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EVIDENCE OF HEALTH HAZARDS
By: Cindy Duering
The stage has been set for increased health problems from the largely unregulated fragrances that saturate modern society in personal care products, detergents and fabric softeners, cleaners, and a host of other consumer products. A study analyzing chemical ingredients in certain fragrances warns: "The ubiquitous nature of these fragrance chemicals, when viewed with the trend toward more energy-efficient buildings and the attendant lower air exchange rate, increases the possibility of greater human exposure to fragrance components. Indoor atmospheres thus contain many sources of volatile fragrance compounds or, more generally, volatile organic compounds (VOCs), resulting in chronic exposures to these low-level VOCs. As the levels of these compounds increase due to broader use, the possibility of negative effects on the building inhabitants increases, especially for chemically sensitive persons. Sick Building Syndrome [SBS] is one possible manifestation of such exposure. Persons suffering from sick building syndrome have reported symptoms such as headache, nausea, disrupted concentration, and respiratory problems. It is known that a number of individuals are sensitive to these VOCs and cannot use certain perfumes, colognes, or products containing fragrances, or be in the proximity of others who do."(1)
A large portion of the general population experiences adverse respiratory, irritant, or neurological reactions to the fragrances which permeate society's products. A survey of 1,027 households sampled randomly in North Carolina found 10.5% (108) of them had one or more individuals who experience adverse reactions to perfumes.(2,3) Perfume sensitivity is a hallmark of chemical sensitivity, and studies in the U.S. are consistently estimating that approximately one-third of the U.S. population have chemical sensitivities, including 31% of 3,955 U.S. EPA workers, 34% of 192 Arizona elderly living in a planned retirement community, 28% of 809 University of Arizona college students, and 33% of 1,027 rural North Carolinians.(4)
The U.S. Consumer Product Safety Commission (CPSC) and other investigators have recommended the use of the standardized ASTM-E-981 toxicological test method to assess true biologic effects of full product formulations for consumer products and chemicals that contribute to poor indoor air quality.(5,6) The rodent test determines lung or respiratory irritation and sensory irritation of chemicals that stimulate the trigeminal nerve system upon inhalation.(6) A large database of toxicologic information from this test already exists, with extensive quantitative correlation between the effects of airborne irritant chemicals on mice and humans.(3,6) Mice are less sensitive than most humans to irritant airborne chemicals, so there is little risk of false positive results.(3)
In the first study to use this test method to assess biological effects of fragrance products, researchers found one-hour exposures to volatilized fragrance fumes in pure zero-grade medical air caused statistically significant acute toxic effects for sensory irritation, pulmonary (lung) irritation, and airflow limitation" in healthy mice as compared to control mice with sham exposures in the same test apparatus. Five fragrance products (four different brands of cologne plus one toilet water with up to four different commercial samples of each product) were individually tested on 186 groups of mice, with 21 sham tests on unexposed control groups.(3) The experiment was exquisitely designed to rule out possible confounding factors, and the initial developer of the ASTM-E-98 1 test method has found this research laboratory's protocol to be above reproach.(7)
In this study, the Functional Observation Battery (FOB), a neurobehavioral screening tool similar to that of the U.S. Environmental Protection Agency was used by EPA-trained technicians to evaluate the animals for adverse neurological effects 15 minutes after the exposures ceased. Statistically significant acute neurotoxicity was found. Abnormal responses included altered posture, gait, and muscle tone; tremors; abnormal repetitive movements; increased responsiveness to stimuli; abnormal reflexes and grip strength; and balance problems. Response to stimuli was markedly exaggerated in most fragrance product-exposed mice. Some mice developed paralysis of one or two limbs, coma, convulsions or death. Overall, five mice died in the 186 experiments with five fragrance products. No deaths occurred among the 123 sham-exposed animals.(3)
Repeat exposures (two per day for two days with a minimum of two hours between exposures) produced no increased symptoms in sham-exposed controls. However, each successive exposure in the fragrance-exposed mice caused increased neurotoxicity, indicating the possibility of "some component of increasing sensitivity to the fragrance product emissions, perhaps even time-dependent sensitization." The researchers stated, "We believe that these behavioral changes reflected toxicity in selected areas of the nervous system, rather than nonspecific effects (e.g. general anesthesia, anoxia), because some functions were decreased whereas others were unchanged."(3)
