It is often possible to accommodate people with chemical sensitivities, so they can continue a productive work life. But there are no one-size-fits all solutions.
Keywords: chemical sensitivity, environmental sensitivity, MCS, employer, work, accommodation, rehabilitation, indoor air quality
A growing number of people are affected by minute amounts of chemicals, such as fragrances, cleaners, solvents, pesticides, fumes from electronics and much else found in offices and factories.
People with mild cases of chemical sensitivity may simply get mild headaches after being at work for a few hours.
Severe cases can be so strongly affected their work performance is severely impacted.
The symptoms vary with the person, though the common ones involve headaches, dizziness, difficulty concentrating, irritated sinuses and feeling tired â€“ i.e. somewhat like having a flu, but without the fever.
The symptoms typically lessen or clear up when going outdoors for a while.
A variant of chemical sensitivity is "sick building syndrome" if the symptoms happen in just one particular building.
The typical person with MCS is a woman older than thirty years, but it can also strike men and at any age. It affects people of all races, social classes and educational levels (Katerndahl, 2012).
People working in jobs where they are exposed to chemical fumes are more prone, such as industrial workers, flight attendants, hair dressers and office workers in poorly ventilated buildings (Martini, 2013).
The workplace challenge
Chemical sensitivity is still poorly understood and thus controversial. There is no standard treatment and no reliable cure. The most effective mitigations are to remove the triggers.
When people with chemical sensitivities have their needs for better air quality accommodated, they can function better and be more productive in the workplace. It may also raise the productivity of the other employees (see later).
In some cases employers are unwilling or unable to accommodate the employee with MCS, especially if the sensitivities are severe.
Many people with severe chemical sensitivity are forced to change jobs, become underemployed or go on disability (Kreutzer, 1999; Berg, 2008; Evans, 2010; Soderholm, 2011).
The Canadian Human Rights Commission suggests:
...developing and enforcing fragrance free and chemical avoidance policies, undertaking educational programs to increase voluntary compliance with such policies, minimizing chemical use and purchasing less toxic products, and notifying employees and clients in advance of construction, re-modeling and cleaning activities. (Canadian Human Rights Commission, 2014.)
The Centers for Disease Control, a U.S. government agency, has its own internal "Indoor Environmental Quality Policy" developed to protect the health of their own staff, including "workers with chemical sensitivities." The policy is publicly available and can serve as a template for other workplaces (CDC, 2009).
Communication between the treating physician and the employer may help getting the ball rolling. Sometimes a physician specializing in occupational health can be helpful (Martini, 2013). As MCS is still controversial, it is best to find a specialist who will focus on the employees' needs and not the controversy.
To be successful, it is best if policy changes and modifications are tailored to the individual, especially if there is just one person with chemical sensitivity. The sensitive person needs to be involved in the decisions.
There are many options to consider, and some experimentation may be necessary.
There are no "one size fits all" accommodations, as it is individual which chemical agents are the worst triggers, and at what levels.
Improving the ventilation
How much to ventilate is a compromise between cost and employee comfort. The ventilation standards for the United States are designed for healthy people, with an air quality intended to satisfy 80% of the building occupants (ASHRAE, 2004). That means it is "acceptable" when up to 20% of the employees find the air quality objectionable.
The US federal workplace standards (OSHA/NIOSH) are also designed solely for healthy people, and not sensitive people (ASHRAE, 2004).
The air intake is usually placed next to the mechanical room, which is often at ground level near a loading dock or traffic, so exhaust fumes are sucked into the building.
Improving the ventilation system can benefit the entire staff and raise their productivity, so it actually is a net financial gain (MacNaughton, 2015; Bako-Biro, 2004). The total annual cost of poor indoor air quality in the United States is estimated at 100 billion dollars, due to reduced productivity (Wallace, 2001).
However, improving the ventilation is not always helpful (Menzies, 1993).
No amount of ventilation can adequately mitigate major and nearby sources of pollution. If a sensitive employee sits near a highly fragranced coworker, even sitting outdoors may not be enough ventilation.
Be aware that the ventilation system itself can be a problem, as it may harbor dust, mold and microbes and fumes from the heating and cooling systems.
Providing a window that can be opened, next to the person with chemical sensitivities, may be an excellent solution.
Air cleaners have electric fans that pull air through some sort of filter. They are not magical devices that turn bad air into pristine air. It is limited what they can do and they are rarely a "solution" in itself. They can only help once all major sources of pollution have been removed.
Air cleaners can help, but are rarely enough by themselves. They need to be of good quality, like this one from Austin Air.
