Don’t take our word for it. Here’s every fact on this site, with its evidence grade, its caveats, and a link to the source, so you can check us.
We start you on the strong ones: findings that have been replicated or come from one large, well-controlled study. Moderate and weak facts are here too, labeled for what they are. Use “Link to this fact” to share a single card.
Health effects / Advocacy group testing
Six substances found in the tested perfumes are classed by this report as suspected endocrine disruptors: benzyl salicylate, BHT, butylphenyl methylpropional, ethylhexyl methoxycinnamate, ethylhexyl salicylate, and octocrylene.
Moderate evidence: 'suspected' means the substance appears on one or more screening/priority lists, not that endocrine disruption in humans at perfume-use doses has been demonstrated.
Source: Tegengif 2022 Link to this fact
Health effects / Advocacy group testing
Butylphenyl methylpropional, found in several of the tested perfumes, is the one substance in this report's list of 26 that is also classed as reprotoxic.
Moderate evidence.
Caveats
NGO audit of ingredient labels on 20 popular perfumes bought in three EU countries, not a random sample; it checks declared ingredients against hazard lists and measures no concentrations.
Source: Tegengif 2022 Link to this fact
Health effects / Measured in people or real products
Adaptation to a scent is specific to that scent, not a general loss of smell: in the same home-exposure study, sensitivity to a control odorant that was never part of the exposure stayed normal throughout, so someone who has gone nose-blind to their own perfume can still smell other things fine.
Moderate evidence.
Caveats
Same single small study (n=10) as the companion claim above; the specificity finding is corroborated qualitatively by an independent occupational study (acetone-exposed workers, no change to control odorants) already in our evidence base.
Source: Dalton 2000, Chemical Senses Industry-funded Link to this fact
Health effects / Self-reported survey
In a Brazilian headache-clinic study of 200 diagnosed migraine patients, 70% (140/200) reported that an odor — most often perfume (75.7% of those affected) — had triggered a headache at least once in their life, with pain typically beginning within about 10 to 25 minutes of exposure.
Moderate evidence.
Caveats
Retrospective lifetime recall at a single referral clinic in Teresina, Brazil (2011); non-random convenience sample; no prospective diary, blinded challenge, or control for premonitory-phase symptoms that can be mistaken for triggers.
Health effects / Self-reported survey
Among the same 113 migraineurs, 90.2% had migraine crises triggered by odors, and of those, perfume was by far the most common odor trigger (95.1%), followed by cleaning products (81.3%), cigarette smoke (71.5%) and motor vehicle exhaust (70.5%).
Moderate evidence: Self-report, unvalidated questionnaire, single clinical sample, no provocation testing of the named odors.
Source: Fornazieri 2016, Headache: The Journal of Head and Face Pain Link to this fact
Health effects / Self-reported survey
Perfume as a migraine trigger was significantly more common in migraineurs without auras than with auras (P = .02), while physical exercise as a trigger was more common in those with auras (P = .01); no other olfactory symptom (osmophobia, odor-triggered crisis, interictal hypersensitivity, hallucinations, phantosmia, cacosmia/euosmia) differed between the two groups (all P > .4).
Moderate evidence: Single-center cross-sectional sample; aura classification self-reported, not independently verified.
Source: Fornazieri 2016, Headache: The Journal of Head and Face Pain Link to this fact
Health effects / Self-reported survey
Migraine patients with interictal olfactory hypersensitivity scored far higher on a validated 5-item chemical odor intolerance index (pesticide, paint, perfume, new carpet, car exhaust) — 18.7 +/- 3.2 — than migraineurs without it (11.7 +/- 3.6) or headache-free controls (9.9 +/- 3.5), a clear dose-like gradient (all pairwise P <= 0.02).
Moderate evidence: Single-center, cross-sectional; the index is validated but coarse (5 items) and self-report.
Health effects / Other evidence
In a 2007 study of 1,207 migraine patients at one Atlanta headache clinic, 43.7% said perfume or odor triggered their attacks at least occasionally, but only 10.7% said it did so in most attacks (more than 66%).
Moderate evidence.
Caveats
Single specialist clinic, 84% of the wider cohort women; self-reported recall with no diary or exposure measurement; 'perfume or odor' is one lumped item, not fragrance products specifically.