Unlike the irritant effect data from the test, researchers are not sure how the neurotoxicity data extrapolates to humans: "In sensory irritation and pulmonary irritation tests we deal with direct interactions of airborne chemicals with receptors on cell surfaces, but with neurotoxicity we are presumably dealing with a much more complex process. Some toxins might be absorbed into the circulatory system and distributed to the nervous system via blood. Some chemicals can enter the nervous system apparatus, and metabolites of some common volatile organic chemicals accumulate in the nasal mucosa. The deaths observed in a few of these mice merely represented severe effects; they did not constitute any basis for extrapolation of the death phenomenon per se to man."(3)
The researchers conclude: "Collectively, the experimental data and chemistry predict that some humans exposed to these fragrance products might experience some combination of eye, nose, and/or throat irritation; respiratory difficulty; possibly broncho-constriction or asthma-like reaction; and central nervous systems reactions (e.g. dizziness, incoordination, confusion, fatigue). The results of our study might help explain why some individuals report an intolerance to fragrance products, and why some fragrance products can exacerbate airflow limitation in some asthmatics."(3)
The fragrance industry has been aggressively conducting fragrance research on humans with brainwave machines, and has been quietly marketing fragrance combinations geared to neurologically alter the mood and physiological functions of individuals.(8-9) An irony that apparently hasn't been grasped yet by the industry in spite of the large numbers of individuals who report adverse reactions - is that the neurological stimulation they are deliberately provoking can impair brain function, as noted below.
This has raised concerns of manipulation by mind or mood control, and has drawn charges that fragrances are in reality being used as drugs to alter human functions.(8) These issues and other legal concerns, as well as the widespread use of fragrances on the general public in mass delivery systems will be addressed in part two of this article.
The mid 1980s saw a tremendous surge of interest in aromachology, the term coined to describe the study and use of fragrances to alter mood and brain function. Henry Walter, chairman of the board of the International Fragrance Foundation said, "We envision a zillion different possibilities," including pumping" stimulating aromas into schools to wake people up.(9)
The mechanism of this stimulation was revealed by a fragrance researcher who said an odor is "invigorating" if it stimulates the trigeminal nerve.(10) This is the same nerve used as a marker for irritant chemicals by the ASTM-F-981 test used in the fragrance study.(3,6) The ASTM-E-981 was initially developed under contact for the U.S. military to detect toxic nerve gases for chemical warfare.( 11) Chemicals that stimulate the trigeminal nerve are by nature irritant chemicals and are considered an occupational hazard that must be closely monitored.(6)
Another study of paint ingredients warns that irritant chemicals may lead to headache mediated by trigeminal nerve stimulation."(12) And now the fragrance industry blandly calls trigeminal nerve system stimulation “invigorating" and wants to pump irritant chemicals into our nation's schools to stimulate students?(9,10)
Symptoms of attention deficit disorder have been linked with excessive neurological firing in the brain.(13) Any chemical that stimulates the trigeminal nerve system has the capacity to trigger not just the irritant trigeminal effects, but also excessive neurological firing or excitotoxicity in vulnerable individuals(14) (some researchers have dubbed this as "partial kindling"). The complexities of the brain are only beginning to be understood. The brain is not wired with simple mood buttons as the fragrance industry's marketing plans would suggest, and one thing is certain, deliberate inhalant stimulation of the brain's neurons by complex combinations of chemicals called fragrances is sure to backfire. The fragrance test on mice using the ASTM-E-981 trigeminal nerve stimulation test is clear evidence of this.(3)
Perfumers expect a synthetic spiced apple scent will conjure up a happy relaxed mood. However, when independent researchers tested a synthetic spiced apple perfume on healthy subjects at levels too low for them to detect, EEG testing showed their brainwaves were altered, and the exposure decreased self-reports of happiness. This physiological effect was offset when the perfume levels were increased to detectable levels, presumably because of positive cognitive associations with good memories.(15)
