Migraine headaches and fragranced consumer products: an international population- based study

DOI: https://doi.org/10.1007/s11869- 020- 00807- 9

Abstract-Summary Fragranced consumer products, such as air fresheners and cleaning supplies, have been associated with health problems including migraine headaches.

This study investigates the prevalence of migraines associated with exposure to

fragranced products.

Findings from this study indicate that migraine headaches can be associated with fragranced consumer products, and that reducing exposure could reduce adverse health and societal effects.

Introduction Prior international studies (US, AU, UK, SE) found that, on average, 32.2% of the general population (34.7%, 33.0%, 27.8%, 33.1%, respectively) report adverse health effects when exposed to fragranced products (Steinemann [634–637]).

In the aforementioned studies (US, AU, UK, SE), a foundation for the present study, 12.6% of the general population, 22.6% of asthmatics, 42.9% of autistic adults, and 36.9% of chemically sensitive individuals, on average, report migraine headaches from fragranced products (Steinemann [638]; Steinemann and Goodman [639]; Steinemann [640]; Steinemann [641]).

2.4 Lifestyle

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While other studies have examined reports of migraines from fragranced prod- ucts, results are limited in comparability due to lack of specificity; for instance, migraines were not distinguished from headaches or other health problems (e.g., Caress and Steinemann [642]; Farrow and others [643]); perfumes were not distin- guished from odors generally (e.g., Kelman [644]); or some products were not dis- tinguished as containing fragrance (e.g., Andress-Rothrock and others [645]; Silva-Néto and others [646]).

This study extends and deepens prior work by providing a more extensive and focused analysis of associations between exposures and migraines, and the health and societal effects on individuals who report migraines from fragranced products.

Methods Nationally representative cross-sectional population-based surveys (confidence limit = 95%, margin of error = 3%) were conducted of adults ages 18–65 in the US, AU, UK, and SE.

Using the same questionnaire in each country’s native language, surveys were

implemented in June 2016 (US, AU, UK) and June 2017 (SE).

Survey response rates were 95%, 93%, 97%, and 92% (respectively).

Results and Discussion Demographic proportions of individuals reporting migraines from fragranced prod- ucts are 33.1% male and 66.9% female, compared with the general population of 48.9% male and 51.1% female.

The percentage of individuals reporting migraines from fragranced products has

a female bias (+ 15.8%).

As study limitations, the survey covered adults ages 18–65, which excluded other age groups; the survey obtained data on reports of migraines from exposures to fragranced products, but without data on prior diagnoses of migraines; and the survey relied on self-reported data, which is nonetheless an accepted approach for survey research as well as for assessment of migraine.

Given the results of this survey, and the relevant population affected in the four countries (United States Census Bureau (USCB) [647], Australian Bureau of Statistics (ABS) [648], Office for National Statistics, United Kingdom (ONS) [649], Statistics Sweden, Statistiska centralbyråns (SCB) [650]), everyday fragranced products are estimated to trigger migraines in over 36.8 million people, with over 14 million people losing workdays or a job in the past year due to fragranced product exposure in the workplace (See ESM-Survey Data).

Conclusion This study provides important evidence that exposure to fragranced consumer prod- ucts can be associated with migraine headaches and adverse societal effects.

Given the prevalence and severity of effects, reducing exposure would appear to

be an important way to reduce the individual and societal burden of migraine.

Acknowledgement A machine generated summary based on the work of Steinemann, Anne; Nematollahi, Neda2020 in Air Quality, Atmosphere & Health

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2 Mechanisms

Clinical characteristics of sleep disorders in patients with vestibular migraine