Source: Kelman 2007, Cephalalgia, Cephalalgia Link to this fact
Health effects / Other evidence
In the same review, about 40% of migraine patients (40.1%, 95% CI 32.7-47.8) said an odor can trigger their attacks; among those naming odor triggers, perfume was the most common (65.0%), then smoke (36.3%) and household cleaners, bleach, or chemicals (29.0%).
Moderate evidence: Retrospective self-report; trigger vs premonitory aversion not separated; the same 40.1% figure also appears for in-attack hypersensitivity with a different CI.
Source: Briggs et al. 2025, World J Otorhinolaryngol Head Neck Surg, World Journal of Otorhinolaryngology – Head and Neck Surgery Link to this fact
Health effects / Other evidence
In 400 Boston men, those who used cologne or perfume in the past 24 hours had about 83% higher urinary MEP, the breakdown product of the fragrance solvent diethyl phthalate, than men who did not.
Moderate evidence: One cohort at one clinic, shared lab and authors with the women's EARTH study; exposure marker only, no health outcome. Whether MEP marks DEP or the fragrance mixture is disputed.
Source: Nassan 2017, Environmental Health Perspectives Link to this fact
Health effects / Measured in people or real products
The phthalates linked to lower vocabulary scores in this Korean child study were DEHP metabolites (plastics, food contact); the fragrance-phthalate marker MEP was not measured, so the study says nothing about perfume.
Moderate evidence: Only MEHP, MEOHP and MBP were measured.
Source: Cho 2010, Environmental Health Perspectives Link to this fact
Health effects / Other evidence
In a random survey of 1,582 adults in the Atlanta, Georgia metro area (1999-2000), 12.6% said they were allergic or unusually sensitive to everyday chemicals like cleaning products, paints, perfumes, detergents and insect spray, and 3.1% said a doctor had diagnosed multiple chemical sensitivity or environmental illness.
Moderate evidence: Self-report only, one metro area; sampling frame, interview mode and response rate are not reported in this brief; no clinical verification.
Source: Caress & Steinemann 2004 (AJPH), American Journal of Public Health Link to this fact
Health effects / Other evidence
In a Japanese headache clinic, 78% of 101 migraine patients linked their attacks to odors, and perfume was the most-named one (about 56%), ahead of tobacco smoke (47.5%) and fabric softener (32.7%).
Moderate evidence.
Caveats
Single clinic, retrospective self-report from a 35-item list, no controls or diary; the authors note early premonitory symptoms may be mistaken for triggers. Association, not proof perfume causes attacks.
Hidden ingredients / Review of other studies
The glycol-ether solvent propylene glycol methyl ether (PGME), mostly used in industrial coatings and cleaners, is officially listed as a possible 'fragrance ingredient' in cosmetics, and a Swiss survey found it making up 30–50% of one perfume.
Moderate evidence: INCI function listing plus one Swiss product survey (Dentan 2000, cited secondhand); US registry shows only nail-product uses.
Source: CIR 2008, International Journal of Toxicology Industry-funded Link to this fact
Hidden ingredients / Review of other studies
Several hundred different label names can signal fragrance (chemical names, over 50 essential oils by common or Latin name, and synonyms such as aroma, parfum, perfume, and scent), so dermatologists say allergic patients are very unlikely to find fragrance-free products by reading labels alone.
Moderate evidence: Expert opinion.
Hidden ingredients / Self-reported survey
About a third of the personal care products people actually used were not in EWG's Skin Deep database at all, including 39% of perfumes and nearly all intimate-care products, so their hazards could not be rated.
Moderate evidence: Database coverage as of July 2022; EWG has since added products.
Source: Barrett 2025, Journal of Exposure Science & Environmental Epidemiology Link to this fact
Hidden ingredients / Measured in people or real products
Lab tests commissioned by US campaigners found 38 chemicals not listed on the label of at least one of 17 popular perfumes; 10 of them had no toxicity study in PubMed.
Moderate evidence.
Caveats
NGO report (Campaign for Safe Cosmetics and EWG), not peer reviewed; one purchase per product; 'secret' means absent from at least one product's label; detection is not exposure or harm.
Source: Sarantis et al. 2010 (Not So Sexy) Link to this fact
Hidden ingredients / Measured in people or real products
Benzyl alcohol, a fragrance allergen dubbed the "covert fragrance," was found in 32 of 533 US baby and children's personal care products (6%) with no "fragrance," "perfume," or "parfum" wording anywhere on the label.
Moderate evidence: Doesn't establish whether these products are marketed "fragrance-free"; measures label wording, not chemical content verification.
