Balancing Fragrance and Patient Safety: A Clinical Framework for Structured Perfume Use in Hospitals Incorporating Infection-Control Principles

1. Introduction

Perfume has accompanied human society for millennia, not merely as a cosmetic product but as an expression of identity, professionalism, and emotional wellbeing. In modern hospital practice, fragrance use by healthcare workers is common and often arises from practical realities: prolonged duty hours, physical exertion, perspiration under personal protective equipment, and a desire to feel clean and confident while delivering demanding care. In community and social settings, fragrance can be applied more liberally and aesthetically, where wider projection and sillage may be acceptable or even desirable. The hospital environment, however, is fundamentally different. Patients are frequently physiologically vulnerable, confined to enclosed spaces, and unable to escape sensory triggers. What is pleasant to one person may become distressing or clinically destabilising to another.

A growing body of evidence shows that fragranced products can trigger adverse symptoms in a significant proportion of individuals, particularly those with asthma and other airway diseases, as well as those with chemical sensitivity and migraine. Respiratory symptoms, airway irritation, headache, fatigue, and general malaise have been documented following exposure to fragranced consumer products, including perfumes and other scented items used in public indoor spaces [1,2,3,4]. Importantly, many hospitalised patients disproportionately belong to symptom-prone groups. Oncology patients undergoing chemotherapy may have heightened odour sensitivity, severe nausea, and mucositis; post-operative patients may experience pain exacerbated by coughing; intensive care and respiratory patients often have reduced physiological reserve; and transplant recipients are frequently confined to controlled environments where any persistent odour becomes magnified in its effect.

Hospitals rightly focus on core patient safety priorities such as hand hygiene, isolation precautions, and safe ventilation, but fragrance exposure is rarely addressed with comparable clinical clarity, even though it intersects with respiratory comfort, nausea control, droplet generation from cough, and equitable access for patients and staff with fragrance sensitivity. When hospitals do address fragrance, policies often take one of two extremes. Some institutions adopt near-total bans on scented products, while others provide vague advice such as “avoid strong perfumes.” In practice, both approaches can be problematic. Absolute bans may be difficult to implement consistently, may be perceived as punitive, and may reduce adherence. Vague messaging leads to subjective interpretations, inconsistent enforcement, and ongoing exposure of vulnerable patients to strong scent. A middle-path approach—structured, quantified, and clinically reasoned—can provide a more realistic, respectful solution.

This manuscript proposes a balanced, practical framework for fragrance use in hospitals, grounded in clinical reasoning and infection control logic, while respecting personal preference and professional dignity. It distinguishes hospital fragrance practice from community/social use, provides quantified dosing guidance (including the number of sprays for different formulations), explains how to “tame” heavier perfumes through layering strategies, and details self-assessment methods that allow staff to assess safety before entering patient-facing areas. It also outlines how hospitals can implement these recommendations through education, patient leaflets, visitor communication, and environmental cues, without advocating blanket avoidance.

2. Existing Policies and the Policy Gap

A number of hospitals and occupational health organisations have recognised fragrance exposure as an indoor health and accessibility issue and have published fragrance-free or scent-restricted policies. Hospital-facing policies include, for example, Sunnybrook Health Sciences Centre’s fragrance-free policy, which applies broadly to the hospital environment and reflects concern for patients, visitors, and staff with sensitivities [5]. A United Kingdom example includes the Royal Devon University Healthcare NHS Foundation Trust’s staff policy on fragranced products, demonstrating that concerns about fragranced exposures are not limited to North America and are increasingly visible in public healthcare systems [10]. Professional and occupational bodies have also published model policies and practical guidance for workplaces, including the Massachusetts Nurses Association, the Canadian Centre for Occupational Health and Safety, and the Canadian Coalition for Green Health Care [6,7,8]. These resources commonly justify fragrance restriction on the basis of respiratory symptoms, headaches, and fairness to individuals with sensitivity, and they emphasise that indoor shared spaces function as a common exposure environment.

However, a significant policy gap is evident when these documents are reviewed through a clinical implementation lens. Many policies are written as prohibitions (“do not wear scented products”) or as broad discouragement (“please refrain from strong perfumes”). Few provide quantified dosing guidance that clinicians can interpret and staff can apply consistently. In other words, most policies do not define what constitutes “strong” fragrance using measurable parameters such as number of sprays, fragrance formulation category, application sites, or practical self-assessment tests. This omission leaves enforcement subjective and inconsistent and often leads to either informal tolerance of strong fragrances or uneven, complaint-driven enforcement.