Extremely low level perfume exposure can adversely interfere with brain function in healthy individuals with no allergies or chemical sensitivities. One experiment found that perfume exposure at levels too low to be detected by the subjects doubled the time necessary to solve a visual search task. Cognitive evoked potentials, or event-related potentials. were also altered even at perfume levels too low to detect, "suggesting that odors may be distracting or produce divided attention even when undetected" in healthy individuals.(16)
In chemically sensitive patients, brainwave changes from low level perfume and other exposure were much more profound and indicated severe impairment from neurotoxic reactions to perfumes, as objectively demonstrated in a clinical challenge inhalation study. Low levels of perfume caused brain-wave abnormalities corresponding to cognitive symptoms such as changes in ability to concentrate, think, memorize, and speak upon inhalation exposure in chemically sensitive patients as confirmed by quantitative EEG cognitive evoked potentials (also referred to as event-related potentials). The researcher noted the organic changes in the patients' brains were consistent with areas of the brain from which these adverse symptoms would originate.(14,17) The MCS individuals had a delayed latency for the P300 component.(17) The P300 latency is also delayed in brain injury cases of toxic encephalopathy and Alzheimer's disease.(18)
Another research clinician has stated that challenge testing MCS individuals with perfume has resulted in decreased blood flow in the brain and increased impairment as assessed objectively by single photon emission computed tomography (SPECT) scans. The results went from an initial abnormal finding to an even more abnormal finding after the perfume challenge. The abnormalities corresponded well with the patients' symptoms of headache, fatigue, spaciness, memory problems, and concentration difficulties.(19)
The toxicology book Chemical Exposure and Human Health lists numerous hazardous common perfume and fragrance ingredients gleaned from government databases. (20) Forty-three of those chemicals are listed in the U.S. National Institute for Occupational Safety and Health's NIOSH Pocket Guide to Chemical Hazards, which classifies 42 of them as respiratory system toxins, and 32 as neurotoxins targeting the central nervous system. Thirty-nine of the 43 fragrance chemicals are severe eye irritants, 36 are skin irritants, 24 are nose irritants, 12 are throat irritants, and 19 are directly associated with causing headaches. NIOSH classifies five of them as carcinogens, for which NIOSH states it cannot establish safe thresholds.(21) This is just the tip of the iceberg. Chemical Exposure and Human Health lists these adverse health effects from the NIOSH guide as well as numerous other hazards from the government literature on the chemicals commonly used as perfume ingredients. And these are just some of the few ingredients that have been tested.(20) Over 5,000 ingredients are used in fragrances, and the final products are complex untested mixtures of chemicals.(22) The perfume Red by Giorgio, for example, has over 600 ingredients.(23)
Perfume is a major cause of respiratory symptoms in susceptible individuals. Shim noted that perfume and cologne are two of the "most frequently mentioned offenders" for worsening respiratory symptoms in asthma patients. Challenge testing with perfumes confirmed their ability to decrease lung function in asthmatic patients.(24) A National Research Council report stated perfumes can induce reactive airway disease and bronchospasm in asthma patients, as confirmed by provocative challenge testing.(25)
Inhalational challenges of the perfume ingredients in advertisement strips (as compared to placebos) produced significant declines in lung functions of asthmatic patients as compared to controls. The authors concluded: "Perfume-scented strips in magazines can cause exacerbations of symptoms and airway obstruction in asthmatic patients." The perfume used in this study had at least 29 ingredients. Isopropyl alcohol (one of the most common ingredients in perfumes) alone was also able to impair lung function. Other unidentified perfume ingredients contributed to maximum respiratory impairment.(26)
Researchers believed perfume to be the responsible agent in a study that found significantly decreased lung function in hyperreactive individuals challenged with brief 20-second exposures to two different hairspray formulations. Healthy individuals in this study had no impairment from the exposure. The doctors warn that individuals with "hyperreactive airways, as seen in asthmatic subjects and in some people with allergic rhinitis and viral respiratory infections" may experience "an immediate response of the airways" from such exposure.(27)
