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Addressing the Needs of People with Chemical & Electrical

Sensitivities and Fragrance-Free Policiesin Emergency Preparedness

New Jersey Group for Access and Integration Needs in Emergencies and Disasters (GAINED)

January 25, 2012

Mary Lamielle, Executive DirectorNational Center for Environmental Health Strategies, Inc.

1100 Rural AvenueVoorhees, New Jersey 08043

(856)429-5358; cell (856)816-8820marylamielle@ncehs.org

www.ncehs.org

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Overview Unique health problems faced by people with chemical and

electrical sensitivities or intolerances Emergency preparedness and accommodations for people

with CS/ES Equipment, devices, and supplies Evacuation and shelter

Assisting people with CS/ES in an emergency situation

Eliminating or reducing access barriers for people with CS/ES

Improving services for people with CS/ES

Fragrance-free policies as a first step toward access for people with allergies, asthma, chemical sensitivities, migraines, autism, and others impacted by indoor pollution

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People with CS react to low level everyday chemical exposures

Reactions are triggered by various substances and products such as:

pesticides, perfumes, air fresheners, deodorizers, disinfectants, tobacco smoke, auto and diesel exhaust, remodeling activities, and cleaning and personal care products;

many individuals also react to foods, medications, and natural substances

Individual tolerances may vary

16% of the population “unusually sensitive” to chemicals

Up to 6% of the population chronically ill and disabled with CS

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People with ES react to electromagnetic fields (EMFs) from electrical devices and frequencies

Reactions are triggered by: electrical appliances and devices, microwaves, transformers, high tension wires, cell phones, cell towers, Wi-Fi, fluorescent lights, Smart Meters, etc.

Individual tolerances may vary

3% of Californians report ES

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Importance of Healthy Indoor Air Quality

90% of Americans spend 90% of the day indoors (home, school, office, vehicle)

Increased indoor air pollution sourcesDecreased fresh air intakeNew or reformulated substances and products

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Synthetic organic chemical productionUnited States, 1945 - 1985

Source: U.S. Intern. Trade Commission

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U.S. pesticide production,All types, 1927-1988

Source: EPA Market Estimates, 1986, 1988; Pimentel & Andow, 1984; Metcalf, 1980.

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ResourcesChemical Sensitivity: A Report to the New Jersey State

Department of Health, December 1989

Chemical Exposures: Low Levels and High Stakes, Nicholas A. Ashford and Claudia S. Miller http://www.chemicalexposures.org

QUICK ENVIRONMENTAL EXPOSURE AND SENSITIVITY INVENTORY (QEEESI) http://drclaudiamiller.com/qeesitest/

The Indoor Environmental Quality Project Report, National Institute of Building Sciences, 2006.http://www.access-board.gov/research/ieq

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In the event of a chemical or environmental incident, people disabled by chemical sensitivities will be sicker faster from much lower levels of exposure, and more debilitated than the average person.

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Emergency Preparedness for People with Chemical and Electrical

Sensitivities Not all emergencies or disasters require evacuation.

The nature of the emergency or disaster and the nature of the disability may define the course of action.

For the CS/ES person, the “safest” place may be his or her own home.

The CS/ES person should also have an emergency or disaster plan in the event of an evacuation. This should include: Emergency equipment and supplies; Location of the “safest” evacuation site; and Location of an CS/ES-accessible shelter.

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Emergency Equipment and Supplies for those Disabled with CS

Mask (cotton, charcoal, or surgical) and/or respirator

Oxygen mask (ceramic, stainless steel, or well-aired plastic) and tubing (tygon, stainless steel, or well-aired plastic)

Tolerated water in [glass] container; foods that require no cooking

Tolerated soap, baking soda, and detergent

Aluminum foil to seal items not well-tolerated or to use as a barrier

Towel, sheet, blanket, sleeping bag, or similar equipment that is tolerated by the individual

Portable air and/or water filter as necessary

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First Aid Kit

Well-aired tissues, paper towels, and/or washcloth

Cotton bandages, gauze, and paper tape

Hydrogen peroxide, zephiran chloride, or tolerated disinfectant

Tolerated over-the-counter and prescription medications, supplements, and homeopathic remedies as necessary

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If the CS Person Can or Must Be Evacuated

The “safest” place for the CS person may be outdoors: the beach; upwind from fires, refineries and traffic;

or a remote area Some shelters may be inaccessible for those with CS

Sealed buildings with inadequate ventilation New or recently remodeled buildings Trailers or tents Buildings with significant pollutants such as a fire

station Shelters with chemical toilets Shelters with fumes or exhaust from generators,

propane, or gas stoves and heaters, or other fuel sources

Shelters with indoor pollution from tobacco smoke, fragrances and fragranced products, pesticides, new furnishings, toxic cleaning agents, etc.

