or semi-volatile organic compounds. This study evaluated nine fragrance materials in an aerosol formulation to assess effects on airway physiology, airway inflammation and symptom perception in normal controls and those with asthma. Methods: The effects of fragrances were evaluated in people without asthma, people with mild asthma and people with moderate asthma in a four-way crossover placebo-controlled study. Subjects were exposed twice to a fragranced aerosol and twice to a placebo aerosol (15 and 30 min each). Subjects completed a questionnaire for 29 symptoms during and up to 3 h after each exposure scenario. Spirometry was performed prior to and 3 h post-exposure; sputum induction was conducted 3 h post-exposure. Results: Nasal symptoms showed the greatest frequency of response in all three subject groups, and moderate asthmatics reported the greatest symptom severity and symptom types. No significant differences were noted in physiology or cellular inflammation. Conclusion: A trend for increased symptoms was noted in moderate asthmatics, suggesting that asthma severity may play a factor in fragrance sensitivity.

• Airway inflammation
• fragrance sensitivity
• mild asthma
• moderate asthma
• symptom perception

Acknowledgements

The authors would like to thank the staff at the Research Institute for Fragrance Materials, Inc. for providing their Expert Panel of clinical and research Dermatologists, Allergy/Clinical Immunologists and Respirologists for their suggestions during the development of the study protocol by the investigative team. As well, we would like to thank Toxcon Health Sciences Research Centre, Inc. (Dr Chwen-Jyh Jeng, PhD and Dr Robert E. Rogers, PhD), and Alberta Health Services for assistance with participation in this study, as well as clinical services performed by Dr Cliff Carter MD FRCPC and Dr Erin Wright MD FRCPC from Department of ENT, University of Alberta and Dr M. Bryson Rogers MD FRCPC from Department of Dermatology, University of Alberta. Also, thanks to Mr Edward James, Mr David Pawluski and Ms Sheryl Madaski (Physiology Laboratory Technologists/Respiratory Therapy) and Ms Laura Rodgers (Cytotechnology).

We would also like to thank Dr Narasimha G. Prasad PhD (Toxcon Health Sciences Research Centre, Inc.; Department of Mathematics, University of Alberta) for his assistance with statistical analysis.

All authors contributed to the design of the study (with the exceptions of D.M. and J.B.). D.V., H.V., J.B. and D.M. participated in the study conduct. All authors were involved in the preparation of this article.

This study was conducted at the University of Alberta Hospital, Canada.