While asthmatics and people with reactive airways disease are clearly susceptible to the adverse respiratory effects of fragrances, other research has shown that perfumes can impact the lung function even in healthy individuals. In another study, just 60 seconds exposure to hairspray (as compared to a placebo) caused decreases in lung function in healthy subjects. Six formulations were tested and the largest overall decreases in lung function were caused by the perfumed sprays. The authors concluded "it seems that perfumes might contribute to bronchoconstriction more than do the other ingredients found in hairspray."(28) The researchers who used the ASTM-E-98 I test on fragrances warn, "The results of our study suggest that the potential for asthma-like reactions may be more widespread than suspected previously; the airflow limitation observed in our study involved moderately severe reactions in mice that had no previous exposure to any known bronchoconstrictor."(3)
There is a common misperception that somehow natural perfumes such as essential oils are automatically safer and shouldn't be a problem for sensitive individuals. However, natural does not necessarily mean nontoxic. Even crude oil is natural. One review article lists 81 common fragrance essential oils that are proven allergens or sensitizers in the medical literature.(29) One of the harmless-sounding essential oils, clove oil, even caused "permanent local anesthesia [neurological numbness, loss of sensation] and anhidrosis [inability to secrete sweat]" in an individual exposed to spilled clove oil.(29)
Tobacco smoke and perfumes, including natural fragrances, were reported to be "the most important troublemakers" for causing respiratory symptoms in both asthmatic patients and patients with rhinitis. The authors stated: "Birch twig and marguerite most frequently induced symptoms, followed by strongly smelling flowers such as hyacinth, lilac, and lily of the valley. A significant positive correlation was found for elicitation of symptoms from flowers and from certain non-specific irritants. It is concluded that non-specific hyperreactivity as well as reaginic hypersensitivity are the mechanisms involved when birch twigs and flowers elicit symptoms."(30)
Essential oils often “co-react” to other fragrance materials in patients allergic to fragrances. For instance, balsam of Peru is used as a test marker for fragrance sensitivity and picks up on approximately 50% of patients allergic to fragrance materials.(29) Not all essential oils are made from plants and animals. They can also be synthesized from fossil fuels, and consumers have no way of knowing what is synthetic and what isn't.(29)
A review of published fragrance sensitivity reports in the medical literature lists 101 fragrance ingredients that are allergens or classic sensitizers. These sensitizing fragrance ingredients are commonly used in cosmetics and toiletries.(29) In an analysis of 400 "commonly purchased products" in the U.S., 18 of the top 25 perfumes used in those products are also classic sensitizers as reported in the above review.(29) Another study has observed, "It is not possible to point out 'safe' concentrations for sensitizing compounds."(12)
For sensitive individuals, perfume exposure can cause life-threatening reactions even apart from asthma attacks or bronchial constriction. In one case that was written up for publication in the medical literature, "contact dermatitis from the application of spray cologne to the chest and abdomen in a female patient resulted in the development of erythema multiforme [capillary congestion usually due to dilatation of the superficial capillaries or blood vessels] with progression to toxic epidermal necrolysis [skin death] and, ultimately her death."(29)
A researcher notes that for some individuals, fragrances may trigger respiratory problems by nonallergic mechanisms: "this is thought to be due to a direct release of histamine rather than an allergic mechanism, caused by fragrance ingredients known to cause non-immunologic immediate contact reactions."(29)
- Both synthetic and natural fragrances are increasingly used in foods. Research has indicated that "in some fragrance-sensitive patients who also react to balsam of Peru (some 50%) and in those reacting to fragrances that are also used as flavours and spices such as cinnamic aldehyde, cinnamic alcohol, vanilla and eugenol, foods and drinks may exacerbate symptoms." Such reactions may be either local or systemic. Foods and medications that may cause such reactions in patients allergic to balsam of Peru include:(29)
- Back to Top
citrus peel: oranges, lemon, grapefruit, bitter orange,
tangerine, mandarin oranges
essence-flavored products: baked goods, sweets, chewing gum
wine, scented tea, tobacco
colas and other soft drinks
spices: cinnamon, cloves, vanilla, curry
- (products from
these include: ketchup, chili sauce, chutney, pickled herring,
pickled vegetables such as beets and cucumbers, baked goods,
pate, liverpaste, vermouth bitters, spiced beverages).