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Recommend that shelters have a “cleaner air room,” an accessible

room for people with chemical and electrical sensitivities, free

of chemical and electrical pollutants, with a handicap

accessible, non-chemical toilet

For more information, check out:“The Indoor Air Quality Project Report,” National Institute of Building Sciences, 2006.http://www.access-board.gov/research/ieq/rooms

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Cleaner Air Room & Paths of Travel

No smoking Fragrance-Free Pesticide-Free (Indoors and Outdoors) Least Toxic/Risk Cleaning Products No Recent Construction or Remodeling Including

Carpet Installation Cell phones turned off Ability to turn off or unplug computers and other

electrical equipment by occupant or staff Ability to turn off fluorescent lighting by occupant

or staff Ability to adjust temperature and air flow by

occupant or staff, or the availability of operable window(s)

http://www.access-board.gov/research/ieq/rooms/si_conditions.cfm?p=1

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How to Best Assist People with CS/ES in an Emergency Situation

or Evacuation Familiarize yourself with common exposures that

trigger reactions.

Listen to and respect what the CS/ES person says about what exposures are or will make them sick and help minimize or avoid those exposures.

Trust the CS/ES person to know how to meet his or her needs.

Do not use tobacco, scented or potent personal care products, pesticides, or similar items.

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How to Best Assist…cont.

Provide the CS person with assistance from non-smoking personnel and staff who are free of perfume, cologne, aftershave, and scented personal care products.

Ask the CS/ES person if he or she needs to be moved to a less-toxic area or outdoors.

Do not use latex gloves, disinfectants, or similar products without asking.

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How to Best Assist…cont.

Be aware that some CS individuals may temporarily lose the ability to think clearly or speak during a reaction. They should have immediate access to cleaner air, masks, or oxygen.

If the CS person is wearing a mask or respirator, speak directly to the individual not to a third party.

If the ES person is unconscious or unable to communicate, move the individual to an area with reduced electromagnetic fields. [This can be determined with a handheld Gauss meter.]

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Eliminate Chemical and Electrical Barriers in Emergency Preparedness

Prohibit smoking in and within at least 100 feet of a shelter.

Prohibit idling of vehicles within 100 feet of a shelter.

Require emergency personnel, staff, and shelter to be fragrance-free.

Stock unscented/least toxic cleaning and personal care products.

Require least toxic/low impact pest control practices indoors, on the grounds, and in the ambient air in the vicinity of a shelter.

http://www.nj.gov/dep/enforcement/pcp/bpc/ipm/low_impact.pdf

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Eliminate Chemical and Electrical Barriers… cont.

Shut off fluorescent lights, if possible.

Turn off cell phones and other wireless technology.

Ask if the person needs to be moved or served away from electrical equipment and electromagnetic fields such as computers, microwaves, electrical appliances, transformers, electrical and high tension wires, cell phones, PDA’s, Wi-Fi, Smart Meters, etc.

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Improving Services for People with Chemical and Electrical

Sensitivities

Educate yourself and your agency or organization about the needs of people with CS/ES.

Identify and work with the CS/ES in your community to determine how to best meet their needs.

Provide notification to people with CS of any toxic event so that they can take precautions or evacuate as necessary.

Establish a registry as a means to provide advance notification.

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Improving Services…cont. Keep the needs of those with CS/ES in mind as

emergency preparedness plans are developed.

Work to ensure emergency services and shelters are accessible for people with CS/ES.

Be prepared to respond to any emergency affecting the CS even if the balance of the population is not significantly affected.

Provide for the safe evacuation, if necessary, for those who cannot use public transportation.

Provide outreach to CS/ES people who are unable to get to or be accommodated in a shelter.

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Improving Services…cont. Use least toxic/allergenic cleaning and

maintenance products and Integrated Pest Management (IPM) practices with least toxic/low impact products if necessary.

Adopt and promote best practices policies that restrict the use of fragrances and the purchase and use of fragranced and scented products in emergency services.