Hidden ingredients / Other evidence
Products labeled 'fragrance free' have been shown to still contain fragrance ingredients, used as preservatives, masking perfumes, or botanicals.
Moderate evidence: Secondary citation of Scheinman's clinical observations, not this review's own new data.
Source: Johansen 2003, Am J Clin Dermatol 4(11):789-798, American Journal of Clinical Dermatology Link to this fact
Hidden ingredients / Other evidence
Even "unscented" or "fragrance-free" products may contain a perfume or essential oil added specifically to mask the unpleasant odor of the product or its other ingredients.
Moderate evidence: General statement in a narrative review, not a count of how many fragrance-free-labeled products actually contain a masking fragrance.
Source: de Groot 2020, Dermatitis 31(1):13-35, Dermatitis® Link to this fact
Hidden ingredients / Review of other studies
In the EU, an entire perfume or fragrance composition can be declared on the ingredient list as the single word 'parfum' or 'aroma', legally hiding every chemical in it except the handful of allergens that must be named separately.
Moderate evidence: Restates the regulation's text; not new data, and the same point is made by other evidence base sources.
Source: Tegengif 2022 Link to this fact
Hidden ingredients / Advocacy group testing
Auditing the printed ingredient lists of 20 popular perfumes sold in Belgium, Denmark, and the Netherlands against 13 official and NGO hazard lists (EDC lists, EU harmonized classifications, the SVHC candidate list, the EU fragrance-allergen list, environmental-persistence lists) turned up 26 problematic substances across the 20 products.
Moderate evidence.
Caveats
Based on declared ingredient lists only, not chemical analysis of the products; every label also carries the undisclosed catch-all 'Parfum', so true chemical content is larger than what was audited.
Source: Tegengif 2022 Link to this fact
Hidden ingredients / Advocacy group testing
Only 2 of the 20 tested perfumes contained no suspected endocrine-disrupting chemical (EDC) on their declared ingredient list; the other 18 contained at least one.
Moderate evidence: Counts declared ingredients only; a perfume could contain additional undisclosed EDCs hidden under 'Parfum'.
Source: Tegengif 2022 Link to this fact
Hidden ingredients / Other evidence
Oak moss absolute, jasmine absolute, tuberose oil, cassie absolute, and wintergreen oil, all perfumery materials, are also US food flavorings; the 2020 industry survey reports only tiny volumes (oak moss 34 kg, cassie 29 kg, jasmine absolute 100 kg, tuberose 0.8 kg a year, wintergreen oil 700 kg), or about 0.08 to 72 millionths of a gram per person per day.
Moderate evidence: Food-use volumes from a voluntary industry survey (corrected by an assumed 80% response); says nothing about fragrance volumes, where these materials are used far more.
Source: Guengerich 2026 (FEMA Expert Panel), Food and Chemical Toxicology Industry-funded Link to this fact
Hidden ingredients / Measured in people or real products
All 17 tested perfumes, colognes, and body sprays contained at least one synthetic musk; Galaxolide was in 15 and was not on any of those 15 labels.
Moderate evidence: Qualitative detection; musk concentrations are not reported; one sample per product.
Source: Sarantis et al. 2010 (Not So Sexy, Canadian edition) Link to this fact
Hidden ingredients / Measured in people or real products
All 17 everyday product perfumes (shampoos, baby bath, lotions, deodorants) contained at least one of the fragrance-mix allergens by GC-MS, about 2.6-2.8 on average; geraniol was in 12 of 17.
Moderate evidence: Single manufacturer's lower-priced perfumes, 1990s Denmark; oak moss not analyzed; concentrations are in the perfume, not the finished product.
Source: Johansen 1997, Contact Dermatitis Link to this fact
Hidden ingredients / Measured in people or real products
In the 17 product perfumes the quantified fragrance-mix allergens ranged from about 0.005% to 1.35% w/v of the perfume, with the highest being amyl cinnamal (1.35%) in a creme rinse perfume and eugenol 0.39% in the same perfume.
Moderate evidence: Concentration in the perfume concentrate, not in the finished product; some entries detected but not quantifiable due to interference.
Source: Johansen 1997, Contact Dermatitis Link to this fact
Hidden ingredients / Other evidence
Limonene, linalool and Lyral are fragrance ingredients commonly found in personal care products, processed foods and beverages, and perfumes, and the society judges them relevant for many patch-tested patients.