In light of all the evidence, how does the fragrance industry justify the use of so many sensitizers in their products? This unaccountable industry's capacity for self-deception is exemplified by the claim of the Research Institute of Fragrance Materials (RIFM) that the sensitizing potential of certain fragrance allergens, such as cinnamic aldehyde, phenyl acetaldehyde and citral, can be diminished by the addition of other chemical fragrances.
They call it "quenching" and do not test for other adverse effects that may be caused by these combinations of chemicals.(29) Independent researchers have not been able to confirm quenching action in patients allergic to cinnamic aldehyde, nor in guinea pig sensitization studies. "Therefore, whether quenching in allergic contact dermatitis does exist and, if so, is effective, is rather doubtful."(29) Non-immune immediate contact reactions to cinnamic aldehyde appeared to be blocked by eugenol, but apart from that there is a whole range of potential adverse effects that cannot be quenched.(20,21,29)
The very fact that RIFM recommends the use of limonene as a quenching agent is problematic.(29) Limonene is one of the key ingredients in the ASTM-E-981 study that showed serious respiratory and neurotoxic effects. (3) As noted by those researchers, limonene "has caused symptoms of the eye, skin, mouth, stomach, lung, and brain, including dizziness, incoordination, convulsions, and death." In addition it has been associated with causing kidney damage and lesions, pneumonia, and birth defects, and is suspected of causing cancer.(20) Even if it could "quench" dermatitis reactions, chronic exposure places the consumer at risk for a host of other problems.
The review article also warns that products labeled "unscented" may be loaded with fragrances, as the industry often adds additional chemicals and fragrances in an attempt to "mask" the smells. Therefore, sensitive individuals may have serious adverse reactions to these so-called "unscented" products.(29)
Perhaps the most insidious action of numerous fragrance ingredients that puts everyone's long-term health at risk in a less obvious manner, is neurotoxicity. Chronic low level exposure to neurotoxins can subtly cause cumulative damage to nerve cells. Over a period of years this can lead to permanent or progressive brain damage, including chronic imbalances of enzymes and neurotransmitters essential for normal brain function.(31) A growing number of researchers believe such exposures contribute an important role in the increase of degenerative nervous system diseases such as Parkinson's disease and Alzheimer's disease.(31) A toxicology text notes that for neurotoxins, "most chronic neurotoxic effects are due to repeated lower level exposure. "(32)
A French study has warned that perfumes can cause neurological disorders in addition to skin and respiratory disorders.(22) A report by the U.S. Office of Technology Assessment (OTA) addressing the concerns of neurotoxins in consumer products warns, "The nervous system is particularly vulnerable to toxic substances because: Unlike other cells that make up the body, nerve cells, or neurons, normally cannot regenerate once lost. Toxic damage to the brain or spinal cord, therefore, is usually permanent. Nerve cell loss and other regressive changes in the nervous system occur progressively in the second half of life – toxic damage may therefore progress with aging. Even minor changes in the structure or function of the nervous system may have profound consequences for neurological, behavioral, and related body functions."(33) Because of this, the OTA warns that consumer products should not contain neurotoxins, yet current laws do not require neurotoxicity screening for personal care products. In fact, no premarket toxicity testing of any kind is required.(33) Industry may voluntarily conduct tests to determine acute toxicity or the LD5O level (the dose required to kill half the test animals), but chronic toxicity testing is typically not done. (33)
OTA uses the word “cosmetics" to refer primarily to personal care products used on the body, including perfumes, after-shave, lotions, and other scented products. Because the U.S. Food and Drug Administration (FDA) lacks authority to require toxicity testing and premarket testing of cosmetics, only obvious and gross poisoning incidents voluntarily reported to the FDA may (or may not) prompt the FDA to launch an investigation.(33) Yet the primary hazards of neurotoxic exposures to consumers is not readily apparent.(33)