An aircleaner is only effective in a rather small room, with just a few people in it. The small desktop air cleaners are simply too puny.
Filters that just remove particles from the air are rarely enough. Look for a filter that can actually remove fumes, such as those with zeolite or activated charcoal. There must literally be pounds (kilos) of filter material to have a real effect.
A quality air cleaner will likely cost hundreds of dollars and may have to be ordered from specialty suppliers. What they sell at the local store is unlikely to be sufficient, they are better suited for pollen and dust.
Check independent ratings, such as in Consumer Reports, but be aware that companies too small to be tested in a magazine may offer a superior product.
At least one restroom must be designated as fragrance free. That means:
"Air fresheners" are a misnomer, they do not actually freshen the air. What they do is add chemical fumes that overpower the senses, so people no longer notice objectionable odors. To a person with MCS, they are a steep barrier to using the restroom.
There are no "safe" versions of these products, regardless of any marketing claims. Even essential oils labeled as "natural" or "organic" contain unhealthy chemicals (Nematollahi, 2018).
Any sort of fragrance dispenser must be totally removed. Instructing the custodial staff to just not refill an existing dispenser will eventually be forgotten and the dispenser refilled (we've been there).
If employees complain about any offensive natural odors in the restroom, consider improving the ventilation. Scented restrooms were not common in the United States until the late 1990s. They are not a necessity.
People with MCS consistently rate fragrances as one of their worst problems (Steinemann, 2016, 2018; Larsson, 2009).
Fragrances are largely unregulated and contain many toxic chemicals (Steinemann, 2009; Grenville, 2017).
Restricting them is thus very similar to restricting smoking, which also is an unnecessary habit that is unhealthy to others.
There are many ways fragrances can be brought into the workplace, such as:
A no-fragrance staff policy can provide a major improvement to the air quality. A pioneer was the U.S. Centers for Disease Control and Prevention, which enacted a policy in 2009 (CDC, 2009).
It states in part:
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.
The Canadian Centre for Occupational Health and Safety also provides guidelines for making the workplace fragrance free (CCOHS, 2020).
Consider a gradual approach, starting with banning scented candles and all other kinds of fragrance emitters. Then move on to personal care products.
Such policies may be met with employee resistance, though they may also be welcomed by many employees who have mild symptoms or simply find the smells unpleasant (Steinemann, 2016; Berg, 2008; Johansson, 2005).
Various forms of personal care products and cosmetics can be a problem to other people in the same room.
Education of the entire staff is paramount for acceptance and compliance. It must be stressed that this is a medical issue and not merely that someone doesn't like the smell of fragrances (CCOHS, 2020). It may also help to point out that limiting fragrances is to the benefit of everybody's health, and not just one individual (Vierstra, 2007). A good educational source is the book The Case Against Fragrance, by Kate Grenville.
There are several lines of less-scented personal care products available. It could be helpful to provide the staff with a list of locally available products, especially major brands from major stores.
Essential oils are not an acceptable alternative. Even those products marketed as "natural" or "organic" contain nasty solvents (Nematollahi, 2018).
Plan for how to handle non-compliant employees and visitors, such as sending them home to clean up, placing them in a separate room or other measures. The sensitive person should not be the "fragrance police." That will quickly poison the atmosphere and could result in harassment.
Employers are naturally reluctant to set such a policy. Several employees have tried to get the courts to force the employer. In the past that was not successful (Vierstra, 2007), but more recent attempts have been successful (McBride, 2010).
For the most sensitive, a fragrance policy is a great help but may not be enough. Fragrances will still find their way into the building on people's clothes if they have visited a public restroom on the way, or they use fragrance dispensers at home or in the car. Or if they share a washing machine with other people who use fabric softeners and scented detergent.
Dry cleaned clothes can also be a problem.
Sometimes the employee simply has to be separated from the normal work room and/or the other employees.
It may be sufficient to move the employee's work station well away from the other people, but still in the same large room.
Providing a private office is even better, especially if it has not been renovated for a long time and the window can be opened.
Working from home should be considered, perhaps with a scheduled weekly day at the office for meetings, making photo copies, etc.
It may be an option for the employee to work at hours where there are few or no other employees around. With few people in the building, the overall air quality should be better, and there'll be fewer encounters with overly scented employees.
Personal meetings can be particularly difficult with a group of people sitting around a table.
First consider to what extent the employee actually needs to participate in meetings. Some may actually be a waste of time anyway.
Having the employee participate in a meeting via speaker phone or videoconference system is doable, but tends to leave the employee sidelined and missing out on the non-verbal cues in the room. An alternative is that all participants use a videoconferencing system, even if they are in the same building. This creates a level playing field and can work quite well (Economist, 2020). It may also allow participants to do productive work when they are not actively participating in the meeting.