Moderate evidence: Committee judgment based on cited reviews; no product-survey data in this paper.
Hidden ingredients / Review of other studies
Galaxolide and Tonalide are used in perfumes, cleaning products, detergents and cosmetics, so they are typically covered by the single word 'fragrance' on a label.
Moderate evidence: Statement is in the paper's introduction and describes use, not what any given label discloses; this study measures no exposure.
Source: Schreurs 2005, Toxicological Sciences Link to this fact
Hidden ingredients / Other evidence
Limonene and beta-pinene scent terpenes were measurable in every perfume, deodorant and cleaning liquid tested (about 0.1-0.3% and 0.04-0.65% of product weight), even though labels only say 'fragrance' or, for the cleaners, name limonene.
Moderate evidence.
Caveats
Six products; GC-MS of three terpenes only, so other scent chemicals are unmeasured; alpha-pinene was below the detection range. The abstract's beta-pinene range (0.4-0.7%) differs from Table 1 (0.04-0.65%).
Indoor air / Measured in people or real products
In an office-sized test room with some ozone in the air, a single ordinary spray of perfume, body spray, or hair spray, or a dab of hand lotion, set off a burst of new ultrafine particles within minutes, reaching 34,000–200,000 particles per cubic centimeter, more than in many city streets.
Moderate evidence: One chamber, 5 products, one use each; ozone held at 35–40 ppb (high end for indoors); masked volunteer; no toxicity measured.
Source: Wu 2024, Environmental Science & Technology Letters Link to this fact
Indoor air / Measured in people or real products
Almost everything in a perfume ends up in the air: one perfume released 964 mg of vapor per gram used, mostly alcohol but also about 32 mg per gram of terpene fragrance chemicals.
Moderate evidence: One perfume; emission factors are lower bounds (PTR-MS blind to some compounds).
Source: Wu 2024, Environmental Science & Technology Letters Link to this fact
Indoor air / Journalism
In 2003 Southern California air regulators estimated that household and small-business products, including cleaners, cosmetics, perfume, and room fresheners, released about 108 tons of smog-forming chemicals a day in the Los Angeles region, second only to vehicle tailpipes.
Moderate evidence: Agency inventory relayed by the LA Times; for measured/modeled figures use McDonald 2018 (LA) and Coggon 2021 (NYC 2018: VCPs comparable to vehicle fuels for ozone).
Source: DONTSPRAYCALIFORNIA 2008 (DOJ ADA docket) Link to this fact
Indoor air / Self-reported survey
In a small (n=69) follow-up of Atlanta-area adults with chemical hypersensitivity, the products most commonly reported to trigger symptoms were cleaning agents (88.4%), pesticides (81.2%) and perfume (81.2%), followed by tobacco smoke (82.6%) and car exhaust (72.5%).
Moderate evidence: Small, non-random follow-up sample (n=69, about 35% of the original 199 hypersensitive respondents); self-report of trigger identification, not exposure measurement.
Source: Caress & Steinemann 2003 (EHP), Environmental Health Perspectives Link to this fact
Indoor air / Measured in people or real products
In controlled chamber testing of 12 cosmetic spray products (sunscreens, dry shampoos, hair sprays, a moisturizing and a setting spray, and perfumes) applied 20 cm from the measurement point, one sunscreen spray reached a maximum PM10 particle-number concentration of 1.03 x 10^6 particles per cubic centimeter, and another reached a maximum PM10 mass concentration of 36.17 mg per cubic meter.
Moderate evidence.
Caveats
Single lab, chamber-based, near-field (20 cm) measurement of the immediate spray plume, not a room-average or personal-exposure measurement; one unit tested per product; no replication by an independent group yet.
Source: Dai et al. 2026, ACS Environmental Au Link to this fact
Indoor air / Measured in people or real products
Propellant-based cosmetic sprays (sunscreen, dry shampoo, hair spray) emitted far more submicron particles than pump-based sprays: the two pump perfumes tested stayed below 100 particles per cubic centimeter across all size fractions, while propellant sprays ranged up to hundreds of thousands of particles per cubic centimeter.
Moderate evidence.
Caveats
12 products from unnamed brands, single lab; propellant vs. pump delivery is confounded with product type (perfumes vs. sunscreens/hair sprays), so the difference cannot be attributed to propellant use alone.