The OTA states, “the consequences of inadequate toxicity testing are illustrated by the AETT incident. In 1955, AETT (acetylethyl tetramethyl tetralin) was introduced into fragrances; years later it was found to cause degeneration of neurons in the brains of rats and marked behavioral changes in rats, including irritability and aggressiveness. In 1978, it was voluntarily withdrawn from use by the fragrance industry. Its effects on humans through two decades of use will probably never be known."(34)
Only a few neurotoxic compounds have been removed from consumer products. In 1979, a study observed: “Hexachlorophene was included in many over-the-counter antiseptic and deodorant soaps for more than twenty years before the FDA decided to regulate its use. This action followed outbreaks of neurological disease in infants bathed in detergents containing hexachlorophene for the purpose of reducing staphylococcal infection. Zinc pyridinethione, a compound that produces a primary axonal degeneration in animals has been used as an effective antidandruff agent in shampoos for ten to fifteen years. AETT was in use for 22 years before toxicological testing revealed its insidious neurotoxic properties. The fragrance industry subsequently brought its research findings to the attention of the FDA and voluntarily withdrew the compound from fragrance formulations. There may be a need, however, to subject other ingredients in the preparation of cosmetic and cleansing products to rigorous scrutiny for neurotoxic properties."(35) As noted earlier in this article, numerous other neurotoxic compounds found in perfume and consumer products have not been voluntarily withdrawn by industry.
Animal studies have also identified musk ambrette as having deleterious neurotoxic effects. Industry's response to this discovery, however, was markedly different than its response to AETT. Musk ambrette is a nitro-musk compound still widely used as a fixative in fragrance formulation and also in flavor composition.(29,35)
The Research Institute of Fragrance Materials was formed in the U.S. in 1966 to carry out definitive research on fragrance ingredients for the sole purpose of establishing fragrance safety," though it makes no recommendations on safe levels. RIFM has compiled a computer databank of fragrance ingredient data and has published 1500 monographs on the most frequently used materials. Unfortunately, their screening tests are only the most rudimentary acute toxicity and skin irritation tests not able to pick up on organ system health effects from chronic exposure, which is the real life exposure situation for consumers. No chronic testing is done to determine possible neurotoxic effects, birth defects, respiratory irritant hazards, reproductive effects, and other hazards that government agencies have already assigned to chemicals used in fragrances. RIFM's “definitive research" only includes acute oral toxicity (limit test or LD5O the amount the rats have to drink before 500/0 of them die), acute dermal toxicity, dermal irritation, dermal sensitization, and dermal phototoxicity. Not even mutagenic or carcinogenic effects are studied, let alone endocrine effects.(29) Nor are these tests conducted on fragrance combinations, which significantly changes the toxicological profile, as evidenced by the full product biological testing study utilizing the ASTM-E-981.(3)
The increasing reports of adverse reactions to fragrances is not surprising in light of the lack of regulation and industry accountability, the absence of premarket full toxicity testing, and the emerging clinical and research evidence.
1. Cooper, S.D.; Raymer, J.H.; et al. "The Identification of Polar Organic Compounds Found in Consumer Products and their Toxicological Properties." Journal of Exposure Analysis and Environmental Epidemiology 5(1): 57-75 (1995).
EARN Library Code: 0030-COOP-95-019
2. Meggs, W.J.; Dunn, K.A.; et al. "Prevalence and Nature of Allergy and Chemical Sensitivity in a General Population." Archives of Environmental Health 51(4): 275-282 (1996).
EARN Library Code: 0030-MEGG-96008
3. Anderson, R.C.; Anderson, J.H. "Acute Toxic Effects of Fragrance Products." Archives of Environmental Health 53(2): 138-146 (1998).
EARN Library Code: 0030-ANDE-98-009
4. Miller, C.S. "Chemical Sensitivity: Symptom, Syndrome or Mechanism for Disease?" Toxicology 111: 69-86 (1996).
EARN Library Code: 0030-MI LL-96-01 8
5. U.S. Consumer Product Safety Commission. Memorandum and Final Report from Interagency Agreement on Volatile Organic Chemical Emissions from Carpets. (see pages 60-62) CPSC-IAG-90-1256 (Aug. 13,1993) 125 pages.
