I bank at a credit union and for over a year we have been at war. Not because of any discrepancy in my account, but because of the overwhelming, breathtaking fragrance inside. This odor permeates even the drive-up tubes and this toxic air comes inside the vehicle whenever I open one to retrieve my deposit slip. Those folks at the credit union think I am a bit emotionally labile and you can be sure I am when it comes to the ability to breathe.

The American Lung Association published an article in ìAsthma Magazineî, Wheezing at Work - The Office Can Be Home To An Assortment of Asthma Triggers. This article states ì70% of people with asthma experience a worsening of symptoms when exposed to allergens and irritants. ..... but many asthma triggers can be found in offices as well. Some common asthma triggers in the office setting include: ..... perfumes and colognes (from coworkers) ....î

We have to conclude from this article that the American Lung Association recognizes chemicals and fragrances to be asthma triggers.

Perfume is made of toxic chemicals that can injure your health. The National Institute of Environmental Health Sciences, National Institutes of Healthís listing of ìCommon Indoor Air Pollutantsî is proof enough for me that our government also recognizes that fragrances are pollutants. http://www.niehs.nih.gov/external/faq/indoor.htm

The 20 most common chemicals found in 31 fragrance products can be found on the website, http://users.lmi.net/~wilworks/ehn20.htm. This site also lists the effects these chemicals have on our central nervous systems, lungs, skin, eyes, etc. Not pretty.

In the article Smelling Good But Feeling Bad - Synthetic Perfumes, Colognes and Scents Are Turning Up Noses, by Damon Franz and Holly Prall, http://allergies.about.com/gi/dynamic/offsite.htm?site=http%3A%2F%2Fwww.ourlittleplace.com%2Fperfume.html -- the writers cite the Louisiana State Medical Centerís finding that one out of every five asthmatics experiences an attack as a result of exposure to perfume. Since the American Lung Association states that asthma attacks afflict about 14.6 million Americans and kill an estimated 5,000 each year, that equates to an estimated 2.92 million asthmatics whose asthma attacks are a result of exposure to perfume.

Acute severe reactions may be associated with hypersensitivity, a condition of hyperreactive airways that effects 10-20% of the U.S. population, according to the EPA. Concentrations of VOCs measured indoors are usually far below occupational threshold limit values (TLVs), the point above which health effects may occur, but they may at times, exceed human odor thresholds, or the point at which an odor becomes offensive.

Fragrance chemicals are volatile by nature. This means some of each fragranced product used ends up in the air. The result is a complex mixture of chemicals that is constantly changing. The Environmental Health Center, A Division of the National Safety Council, lists Volatile Organic Compounds (VOCs) as one of the major air pollutants.

Dozens of different VOCs have been measured in indoor air from a variety of sources including building products, cleaning agents, paints and finishes, fragrances and hair sprays, office equipment such as copiers and printers, and infiltration of outdoor air. Using air cleaners or filtration devices proves ineffective.

The issue of fragrances in the workplace can be addressed from several perspectives. Fragrances add to indoor air pollution and are a general health concern whether a person is fragrance sensitive or not. The chemicals in perfumes, colognes, and deodorants worn by employees add to the chemical mixtures in indoor air, as do fragrances in cleaning products.

Simply touching a surface that someone else with fragrance on their hands has touched can cause allergic reactions. Since fragrance chemicals are absorbed through the skin, they can and do affect other organs of the body.

A person that is fragrance sensitive is often put into a ìno winî situation.

It is not as simple as it sounds to avoid exposure to fragrance chemicals. Even when purchasing fragrance free materials, there is no assurance the product will not contain fragrance chemicals. Fragrance chemicals can be added to a product to cover or mask the odor of other chemicals in the product. This is often listed on the label with other ingredients as "masking fragrance". It is not required by law to be put on the label and not all manufacturers list the masking fragrances.

Avoidance of exposure to other's fragranced products is even more difficult. By design, fragrances get into the air and linger a long time. They settle and stick to hair, clothes, furniture, and furnishings. People often spray their clothes with fragrance so what ever their clothes touch have some of the fragrance materials on it. It is impossible to be in an environment where fragranced products are used and not be exposed. The minute we breathe in, whatever chemical is in the air is in our bloodstream. This is because our lungs are designed to extract air (oxygen) and place it in our blood. If the air is polluted with toxic chemicals, so are our bodies.

No agency regulates the fragrance industry. According to John Baily, Phd, Director, Colors and Cosmetics, FDA, "The fragrance and cosmetic industry is the least-regulated industry. There is no pre-clearing of chemicals with any agency."

The FDA has suggested the best method "to protect sufferers from odor sensitivities might be to curtail odor exposures under specific circumstances through local or state regulatory action."

Some progress in this respect has been made:
* The federal Access Board adopted a ìfragrance-freeî meeting policy.
* Postal Regulations, Domestic Mail Manual, 124.395 Fragrance Advertising Samples (39 USC 3001 (g) April 1990), states that fragrance strips for mailing "cannot be activated except by opening a glued flap or binder or by removing an overlying ply of paper."
* California AB 2709 (as of January 1, 1992) states that "fragrances contained in any newspaper, magazine, or other periodically-printed material, published or offered for sale, or contained in any advertisement - mailed or otherwise distributed - shall be enclosed in a sealant sufficient to protect a consumer from inadvertent exposure to the cosmetic - including, but not limited to, the inadvertent inhalation thereof."
* The Americans with Disabilities Act of 1992 guarantees access to disabled to institutions, such as government agencies, libraries, doctor's offices, retail stores, and many others.

There are no such ordinances, local or state, that I know of in my area. It is time.

Fragrances are a "barrier to access" for the MCS/EI disabled, since breathing is affected.

Breathing is a "major life activity" as defined by the ADA. Fragrance bans meet the "reasonable accommodation" clause of the ADA, since elimination and substitution are not expensive.

Inform the US Access Board (http://www.access-board.gov/) when you are denied access due to fragrances. Air is part of every building and conveyance, and it cannot be "shaken out."

We must all work toward better indoor air quality using all the legal and ethical means available to us. In the meantime, if you have problems with chemical sensitivity, help is available. Tipu Sultan, MD, has been practicing Environmental Medicine in the St. Louis area since 1979. Dr. Sultan can help the chemically sensitive individual through support of the immune system. The chemically sensitive have a tough row to hoe, and in most cases they can improve. Dr. Sultan is head of the Environmental Health and Allergy Center ñ St. Louis, located at 11585 W. Florissant Ave., Florissant, MO, and can be reached by calling 314-921-5600.