In one case story, they used an oversized meeting room with a powerful ventilation system and then arranged the chairs and tables so the employee was well away from the more fragrant participants (Evans, 2010: ch 2 & 9).
The employee may have to be reassigned to a different job. If the job involves working with chemicals, such as paint, epoxies or strong cleaning agents, it may not be possible to modify the job itself. But be aware that if the reassignment is in effect a demotion, that is likely to be illegal under the law.
Bullying by supervisors and co-workers are a common problem for people with chemical sensitivities and can make work hell (EI wellspring, 2019; Soderholm, 2011; Lipson, 2004; McCormick, 2001; Gibson, 1996).
Harassment can take many forms – both subtle and not so subtle. Some employees have successfully sued their employer on this issue (EI wellspring, 2019).
Bullying of employees with disabilities is unfortunately a common problem that is not limited to environmental disabilities (Fevre, 2013).
Many companies have janitors clean on a daily or weekly basis. The cleaning agents are usually harsh chemicals that can leave a residue.
One patient describes how he had to go to a doctors' office once a week to get an allergy shot. He noticed he got dizzy in the waiting room every time – except on Mondays. A sympathetic nurse figured out why: housekeeping came in every morning before the clinic opened – except on Monday mornings (Evans, 2010: ch 5).
If the cleaning agents seem to cause problems, it may be possible to get housekeeping to switch to less-toxic products. That may also be a long-term health benefit for the janitors. But better products often cost more – and beware of "green-washed" cleaning products that aren't so healthy after all.
Another option is to see if the cleaning can be done in the evening rather than in the morning, so there is more time for the residues to offgas.
It may not be necessary to clean the room the sensitive person works in, or at least not as often. Perhaps do a trial of some weeks without cleaning the room to see if it helps.
Using Integrated Pest Control will dramatically reduce the use of pesticide, as this method focuses on preventing and trapping pests instead of simply spraying on a schedule.
If spraying is unavoidable, notify the employee and try to schedule the spraying for after hours, especially on a Friday night or Saturday, so the fumes can dissipate somewhat before the next workday. The employee may not be able to return for a period of time.
Desktop computers, copy machines, printers and other electronics emit chemical fumes from their circuit boards, plastic cabinets and other parts. This is especially the case when they are turned on and warm.
In one experiment a group of workers used computer that were just three months old, and then computers that were much older. The fumes from the three-months-old computers clearly lowered the productivity of the workers, who were all healthy and did not have MCS (Bako-Biro, 2004).
When the electronics needs to be upgraded, consider "burning it in" for some months in a different room, or let someone else use it first while it offgasses.
Remodeling and maintenance
Any kind of remodeling, maintenance or new furniture can cause problems for people with MCS. Depending on the person's level of sensitivity and the type of change, the problem may persist for just a day, or may take weeks or months to offgas the offending chemicals.
Discuss the project with the sensitive person to get an idea of what may be needed, but also be aware that he or she may not know in advance when it will be safe again.
For some, a new carpet is safe in a well-ventilated room after just a couple of weeks. For others it can take more than a year. It may also depend on the brand of carpet.
There are many options to consider. Here are some suggestions:
See if the maintenance can be done somewhere else, such as on equipment that can be moved out of the room.
Consider if there are optional ways to do the maintenance that may not result in noxious fumes. There are less-toxic paints and other building materials available, though they are not guaranteed to be any more tolerable.
Carpets are particularly troublesome. They cover a large surface and give off fumes for a long time.
Instead of carpets, put in vinyl, linoleum, hardwood or tile. They are easier to clean, last much longer and are a lot less problematic than carpets, but their hard surfaces reflect noise and they cost more.
If carpeting is unavoidable, research what less-toxic brands are available and install with tack strips instead of glue. Avoid any pad underneath.
For a small project, the sensitive person could work from home or in another room for the day.
Larger projects could be done on a Friday after hours and the ventilation system be set to run all weekend with 100% fresh air.
Increased ventilation may be needed for an extended period of time.
The project may be scheduled for the beginning of the sensitive person's vacation or before a major holiday.
The sensitive person could work elsewhere for a while.
New furniture made of glass and steel should be tolerable very quickly, while furniture made of veneer, particle board and upholstery is best avoided. If the new furniture is not tolerable, it could be offgassed elsewhere for some months.
Major outdoor maintenance projects can be a problem and should be communicated in advance. This especially includes repaving access roads and parking areas, tarring the roof, painting the facade, etc.