EARN Library Code: 0029-CPSC-92-1 25
6. Schaper, M. "Development of a Database for Sensory Irritants and Its Use in Establishing Occupational Exposure Limits." American lndustrial Hygiene Association Journal 54(9): 488-544 (1993).
EARN Library Code: 5362-SCHA-93-057
7. Alarie, Y. "Testimony before the Subcommittee on Environment, Energy and Natural Resources. House of Representatives, Committee on Government Operations June 11,1993."
EARN Library Code: 0029-ALAR-93-019
8. R.A. "Firms Push 'Aroma Therapy' to Treat Flat Fragrance Sales." Wall Street Journal (March 20,1986) 2 pages.
EARN Library Code: 5516-ALSO-86-002
9. Goodwin, B. "Fragrances Offer Latest Clues in Ways to Combat Stress, Fatigue." Los Angeles Times (Aug. 23,1985) 4 pages.
EARN Library Code: 551 5-GOOD-85-004
10. Stone, J. "Cents and Sensibility." Discover Vol. 10 No.12 (Dec. 1989) 3 pages.
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11. Duehring, C. "Carpet Part One: EPA Stalls and Industry Hedges While Consumers Remain at Risk." Informed Consent (Nov,/Dec. 1993)10 pages.
EARN Library Code: 0029-DUEH-93-010
12. Hansen, M.K.; Larsen, M.; et al. "Waterborne Paints. A Review of Their Chemistry and Toxicology and the Results of Determinations Made During Their Use." Scandinavian Journal of Work Environment and Health 13: 473-485 (1987).
EARN Library Code: 0032-HANS-87-013
13. Uhlig, T.; Merkenschlager, A.; et al. "Topographic Mapping of Brain Electrical Activity with Food-Induced Attention Deficit Hyperkinetic Disorder. European Journal of Pediatrics 156(7): 557-561(1997).
EARN Library Code: I 263-UHLI-97-005
14. Dudley, D.L. "Chemical Toxicity: A Neurometric Study of Changes in the Auditory and Visual Cognitive Evoked Potential in Response to Olfaction." [Submitted for publication. The abstract of this article was published in Clinical Research 41(2): 383A (1993)].
EARN Library Code: 0030-DUDL-93-024
15. Lorig, T.S.; Herman, K.B.; et al. "EEG Activity During Administration of Low-Concentration Odors." Bulletin of the Psychonomic Society 28(5): 405-408 (1990).
EARN Library Code: 5515-LORI-90-004
16. Lorig, T.S.; Huffman, E.; et al. "The Effects of Low Concentration Odors on EEG Activity and Behavior." Journal of Psychophysiology 5: 67-77(1991).
EARN Library Code: 5515-LORI-91-009
17. Dudley, D.L. "Olfactory Uptake and the Auditory and Visual Cognitive Evoked Potential, Rare: Olfactory Uptake and the Mapped Pattern Reversal Evoked Potential and the Mapped Visual Cognitive Evoked Potential, Rare." Clinical Research 41(2): 383A (1993).
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18. Morrow, L.A.; Steinhauer, S.R.; Condray, R. "Differential Associations of P300 Amplitude and Latency with Cognitive and Psychiatric Function in Solvent-Exposed Adults." The Journal of Neuropsychiatry and Clinical Neurosciences 8(4): 446-449 (1996).
EARN Library Code: 0259-MORR-96-004
19. Phone interview with neurotoxicologist and immunotoxicologist Gunnar Heuser, M.D., Ph.D., F.A.C.P., NeuroMed and NeuroTox Associates, Agoura Hills, CA. June 24, 1993.
20. Wilson, C.W. "Perfumes and Fragrances." Chemical Exposure and Human Health. Jefferson, NC: McFarland & Company, Inc. (1993) 56 pages.
EARN Library Code: 551 5-WI LS-93-056
21. U.S. National Institute for Occupational Safety and Health, U.S. Dept. of Health and Human Services. Toxicology excerpts for 43 of the perfume ingredients listed by Chemical Exposure and Human Health (By C. Wilson, McFarland & Company, 1993). NIOSH Pocket Guide to Chemical Hazards (June 1994) 57 pages.
