 In a recent review of the damaging effects of household cleaning products on the lungs, researchers noted that the adverse respiratory effects of cleaning products were first observed in populations experiencing high levels of exposure at the workplace, such as cleaners and health care workers, with a primary focus on asthma. But the occupational use of disinfectants has also been linked to a higher risk of developing chronic obstructive pulmonary diseases like emphysema. And now we know it's not just workplace exposures, but also common household exposures that are risk factors for respiratory disorders and childhood, as well potentially an important risk factor for adult asthma, with common household cleaning spray use accounting for as many as 1 in 7 adult asthma cases. The thought is that the inhalation of chemical irritants may cause injury of the airways that leads to oxidative stress and inflammation. OK, so what can we do about it? Well it may indeed be limited to sprays. Cleaning products not applied in spray form were not associated with asthma, and it's possible that environmentally friendly cleaning products may represent a safer alternative, though they may still present some risk. Ideally, safer cleaning products should be available. Unfortunately, the research suggesting harm has seldom been heated by manufacturers, vendors, and commercial cleaning companies. I wonder how much of that is because most of the workers exposed to cleaning products, both occupationally and presumably domestically, are women. One of the problems may be the fragrance chemicals. One in three Americans surveyed reported health problems, such as migraine headaches and respiratory difficulties, when exposed to fragrance products. And in about half it was so bad they actually lost work over it. Results from this study reveal that more than one-third of Americans suffer adverse health effects, such as respiratory difficulties and migraine headaches, from exposure to fragrance products. Of all individuals, half reported that the effects can be disabling, yet more than 99% of Americans are exposed to fragrance products at least once a week. The effect on asthmatics may be even worse, affecting closer to two-thirds. One compound that may be of particular concern is called 1,4-dichlorobenzene, also known as para-dichlorobenzene, which is found in many air fresheners, toilet bowl deodorants, and moth balls. It breaks down in the body into a compound called 2,5-dichlorofenol, which you pee out, giving researchers a reliable measure of your dichlorobenzene exposure. Not only may it make respiratory problems worse for those already suffering from compromised airways, but exposure to dichlorobenzene at blood levels found in the general U.S. population may result in reduced lung function in people who start out with normal breathing. What's worse, higher exposure was associated with greater prevalence of cardiovascular disease and cancer. Well, that's not good, so better read the labels, right? Surprisingly, there is no law in the U.S. that requires the disclosure of all ingredients in fragrance consumer products. In fact, for air fresheners, laundry supplies, and cleaning products, they don't even need to say it has fragrance at all. You don't know until you smell it. So if you can't tell which products have which chemicals, you can follow the lead of the CDC, the Centers for Disease Control and Prevention. Not only is cigarette smoking indoors prohibited at all times, scented or fragrance products are also prohibited at all times in all interior space owned, rented, or leased by the CDC. I wish rideshare services like Uber and Lyft would have a similar policy or at least a fragrance-free option. About one in five of more than a thousand Americans surveyed said they would turn right around and leave a business if they smelled air fresheners or some fragrance product. So it's in business's best interest too, since more than 50% of the population would prefer that workplaces, healthcare facilities, and their healthcare professionals hotels and airplanes were fragrance-free.