Source: Dai et al. 2026, ACS Environmental Au Link to this fact
Indoor air / Other evidence
A lemon-scented general-purpose cleaner, a wood floor cleaner, and a perfume sprayed into a chamber with 95-219 ppb ozone added about 16, 70, and 22 micrograms per cubic meter of fine particles, much less than the air fresheners.
Moderate evidence: Single chamber runs; the floor cleaner run used the highest ozone (219 ppb) so it is not comparable with the others; particle mass modeled from counts.
Source: Sarwar 2004, Journal of the Air & Waste Management Association Link to this fact
Indoor air / Other evidence
In the fragrance industry's 2015 aggregate exposure model, perfume, body spray, and deodorant spray were counted only as skin exposure; the paper reports no figure for how much is breathed in when a spray is used on the body.
Moderate evidence: Industry-funded paper by RIFM, Unilever, P&G, Givaudan and Firmenich staff; it shows the model did not estimate inhalation, not that inhalation is large or small.
Source: Safford et al. 2015, Regulatory Toxicology and Pharmacology Industry-funded Link to this fact
Indoor air / Other evidence
In a lab chamber with a very high ozone level (about 6.5 ppm), all six ordinary perfumes, deodorants and cleaning liquids tested formed new particles; about 0.2% to 17% of the product's evaporated mass became aerosol, with an average near 4%.
Moderate evidence.
Caveats
One lab, six products, a closed 0.68 m3 chamber at roughly 100 times typical indoor ozone, very dry air, no vapor wall-loss correction; a yield, not an indoor concentration. NSF and Sloan funded; no industry funding.
The industry / Journalism
A perfumer writing in a chemistry journal said a natural ingredient such as rose oil is sometimes added in a "negligible quantity only to be able to say that you have rose oil in your formula", which "will please the marketing people" but does nothing for the scent.
Moderate evidence: Opinion; she advises against the practice and gives no frequency.
Source: Ellena 2008, Chemistry & Biodiversity Industry-funded Link to this fact
The industry / Self-reported survey
More than a third of Germans (37.8%) think people who wear perfume are more hygiene-conscious; fragrance can mask a smell but does not clean.
Moderate evidence: Attitude item; the 'does not clean' half is the author's argument, not a measurement.
Source: Klaschka 2020, Environmental Sciences Europe Link to this fact
The industry / Measured in people or real products
Perfume that washes off fabric during rinsing does not just disappear into the drain: as surfactant concentration drops below the critical micelle concentration (measured at about 73.4 ppm in this study), micelles trapped in the wet fabric break open and redeposit their more hydrophobic perfume ingredients back onto the fabric, more strongly on cotton than on polyester because cotton retains far more water after spinning (about 0.7 kg water per kg dry cotton vs about 0.1 kg/kg for polyester).
Moderate evidence.
Caveats
Coi/industry-funded (Procter & Gamble); single small-scale bench wash simulator, one model detergent formulation, and one synthetic perfume accord; mechanism inferred from surfactant titration and headspace GC-MS, not directly visualized.
Source: Marcotullio 2025, Journal of Surfactants and Detergents Industry-funded Link to this fact
The industry / Self-reported survey
The cosmetics and fragrance industry generated its own dataset for how much perfume, hairspray, foundation, shampoo, body wash, and antiperspirant people actually use, written by staff of the cosmetics trade association (CTFA), the fragrance industry's safety institute (RIFM), and personal-care manufacturers including P&G, Unilever, Avon, Johnson & Johnson, Mary Kay, L'Oreal, Dial, and Takasago.
Moderate evidence.
Caveats
No funding statement is printed in the paper, but every author's affiliation is a cosmetics/fragrance trade body or personal-care manufacturer; absence of a disclosure is not evidence of independence.
Source: Loretz 2006, Food and Chemical Toxicology Industry-funded Link to this fact
The industry / Other evidence
As of 2025, the cosmetics industry's own safety scientists say the 'airborne fraction' values used to calculate inhalation exposure to hairspray, deodorant, and perfume sprays are a heuristic convenience carried over from a 2009 model, not physically grounded measurements, and a dedicated industry project (ICCS) to generate real product-specific values is still ongoing.
Moderate evidence: This is the industry's own admission of a data gap in its own exposure model, not an outside critique.
Source: Steiling et al. 2025, Toxicology Letters Industry-funded Link to this fact
The industry / Other evidence
A fragrance fixative left on skin for hours in a lotion or perfume penetrates far more than the same chemical in a soap that is quickly rinsed off: an FDA lab's modeled estimate for musk xylol found roughly 50-60 times more absorbed mass from a 12-hour lotion application than from a 4-minute soap wash, at realistic in-use concentrations and body-surface areas.