EARN Library Code: 5515-NIOS-94-058
22. Meynadier, J.M.; Meynadier, J.; et al. "Formes Cliniques: Des Manifestations Cutanees D'Allergie Aux Parfums." (French with English summary) Annales de Dermatologie et de Venereologie 113: 31-39(1986).
EARN Library Code: 5515-MEYN-86-009
23. Givhan, R.D. "A Sniff Penalty: One Whiff Can Be Too Much for Those Who React to Compounds in Perfume." Detroit Free Press (March 18,1990) 1 page.
EARN Library Code: 5515-GIVH-90-001
24. Shim, C.; Williams, Jr., M.H. "Effects of Odors in Asthma." American Journal of Medicine 80:18-22 (1986).
EARN Library Code: 0181-SHIM-86-005
25. National Research Council, Commission on Life Sciences, Board on Environmental Studies and Toxicology, Committee on Biologic Markers, Subcommittee on Immunotoxicology. "Use of Biologic Markers in Controversial Areas of Environmental Health." In Biologic Markers in Immunotoxicology, Washington, DC: National Academy Press (1992) pp. 1-5,127-139,148.
EARN Library Code: 0030-NRCB-92-023
26. Kumar, P.; Caradonna-Graham, V.M.; et al. "Inhalation Challenge Effects of Perfume Scent Strips in Patients with Asthma." Ann. Allergy Asthma Immunol. 75(5): 429-433 (1995).
EARN Library Code: 5515-KUMA-95-005
27. Schlueter, D.P.; Sato, R.J.; et al. "Airway Response to Hair Spray in Normal Subjects and Subjects with Hyperactive Airways." Chest 75:543-548(1979).
EARN Library Code: 5515-SCHL-79-006
28. Zuskin, E.; Bouhuys, A.; Beck, G. "Hairsprays and Lung Function" Lancet 2(8101): 1203 (1978).
EARN Library Code: 5551-ZUSK-78-001
29. DeGroot, A.C.; Frosch, P.J. "Adverse Reactions to Fragrances: A Clinical Review." Contact Dermatitis 36: 57-86 (1997).
EARN Library Code: 5515-DEGR-97-030
30. Eriksson, N.E.; Lowhagen, 0.; et al. "Flowers and Other Trigger Factors in Asthma and Rhinitis - An Inquiry Study." Allergy 42(5): 374-381(1987).
EARN Library Code: 5515-ERIK-87-008
31. U.S. Committee on Science and Technology, Fuqua. Neurotoxins: At Home and the Workplace. Report to the Committee on Science and Technology, U.S. House of Representatives, Ninety-Ninth Congress, Second Session on June 1986. Washington DC: U.S. Government Printing Office (1989).
EARN Library Code: 0359-COST-86-047
32. Rosenberg, N.L. "Neurotoxicology." In Hazardous Materials Toxicology: Clinical Principles of Environmental Health. Eds. J.B. Sullivan, Jr.; G.R. Kneger. Baltimore, MD: Williams & Wilkins (1992) pp. 145-153.
EARN Library Code: 0359-ROSE-92-010
33. U.S. Congress, Office of Technology Assessment. "Summary, Policy Issues and Options for Congressional Action." In Neurotoxicity: Identifying and Controlling Poisons of the Nervous System OTA-BA-436 Washington, DC: U.S. Government Printing Office (Apr. 1990) pp. 3-40.
EARN Library Code: 0359-OTAO-90-042
34. U.S. Congress, Office of Technology Assessment. "Chapter Two: Introduction." In Neurotoxicity: Identifying and Controlling Poisons of the Nervous System OTA-BA436 Washington, DC: U.S. Government Printing Office (Apr 1990) pp.43-59.
EARN Library Code: 0359-OTAO-90-021
35. Spencer, P.S.; Sterman, A.B.; et al. "Neurotoxic Fragrances Produces Ceroid and Myelin Diseases." Science 204 (4393): 633-635 (1979).
EARN Library Code: 5515-SPEN-79-003
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