ANSES calls for vigilance concerning essential-oil based sprays and diffusers
Described as having the ability to “cleanse” or “purify” the air, essential-oil based sprays and diffusers are increasingly present in our homes. Continuing the studies undertaken in 2017 on indoor air purification techniques, ANSES is publishing a toxicovigilance study on exposure to these essential-oil based products, along with a review of scientific literature on the health effects of the substances emitted. An analysis of the cases of poisoning reported to the French Poison Control and Monitoring Centres highlighted a range of adverse effects in normal conditions of use, mainly irritation of the eyes, throat and nose, and respiratory effects. These products also emit volatile organic compounds, which may be a source of indoor air pollution. ANSES is alerting the public authorities to the need to better inform consumers of the precautions to be taken when using these products, particularly in the case of people suffering from asthma or other chronic respiratory diseases, owing to the irritating substances potentially emitted by these products.
Following the expert appraisal conducted by ANSES on emerging indoor air purification techniques, the French Directorate General for Health and Directorate General for Risk Prevention asked the Agency to analyse the cases of poisoning by essential-oil based sprays and diffusers reported to Poison Control Centres and to review scientific literature on the health impact of these products and their potentially harmful effects on health.
A few cases of irritation reported to the French Poison Control and Monitoring Centres
Some of the cases observed by the Poison Control Centres following the use of sprays or diffusers in the home revealed symptoms of irritation to the eyes and upper airways (mouth, nose, throat, larynx and trachea), as well as coughing and breathing difficulties.
These irritations may be due to essential oils with a high phenol or ketone content, unsuitable for inhalation and irritating to the respiratory tract, or to the diffusion of these products via a spray or diffuser. Most of these symptoms are minor and resolve rapidly after exposure is stopped.
Emissions of reactive, irritant volatile organic compounds
According to the data available, essential-oil based sprays and diffusers emit a number of airborne volatile organic compounds (VOCs). Some of these VOCs may have irritant or sensitising properties, even when they are of natural origin.
Moreover, some of the VOCs emitted are likely to oxidise, primarily by reacting with the ozone naturally present in the air. These sprays and diffusers can therefore be an additional source of indoor air pollution. Their VOC emissions add to the airborne VOCs already produced by other sources, such as furnishings, building materials, cleaning products or cosmetics.
Nevertheless, the studies available are insufficient to produce an exhaustive list of the full range of substances emitted by these products. More studies are therefore required in order to better characterise the long-term emissions of organic compounds, and the secondary formation of other compounds as a result of atmospheric oxidation.
Keep out of the reach of children, provide information on the precautions to be taken in use, limit sources of indoor pollution: ANSES’s recommendations
Keep products out of the reach of children
In addition to symptoms of irritation and respiratory effects in normal conditions of use, the toxicovigilance study showed many cases of poisoning to be linked to accidental exposure, often concerning young children, who are more likely to handle or put into their mouths products not intended for them. ANSES recommends keeping sprays, diffusers and bottles of essential-oil based products out of the reach of young children, in the same way as for detergents or drugs.
Better inform consumers of the precautions to be taken in order to limit risks
ANSES is alerting the public authorities to the need to provide more information on the precautions to be taken when using essential-oil based sprays or diffusers, particularly in the case of people suffering from asthma or other chronic respiratory diseases, owing to the irritating substances potentially emitted by these products.
Improve reporting of cases by health professionals
In order to better identify the potential respiratory effects linked to these products, the Agency recommends improving the collection and follow-up of cases involving people who experience respiratory symptoms after using sprays or diffusers. For this reason, it is important for doctors to report these cases to the Poison Control Centres or on the adverse health event reporting portal.
Limit sources of indoor pollution and ventilate confined spaces
Generally speaking, to prevent the risks associated with poor indoor air quality, it is important firstly to limit sources of indoor pollution and secondly, to ventilate and air confined spaces. This recommendation also applies to the use of essential-oil based sprays and diffusers.
Acquire more information to better characterise potentially harmful health effects
Few data are available in scientific literature concerning the health effects of essential-oil based sprays and diffusers. While some results are provided in the publications analysed, they are not sufficient for drawing unequivocal conclusions. This uncertainty calls for vigilance with respect to respiratory and dermal effects in particular.
ANSES is therefore stressing the need to undertake new independent studies on essential oils used alone or in combination, in order to better characterise the potentially harmful health effects in the short and long term.
#COVID-19 and essential oils: essential oils are not a solution against the coronavirus
In the context of the COVID-19 health crisis, ANSES and the network of French Poison Control Centres are closely monitoring calls made to the centres for reasons related to COVID-19. The purpose is to identify specific risk situations in order to issue recommendations. The Poison Control Centres have identified a number of sources of risk situations, including the use of essential oils.
Various specific risk situations have been identified: self-medication, where essential oils are taken orally in order to boost the body’s natural defences and combat the coronavirus, spraying of essential oils by a person at risk (an asthmatic) to “purify a confined space”, or inappropriate use, to disinfect a surgical mask, for example.
ANSES reiterates that essential oils are not a solution against the coronavirus. It is important to use these oils correctly (route of administration, dosage, area of application, etc.). ANSES and the Poison Control Centres advise against the use of essential oils by people suffering from respiratory conditions (particularly asthma), or by women who are pregnant or breastfeeding. Before using essential oils and if you have any questions, ask a pharmacist for advice.
Read our news update on COVID-19: beware of poisoning linked to disinfection and other risk situations