The approach presented in this paper aims to fill that gap. It does not contradict fragrance-restricted policies; rather, it provides a structured method for hospitals that prefer a balanced pathway: permitting fragrance use in a controlled manner, with clear limits, defined high-risk areas, and measurable strategies. This framework is intentionally designed to be practical in diverse settings, including institutions where absolute bans are culturally difficult, logistically challenging, or poorly accepted.

3. Perfumery Fundamentals for Clinical Translation

To create a hospital-safe fragrance framework, it is necessary to translate basic perfumery concepts into clinical behaviours that can be understood, taught, and followed. Three domains are particularly useful: concentration categories and expected longevity, fragrance families (light versus heavy), and technical performance terms such as projection, sillage, and longevity.

3.1. Fragrance Composition and Concentration Categories (Body Spray, EDC, EDT, EDP, Parfum/Attar):

Fragrance products differ primarily by the proportion of fragrance materials in the carrier base. This is commonly described using categories such as Body Spray, Eau de Cologne (EDC), Eau de Toilette (EDT), Eau de Parfum (EDP), and Parfum/Extrait, as well as oil-based Attar. While commercial labelling may vary by brand and region, the general concept of “concentration category” is widely used in public fragrance education and safety communications. Body sprays typically contain approximately 2–5% fragrance concentration and have a longevity of 1–2 hours. They are designed to be light and refreshing. Eau de Cologne (EDC) contains around 5% fragrance concentration, with a longevity of 1–3 hours. Eau de Toilette (EDT) generally contains 5–15% fragrance concentration and lasts 3–5 hours. Eau de Parfum (EDP) contains 15–20% fragrance concentration and has a longevity of approximately 5–8 hours, sometimes longer depending on skin type and environment. Parfum, Extrait, or oil-based Attar may contain 25–40% fragrance components and are often highly persistent, with effects lasting 8–12 hours or longer[12]. In clinical practice, these categories are useful because they correlate with intensity and longevity: lighter formulations typically evaporate faster and settle sooner; higher-concentration products tend to persist and may project more strongly if applied in routine spray quantities(Table 1). Longevity alone does not determine safety. Fragrance behaviour is influenced by volatility, ventilation, body heat, application site, and molecular composition.

3.2. Fragrance Notes: Top, Heart, and Base Notes:

Fragrances also evolve over time. The initial impression (“top notes”) is dominated by more volatile molecules and can be sharp and intense immediately after application. The “heart” or “middle” notes form the main character as the top notes fade, while “base notes” contain heavier molecules that last longest. This matters in hospital settings because the immediate post-application burst is often the period most likely to cause nausea, cough, or distress in close patient proximity. A practical implication is that applying fragrance immediately before entering a high-risk ward is more likely to cause patient discomfort than applying it earlier and allowing settling.

3.3. Projection, Sillage, and Longevity:

Projection, sillage, and longevity have direct clinical meaning. Projection describes how far a fragrance radiates from the wearer. Sillage describes the scent trail left behind after the wearer moves. Longevity is how long the scent remains perceptible. In social environments, projection and sillage are often prized. In hospitals, they are undesirable. A hospital-safe fragrance ideally remains within the wearer’s personal space and does not create a lingering scent environment for others. The “arm’s-length” concept is explicitly described in workplace fragrance guidance from the University of Toronto Environmental Health & Safety, which discourages scents that are noticeable beyond close personal distance [11]. This provides a practical anchor for a hospital rule: the aim is fragrance that stays within a small personal bubble and does not announce itself in shared air.

3.4. Fragrance Families: Light Versus Heavy, and Why It Matters Clinically

In hospital practice, fragrance “weight” is often more relevant than the brand name. “Lighter” fragrance families tend to feel airy and dissipate more quickly, while “heavier” families tend to linger and project. In general terms, citrus, light florals, aquatics, and gentle green/aromatic profiles are experienced as fresher and are typically more compatible with clinical environments when used within strict dosing limits. By contrast, oriental/spicy profiles, gourmand fragrances (often vanilla/tonka/amber-heavy), dense woody scents (including oud-focused compositions), heavy musks, resins, amber, and saffron-rich accords are more likely to persist and travel.