The fumes can enter the building through the ventilation system and also be a problem when the sensitive person needs to enter or exit the building.
ASHRAE (American Society of Heating, Refrigeration and Airconditioning Engineers), ANSI/ASHRAE Standard 6.21-2004, supplement C appendix B, 2004.
Bako-Biro, Z. et al. Effects of pollution from personal computers on perceived air quality, SBS symptoms and productivity in offices, Indoor Air 14, 178-187, 2004.
Berg, Nikolaj et al. Prevalence of self-reported symptoms and consequences related to inhalation of airborne chemicals in a Danish general population, International Archives of Occupational Environmental Health 81, 881-887, 2008.
Canadian Human Rights Commission. Policy on environmental sensitivities, January 2014.
CCOHS. Scent-free policy for the workplace, Canadian Centre for Occupational Health and Safety, www.ccohs.ca, April 2020.
CDC. Indoor Environmental Quality Policy (CDC-SM-2009-01), U.S. Centers for Disease Control and Prevention (CDC), June 22, 2009.
Economist. The nowhere firm, The Economist, March 28, 2020.
EI Wellspring. Workplace harassment of people with chemical sensitivities, eiwellspring.org, 2019.
Evans, Jerry. Chemical and electrical hypersensitivity: a sufferer's memoir, North Carolina: McFarland, 2010.
Fevre, Ralph et al. The ill-treatment of employees with disabilities in British workplaces, Work, Employment and Society, March 6, 2013. (Summarized in Disabled employees more likely to be attacked and bullied at work, research finds, University of Plymouth, phys.org, March 6, 2013.)
Gibson, Pamela et al. Chemical sensitivity/chemical injury and life disruption, Women and Therapy 19, 1996.
Grenville, Kate. The case against fragrance, Melbourne, Australia: Text Publishing, 2017.
Johansson, A. et al. Prevalence and risk factors for self-reported odour intolerance: the Skovde population-based study, International Archive of Occupational and Environmental Health 78, 559-564, August 2005.
Katerndahl, David et al. Chemical intolerance in primary care settings: prevalence, comorbidity, and outcomes, Annals of Family Medicine 10, July/August, 2012.
Kreutzer, Richard et al. Prevalence of people reporting sensitivities to chemicals in a population-based survey, American Journal of Epidemiology 150, July 1, 1999.
Larsson, Christel and Lena Martensson. Experiences of problems in individuals with hypersensitivity to odors and chemicals, Journal of Clinical Nursing 18, 737-744, 2009.
Lipson, Juliene G. Multiple chemical sensitivities: stigma and social experiences, Medical Anthropology Quarterly 18, 200-213, issue 2, 2004.
MacNaughton, Piers et al. Economic, environmental and health implications of enhanced ventilation in office buildings, International Journal of Environmental Research and Public Health 12, 14709-14722, 2015.
McCormick, Gail. Living with multiple chemical sensitivity, Jefferson, NC: McFarland, 2001.
Martini, A. et al. Multiple chemical sensitivity and the workplace: current position and need for an occupational health surveillance protocol, Oxidative Medicine and Cellular Longevity, 2013.
McBride. United States District Court, Eastern District of Michigan, Southern Division, Susan McBride v. City of Detroit, CA #2:07-CV12794, settlement agreement, February 12, 2010.
Menzies, Richard et al. The effect of varying levels of outdoor-air supply on the symptoms of sick building syndrome, The New England Journal of Medicine 328, March 25, 1993.
Nematollahi, Neda et al. Volatile chemical emissions from essential oils, Air Quality, Atmosphere & Health, 2018.
Soderholm, Anna et al. The experience of living with sensory hyperreactivity – accessibility, financial security, and social relationships, Health Care for Women International 32, 686-707, 2011.
Steinemann, Anne. Fragranced consumer products and undisclosed ingredients, Environmental Impact Assessment Review 29, 32-38, 2009.
Steinemann, Anne. Fragranced consumer products: exposures and effects from emissions, Air Quality and Atmospheric Health, October 2016.
Steinemann, Anne. Prevalence and effects of multiple chemical sensitivities in Australia, Preventive Medicine Reports 10, 2018.
Vierstra, Courtney, Phillip Rumrill, Lynn Koch and Brian McMahon. Multiple chemical sensitivity and workplace discrimination: the national EEOC ADA research project, Work 28, 391-402, 2007.
Wallace, Lance. Human exposure to volatile organic pollutants: implications for indoor air studies, Annual Reviews of Energy and Environment 26, 2001
This website has many other articles on how to cope with severe environmental sensitivities http://www.eiwellspring.org.