Moderate evidence: Modeled, not directly measured for this scenario; the Kp was derived from more-permeable hairless guinea pig skin, which the authors themselves say overestimates human absorption.
Source: Hood 1996, Food and Chemical Toxicology Link to this fact
The industry / Measured in people or real products
Eau de Cologne is applied in far larger amounts per use than eau de toilette/perfume by both French men and women — roughly 1.8-4.3 g (mean) versus about a quarter gram, a 7- to 17-fold difference — reflecting the lower fragrance concentration and more liberal application of cologne-type products.
Moderate evidence: Small Eau de Cologne subgroups (n=11-17).
Source: Ficheux et al. 2016 (amount data), Food and Chemical Toxicology Link to this fact
Laws and loopholes / Lab study (cells or chemistry)
A finished perfume is usually not toxicity-tested as a whole; its safety is assessed on paper from its secret ingredient list. When researchers tested 42 whole perfumes directly, they found hazards that ingredient-by-ingredient assessment is not designed to catch.
Moderate evidence: EU framework described by the authors; the hazards are in vitro and unidentified.
Source: Morlock & Heil 2025, Journal of Chromatography A Link to this fact
Laws and loopholes / Measured in people or real products
Even though EU law requires 26 specific fragrance allergens to be named individually above 0.01% concentration, 60% of the 1,447 scented detergents in this German household study listed only the generic term 'perfume', 'fragrance', or 'aroma' rather than naming any specific allergen, and only 46% named any of the 26 at all.
Moderate evidence.
Caveats
Generic wording can be legal (allergen absent, below threshold, or arriving undeclared via a natural extract, which the rule exempts); this paper did not test which explanation applies in which product.
Source: Wieck 2018, Regulatory Toxicology and Pharmacology Link to this fact
Laws and loopholes / Government agency
The European Commission's own guidance on cosmetic 'free from' claims (agreed with industry in 2017) says a 'free from perfume' claim should not be used if the product contains any ingredient that exerts a perfuming function, regardless of that ingredient's other functions — wording that would exclude a masking fragrance, not permit one.
Moderate evidence.
Caveats
Non-binding guidance, not the regulation itself, and it never uses the words 'fragrance-free', 'unscented' or 'masking agent'; this is our reading of its 'free from perfume' wording, not a direct statement about masking.
Source: EC Technical Document on Cosmetic Claims 2017 Industry-funded Link to this fact
Laws and loopholes / Measured in people or real products
Deodorants marketed with words like 'sensitive', 'soft' or 'skin soothing' were not allergen-free: 95% still contained perfume and 15% contained a strong allergen above the labeling threshold.
Moderate evidence: N=102 of 308 products across the 2010-2011 samples; single-country, label-based.
Source: Klaschka 2012, International Journal of Hygiene and Environmental Health Link to this fact
Laws and loopholes / Review of other studies
Fewer than half (46.0%) of 63 reviewed fragrance-free policies included any supply-chain or procurement control over the cleaning, laundry, or air-freshening products the institution itself buys, even though named triggers in the companion focus-group study rank cleaning and laundry products alongside or above perfume.
Moderate evidence: Document analysis; does not establish that procurement control would reduce measured exposure, only that most policies do not attempt it.
Laws and loopholes / Government agency
In a 1993 letter of findings, the US Department of Justice determined that a public entity is not required to prohibit employees from wearing perfume or other scented products, because that would not be a "reasonable" modification to personnel policy under ADA title II.
Moderate evidence.
Caveats
A technical-assistance letter states DOJ's own enforcement position; it is not a regulation or court ruling and does not bind courts. Addresses title II public access only, not title I employment accommodation.
Source: DOJ Civil Rights Division 1993 (TAL 383) Link to this fact
Laws and loopholes / Other evidence
The Canadian Human Rights Commission's 2019 information sheet says a reaction to much lower levels of chemicals or perfumes than the average person tolerates "is a medical condition. It is a recognized disability."
Moderate evidence: Agency position stated without citation or test; a two-page information sheet, not a ruling. Says 'allergies or environmental sensitivity', never 'multiple chemical sensitivity'.