One must be careful not to oversimplify chemistry, but as a practical clinical statement, the lighter fragrance category is typically experienced as more rapidly dissipating and less “room-filling,” whereas heavy base-rich perfumes are more likely to create prolonged background scent in enclosed wards. The health literature supports that fragranced consumer products can provoke symptoms in sensitive individuals [1,4], and indoor exposure frameworks emphasise the shared-air problem in public settings [8,11]. This means that heavier perfumes—especially in higher concentration categories—require additional controls rather than merely fewer sprays(Table 2).

4. Clinical Rationale: Why Fragrance Control Is a Patient Safety and Infection Control Issue

The most compelling rationale for structured fragrance control is patient vulnerability. Fragranced products have documented health and societal effects, including respiratory and neurological symptoms in sensitive subgroups [4]. In asthmatics, fragranced consumer products have been associated with symptomatic effects at meaningful prevalence [1]. Beyond the direct irritant effect, perception of odours and perceived harm can influence asthma responses, highlighting that both physiology and risk perception may modulate symptoms [2]. These findings matter in hospitals because patients are not a random community sample; they are enriched for respiratory vulnerability, acute illness, anxiety, and limited tolerance (Table 3).

Oncology patients receiving chemotherapy or radiotherapy frequently experience nausea, vomiting, altered smell perception, and heightened sensory sensitivity. Even a fragrance that seems mild to staff may become distressing to a nauseated patient. Similarly, post-operative patients, particularly after thoracic or upper abdominal surgery, experience pain with coughing and deep breathing. A scent-triggered cough can worsen pain and discourage deep breaths, potentially affecting respiratory recovery. In intensive care and respiratory wards, reduced physiological reserve and airway hyperreactivity mean patients may experience disproportionate distress from triggers that would be trivial in healthy individuals.

A distinct category is infectious disease respiratory isolation rooms, including patients with tuberculosis, chickenpox (varicella), measles, or similar conditions. In such settings, strong scents may trigger coughing in vulnerable or infectious patients. Coughing increases droplet dissemination and can increase the infection-control burden even when isolation precautions are in place. This is not an argument for avoiding perfume entirely across the hospital; rather, it is a rationale for stricter dose limits and behaviour modification in specific high-risk zones, where the consequences of provoking cough are higher.

Fragrance policy is also an equity issue. If strong scents are common, some patients and staff with migraine or fragrance sensitivity may experience reduced access to safe care environments. Migraine literature identifies triggers for acute attacks, and osmophobia (sensitivity to smells) is a recognised feature in migraine populations, supported by clinical studies [14,15,16]. Respiratory symptoms linked to fragrances have also been discussed in relation to dermatitis and related symptom clusters, reinforcing the broader sensitivity phenomenon [13]. When such vulnerabilities overlap with severe illness, the ethical imperative is to reduce avoidable triggers.

Finally, there is a professional diagnostic aspect. Clinicians sometimes detect clinical odours (infected wounds, metabolic derangements, gastrointestinal pathology). Pervasive perfume can mask these cues. While modern diagnostics dominate, the sensory environment still matters, particularly in bedside assessment and in resource-limited moments. A controlled fragrance culture preserves clinical neutrality of shared air.

5. Distinguishing Hospital Use From Community/Social Use

A central principle of this framework is that hospital fragrance practice is not equivalent to community or social use. In the community, individuals can move away from scents, ventilation is often more variable, and social norms may permit stronger projection for aesthetic effect. Fragrance in community settings can be applied more liberally, though still respectfully. In hospitals, patients cannot easily escape, ward air is shared, and exposure is ethically asymmetric: one person’s preference becomes another person’s involuntary exposure. Therefore, hospital recommendations should be explicitly framed as setting-specific professional behaviour, not a commentary on personal fragrance use outside the hospital.

6. Hospital-Appropriate Fragrance Dosing Framework

6.1. Hospital-Appropriate Dosing and Micro-Dosing Zones

This paper proposes two related but distinct dosing concepts: hospital-appropriate dosing and micro-dosing.

Hospital-appropriate dosing refers to controlled fragrance use in general hospital areas where patient vulnerability is comparatively lower, such as administrative corridors, outpatient zones with stable patients, and routine non-high-dependency wards. In this setting, the key aim is that fragrance remains subtle, does not exceed arm’s-length projection, and does not produce noticeable sillage.