FEMA Blanket purchase agreements (BPAs) for medical supplies require products be latex and fragrance-free (Source: Getting Real I, September 2010)

See attached:FEMA Proposal: Promote Best Practices that Restrict the Use of Fragrances and the Purchase and/or Use of Fragranced and Scented Products, National Center for Environmental Health Strategies, January 11, 2011

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Fragrances & Fragranced Products

Scents and scented products are significant contributors to poor air quality; they generate substantial levels of indoor pollutants:

VOCs (volatile organic compounds) Particles Secondary pollutants in the presence of ozone

Scents and scented products make indoor environments as well as emergency services and disaster relief inaccessible for people disabled by chemical sensitivities, asthma, migraines…

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Prevalence of Fragrance Sensitivityin the American Population

30% of the American population reported irritation from scented products on others

19% reported adverse health effects from air fresheners

10.9% reported irritation by scented laundry products vented outside

Higher percentage of adverse effects reportedamong those with chemical sensitivities and asthma

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Scents & Scented Products: The Basics

2600 plus natural and synthetic chemicals A single fragrance can have several

hundred chemicals Not regulated Exempted from labeling requirements;

disclosure of ingredients not required; formulations confidential; Trade Secret FDA: personal care products except soaps

CPSC: laundry, cleaning, air fresheners

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Research on Commonly Used Scented Products

25 commonly used scented products emit an average 17 chemicals each ¼ of emissions toxic or hazardous under at

least one federal law More than 1/3 emissions classified as potential

carcinogens Only one of all the chemicals was listed on

label or Material Safety Data Sheet (MSDS) Products marketed as “green” or “organic”

or “natural” emitted just as many toxic chemicals

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Scent-free Policies & Practices

Enhance public health Improve disability access Protective and inclusive Common sense strategy Increasingly commonplace in the

public and private sector

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Federal Fragrance-Free Policies

CDC Indoor Environmental Quality Policy, June 2009

Fragrance-Free Policy “Scented or fragranced products are prohibited

at all times in all interior space owned, rented, or leased by CDC.” (p. 9)

“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.” (p. 9)

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CDC Non-Permissible Products

Incense, candles, or reed diffusers Fragrance-emitting devices of any kind Wall-mounted devices, similar to

fragrance-emitting devices, that operate automatically or by pushing a button to dispense deodorizers or disinfectants

Potpourri Plug-in or spray air fresheners Urinal or toilet blocks Other fragranced deodorizer/re-odorizer

products

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NCEHS Fragrance-Free Proposals:

White House Disability Policy Office

GSA

FEMAFEMA proposal additionally includes a fragrance-free policy for personal care products and cleaning and maintenance supplies for emergency management and disaster relief

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U.S. Access Board1999 Holds training for Board and staff on fragrances

2000 Adopts Fragrance-Free Policy for Board Meetings http://www.access-board.gov/about/meetings.htm

2000 Creates committee to examine CS/ES

2003;2007 Contracts with National Institute of Building Sciences to study indoor environmental quality (IEQ) and CS/ES

2006 Issues “Indoor Environmental Quality Project Report” http://www.access-board.gov/research/ieq

2010 Opens permanent meeting space designated fragrance-

free: all participants refrain from perfume and cologne; unscented personal care products; scent-free cleaning and maintenance (July 2010)

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Federal Fragrance-Free Policies

U. S. Census Bureau, March 2009 Issued fragrance-free policy and implementing language to protect employees and accommodate disabled workers

Department of Health and Human Services, October 10, 2010Restricts application of fragranced products at work; exempts fitness centers and day-care centers List of non-permissible fragranced cleaning and maintenance products identical to CDC Fragrance-Free Policy

FEMA Blanket purchase agreements (BPAs) for medical supplies require products to be latex and fragrance-free (Source: Getting Real I, September 2010)

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Federal Fragrance-Free Policies

EEOC Notice of Proposed Rulemaking ADA Amendments Act of 2008,

September 23, 2009

(A) Example 1: An individual withasthma who is substantially limited inrespiratory functions and breathingcompared to most people, as indicatedby the effects experienced whenexposed to substances such as cleaningproducts, perfumes, and cigarettesmoke, is an individual with a disability.(Federal Register / Vol. 74, No. 183, p. 48442)

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Model Fragrance-Free Policy

This is a Fragrance-Free Workplace

We Share the Air Please refrain from wearing (using) perfume,

cologne, aftershave, or other fragranced, scented, or odorous personal care or laundry products including shampoo, hairspray, hair care product, hand lotion, laundry detergent and dryer sheets for the health and comfort of employees and visitors.

Thank you for your cooperation.

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Mary Lamielle, Executive DirectorNational Center for Environmental Health

Strategies, Inc.1100 Rural Avenue

Voorhees, New Jersey 08043(856)429-5358; cell (856)816-8820

marylamielle@ncehs.orgwww.ncehs.org