Source: [[src-2019-chrc-environmental-sensitivity-scent-free-policies|CHRC 2019]] Link to this fact
Skin allergy / Measured in people or real products
Standard allergy screening misses a large share of fragrance allergy: in one UK clinic 42% of patients allergic to at least one of the 26 EU-labeled fragrance chemicals tested negative on the standard fragrance markers, and about 4 in 10 people who reacted to their own perfume or deodorant were negative on the screen.
Moderate evidence.
Caveats
Comparator-dependent: Sukakul 2022 found ~10% missed when comparing fragrance mixes with their own ingredients (abstract-sourced). The Mann 2014 primary, now read in full (not just its abstract), confirms 203 patients reacted to any of the 26 EU fragrances and only 117 (57.6%) also reacted to a baseline marker = 42.4% missed; Mann's own Discussion states this as "40.6%" in one sentence, a small internal inconsistency in the primary (Results math gives 42.4%). More importantly, Mann's own paper reports a similarly-designed Danish study (Heisterberg 2011, n=1,508, also routine testing of all patients with the same 26 fragrances) that found only 15.6% missed — a ~2.5-fold discrepancy the authors attribute only partly to higher test concentrations and a different patient population, not fully resolved. The own-product figure (41%/45%) is from a different study (Uter 2007), not Mann.
Skin allergy / Measured in people or real products
Concentrations of hydroxycitronellal found in some 'natural' perfumes (up to 6.04%) exceeded the concentration shown to sensitize 36% of healthy volunteers in repeated-insult patch testing (5%), and were also well above the fragrance industry's own 1996 recommended maximum (equivalent to about 1% in the finished product).
Moderate evidence.
Caveats
Single-study 1996 patch-test-sensitization citations (Ford & Api 1988; Suskind 1992) for the 5%/36% figure, not independently verified in this evidence base; product concentration is not the same as measured consumer exposure dose.
Skin allergy / Other evidence
Fine fragrances (perfume, cologne) carry more contact-allergy risk per use than the same allergen amount spread over a larger, more dilute area, because sensitization risk depends on allergen dose per unit skin area, not total allergen delivered.
Moderate evidence: General dose-response principle from cited elicitation studies, not this review's own new experiment.
Source: Johansen 2003, Am J Clin Dermatol 4(11):789-798, American Journal of Clinical Dermatology Link to this fact
Skin allergy / Other evidence
The standard fragrance patch-test screen (fragrance mix I, fragrance mix II, balsam of Peru) misses a large share of true fragrance allergy: this review's own cited figures range from about 40% to 70% missed depending on the comparison, and "approximately half" of relevant reactions to perfumes, deodorants, and shaving lotions go undetected by baseline testing.
Moderate evidence.
Caveats
Different underlying comparators (26-fragrance panel vs hydroperoxides vs own products) give different miss rates; a specific percentage should always name what it was compared against.
Source: de Groot 2020, Dermatitis 31(1):13-35, Dermatitis® Link to this fact
Skin allergy / Other evidence
In a 4-year German patch-test study of 1,468 patients tested with their own deodorants and perfumes, 129 had positive reactions to a specific product, and 58 of them (45%) were missed by the standard fragrance-mix, balsam-of-Peru, and lyral patch tests.
Moderate evidence.
Caveats
Numbers relayed secondhand via this review, citing Uter et al.; the primary IVDK dataset is not yet in our evidence base, and the specific allergens responsible for the 58 missed reactions are not given.
Source: Martini 2020, Annales de Dermatologie et de Vénéréologie Link to this fact
Skin allergy / Other evidence
Among 442 Danish adults aged 28-30, only 0.7% tested positive to fragrance mix I, although 33.0% (293/889) said perfumed products had given them eczema.
Moderate evidence.
Caveats
Self-report is lifetime recall of any eczema from perfumed products; the patch panel was the narrow TRUE Test (no FM II, no own products, no day-7 reading), so the gap partly reflects test sensitivity and irritant reactions.
Source: Mortz 2013, British Journal of Dermatology Link to this fact
Skin allergy / Other evidence
The OEKO-TEX STANDARD 100 document says test samples with "a non-product typical odor (for example fragrance / perfume, mold)" are excluded from testing and cannot get the label.
Moderate evidence: A sensory screen on the submitted sample, not a chemical limit; no fragrance ingredient, allergen or ppm cap is named. Industry-run voluntary scheme.
Source: OEKO-TEX Standard 100 (2026) Industry-funded Link to this fact
Information, not medical advice. See also: myths we won’t tell you.