Micro-dosing refers to much stricter control in high-risk zones where patient vulnerability is extreme or where cough and sensory triggers have higher consequence. High-risk zones include intensive care units, chemotherapy and infusion areas, transplant and bone marrow transplant units, post-operative wards, burns units, palliative care wards, and infectious disease respiratory isolation rooms. In these areas, the intention is that fragrance is barely detectable even at close conversational distance and effectively absent from shared air.

A quantified spray approach is essential because “use mild perfume” is not operationally meaningful. Using the dosing approach consistent with your hospital recommendation framework, hospital-appropriate dosing can be described as follows: Body Spray may be used up to four sprays directed only to the upper torso and preferably under clothing to diffuse softly; Eau de Cologne (EDC) may be used up to three sprays; Eau de Toilette (EDT) may be used up to two sprays; Eau de Parfum (EDP) should be limited to one spray; and Parfum/Extrait or Attar should be applied only as a micro-dot rather than sprayed. The micro-dot concept is critical: a rice-grain amount dabbed onto a covered area can provide a personal scent without projecting into shared air (Table 4).

In micro-dosing zones, the same categories require further restriction, not merely fewer sprays but different technique. In these areas, even Body Spray and EDC should be reduced to one or at most two very minimal applications, with the intent that the scent is not clearly detectable by others. EDT should generally be limited to one minimal spray only if it is clearly light and has already passed self-assessment, while EDP should be restricted to a single minimal spray only when absolutely necessary and compatible with micro-dosing. Parfum/Attar should be limited to a micro-dot only. In practice, micro-dosing means “barely there,” not simply “less than usual.”

Micro-dosing is a deliberate technique. It includes selecting lighter fragrance families, applying only to covered areas, avoiding high-radiation pulse points, and performing self-assessment before patient contact. In addition, in respiratory isolation rooms (for example, TB, chickenpox, measles), strict micro-dosing expectations are especially important because scent-triggered cough may increase droplet spread and create avoidable infection-control risk.

6.2. Practical Techniques for Micro-Dosing

Micro-dosing must be teachable. The most practical method for sprays is to reduce delivery volume by pressing the atomiser partially to produce a shorter, smaller spray. Another pragmatic approach is to spray once into the air at a distance and pass through the faint mist briefly, rather than spraying directly onto the body at close range. For oil-based attars, fingertip precision is a natural advantage: a micro-dot can be applied to a covered site with minimal risk of over-application.

Equally important is timing. Applying fragrance well before entering high-risk zones allows top-note volatility to settle and reduces the chance of triggering nausea or cough during immediate close contact. If staff apply fragrance, the recommendation should be to do so before commencing patient-facing rounds, not between bedside encounters.

6.3. Application Sites: Clinical Logic and Bedside Reality

Application sites must be decided based on patient proximity, movement, and projection pathways. The front of the neck should be discouraged in hospital settings because it is oriented directly toward the patient during examination and conversation, and projection from this location enters the patient’s breathing zone. Covered sites, by contrast, filter and soften scent diffusion. The upper torso under clothing is often the most practical compromise: it allows gentle diffusion through fabric and reduces the initial burst. The back of the neck, partially shielded by hair or collar, can also reduce direct projection.

In hospitals, application of fragrances on the dress or hospital uniform must be discouraged because fabric tends to retain fragrance molecules and may overtly enhance both projection and longevity in shared air, effectively turning a personal scent into a room scent. Uniform fabric also travels across clinical zones, creating unintended “scent transfer” into patient areas. A hospital recommendation should therefore emphasise skin application in controlled sites rather than application onto clothing (Table 5).

Wrist application warrants separate discussion and added caution. Wrist skin is warm and highly mobile, which can increase projection. More importantly, the wrist frequently comes close to the patient’s face and breathing zone during bedside procedures, blood pressure measurement, cannulation adjustments, wound dressing, and examination. For these reasons, wrist application should not be a default “recommended site” in hospitals. If used at all, it should be restricted to light fragrances only, applied using micro-dosing, and only after self-assessment confirms minimal projection. In high-risk zones, wrist application should be minimised further, because bedside proximity is greater and the consequences of triggering cough or nausea are higher.

6.4. “Taming” Heavier Perfumes: Pairing, Layering, and Controlled Aesthetics in Hospitals

Many healthcare workers enjoy heavier fragrance profiles—oud, amber, saffron, dense musks, or gourmand accords. A hospital-safe framework should not simply moralise against these preferences; it should provide strategies to reduce their impact while respecting personal choice. The key is to reduce projection and perceived heaviness without creating an additional over-scented mixture.

A practical “taming” strategy is controlled layering. If a heavier fragrance is used, it should be applied first in a micro-dose (micro-dot or minimal spray) on a covered area, allowing it to settle. Over this, a very light citrus or aquatic fragrance can be layered lightly to soften the initial impact and reduce the perception of heaviness in the opening phase. This layering is not intended to increase total fragrance load; it is intended to reshape the perceptual profile so the scent remains personal and less intrusive. The total dose must still remain within hospital-appropriate limits, and in micro-dosing zones the heavy component should be restricted to micro-dot quantities only.

A second approach is “pairing” by selecting inherently lighter versions of preferred profiles, such as a lighter woody-aromatic rather than a dense resinous oud, or a transparent amber rather than a syrupy gourmand amber. The aim is aesthetic satisfaction with minimal room impact. These strategies acknowledge that hospital fragrance recommendations can be both scientific and aesthetically informed, as long as the exposure logic remains patient-centred.

6.5. Self-Assessment Strategies

Self-assessment is essential because individual perfumes behave differently depending on skin chemistry, heat, and environmental ventilation. Two self-assessment strategies can be formalised into staff education, and both should be described in detail so they are reproducible (Table 6).

The first method is the five-second rule with a ten-second wait. The ten-second wait is crucial because the first burst after spraying is dominated by volatile top notes and carrier evaporation, which can feel much stronger than the settled fragrance profile. Waiting allows this initial burst to reduce. After waiting, the wearer should slowly move the forearm in front of the face for approximately five seconds, as if simulating the distance and duration of real bedside proximity. If the fragrance is clearly strong, sharp, or “fills the nose” at that range, it is not hospital-safe for patient-facing work and requires dose reduction or a change of product. If it is soft and faint, it may be acceptable within the relevant zone’s dosing rules. The five-second duration matters because brief sniffs may underestimate intensity, whereas sustained exposure is closer to the patient experience.

The second method is patient-proximity simulation. The wearer extends the forearm or wrist to approximately one metre (arm’s length) and assesses whether the fragrance is clearly detectable. If it is clearly detectable at one metre, the projection is likely excessive for hospital use, particularly in micro-dosing zones. If the fragrance is barely detectable or not detectable at that distance, it is more likely to remain within personal space. This method operationalises the arm’s-length concept described in workplace fragrance guidance [11] and converts it into a simple bedside-relevant rule.

Both methods should be taught as “dose-check” tools rather than moral tests. The message is not “do not wear perfume,” but “ensure your perfume stays within your bubble.” These tools also help staff adjust in real time—reducing dose, changing application site, delaying entry into high-risk areas until the fragrance settles, or switching to a lighter category on duty days.

7. Deodorants, Antiperspirants, Body Sprays, and the Management of Body Odour

A hospital fragrance framework must address the reality that many people use perfume to compensate for body odour rather than as a purely aesthetic choice. The correct approach is to prioritise hygiene, clean uniforms, and appropriate underarm products rather than increasing perfume load.

Deodorants reduce odour primarily by targeting odour-causing bacterial activity, while antiperspirants reduce sweating, thereby reducing the substrate for bacterial metabolism. These products are designed for underarm use. Perfumes and attars should not be applied to underarms because they are not intended for high-moisture, high-bacterial-load sites and may create intense local projection and discomfort for patients and colleagues. Body sprays, although lighter, still contribute to indoor fragranced exposure and should follow hospital dosing limits rather than being treated as “free use.” Persistent or distressing body odour despite hygiene measures should prompt medical evaluation; reputable clinical guidance frames persistent sweating and body odour as medical concerns warranting assessment, not simply cosmetic masking [21,22,23].

8. Indoor Air Quality, VOCs, and the Shared-Air Principle

Fragranced products contribute to indoor volatile organic compound (VOC) burden and may influence air quality in enclosed environments. The U.S. Environmental Protection Agency provides general indoor air quality education regarding VOCs and indoor exposure [17]. Scientific reviews have discussed the inhalation effects of abundant indoor fragrance chemicals and have emphasised sensory irritation and symptom links [18]. Studies of room fragrance products have demonstrated measurable impacts on indoor air chemistry [19], and research has evaluated VOC emissions from fragrance diffusion products [20]. While hospitals often have stronger ventilation systems than homes, the shared-air principle remains: if many individuals wear strong fragrance, cumulative exposure increases, and vulnerable patients cannot opt out. This strengthens the rationale for dose-limited fragrance practice rather than unregulated use.

9. Implementation: Making Hospital Fragrance Recommendations Work

A well-written recommendation will fail if implementation is not designed thoughtfully. The goal is to create a culture of respectful, patient-centred fragrance practice rather than a punitive atmosphere.

Implementation should begin with staff education that explains clinical rationale in plain language. Education should cover vulnerable patient populations, the difference between community and hospital settings, the meaning of projection and sillage, the concept of micro-dosing zones, and the practical self-assessment tests. Education should emphasise that the hospital is a shared-air environment and that professional fragrance practice is analogous to professional voice control: a normal human behaviour, moderated because patients are vulnerable.

Hospitals should provide simple patient-facing communication. Admission leaflets and ward signage can politely request that visitors and bystanders limit fragrances and follow micro-dosing expectations in high-risk areas. This aligns with existing policy approaches that apply restrictions to staff, patients, and visitors [5]. The language should avoid shaming and instead stress patient comfort and safety.

Unit-specific reinforcement is useful. For example, chemotherapy day-care, ICU, transplant wards, post-operative wards, and respiratory isolation areas can be clearly labelled as micro-dosing zones. The message should be consistent: micro-dosing is not a ban; it is a strict limitation to protect vulnerable patients. In respiratory isolation rooms, the message should explicitly explain that strong scents may trigger coughing, and in such rooms cough may increase droplet spread, adding infection-control risk.

Feedback mechanisms should be non-punitive. If complaints occur, the response should be education-first, guiding staff toward dose reduction, site modification, or switching to lighter families on duty days. A small number of repeated violations may require managerial reinforcement, but the default tone should be respectful and supportive.

Hospitals may also integrate fragrance practice into broader patient-safety conversations. Just as noise reduction and light discipline are discussed in ICU patient comfort, fragrance control can be included as another sensory safety domain.

10. Policy Positioning: A Balanced Middle Path

The framework proposed here is intentionally a balanced middle path. Existing policies often occupy extremes: strict bans or vague discouragement. This paper recognises the legitimacy of fragrance-restricted policies grounded in occupational health and accessibility [6,7,8,11] and acknowledges arguments that artificial scents do not belong in hospital environments [9]. At the same time, it proposes that many institutions—especially those aiming for pragmatic implementation—may benefit from quantified dosing guidance and teachable behavioural strategies rather than binary rules.

The framework explicitly allows limited fragrance use. It does not recommend blanket avoidance. It sets measurable limits (spray numbers by category), defines micro-dosing zones, discourages high-projection sites such as the front of the neck, discourages application on clothing due to enhanced projection and persistence, and cautions wrist use due to direct patient proximity. It provides layering strategies that respect aesthetic preference while limiting patient exposure. This is intended to be workable in real hospital culture while still prioritising patient comfort and safety.

11. Conclusion

Fragrance use in hospitals is not a trivial personal preference issue; it intersects with patient comfort, respiratory physiology, migraine triggers, indoor air exposure, infection-control logic, and equitable access for sensitive individuals. Evidence shows that fragranced consumer products can provoke symptoms, particularly in asthmatics and sensitive subgroups [1,4], and the clinical reality is that hospital populations are enriched for vulnerability. Existing hospital and workplace policies demonstrate recognition of the problem [5,6,7,8,10,11], but many policies lack quantified, clinically reasoned dosing and behavioural guidance, leaving implementation subjective.

A structured, measured framework can provide a workable solution without advocating blanket bans. By distinguishing hospital practice from community use, defining hospital-appropriate dosing and micro-dosing zones, discouraging high-projection application sites, including careful guidance on wrist proximity, discouraging fragrance application on clothing, teaching layering strategies for taming heavy perfumes, and implementing detailed self-assessment tools, hospitals can protect vulnerable patients while respecting staff wellbeing and professional dignity. This is best framed not as a restriction of personal freedom, but as a form of patient-centred professionalism in shared air.