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

Fragrance use is deeply embedded in personal identity, culture, and wellbeing, and many healthcare workers use perfumes and body sprays to feel fresh and confident during long duty hours. In hospitals, however—especially in oncology units, intensive care units, transplant wards, post-operative areas, and respiratory isolation rooms—strong fragrances can provoke patient distress and contribute to avoidable clinical complications, including nausea, headache, bronchospasm, cough, and sensory intolerance in physiologically vulnerable individuals. Several hospitals and health systems have implemented fragrance-free or fragrance-restricted policies, but many existing policies remain binary (“allowed” versus “not allowed”) and rarely provide quantified, clinically reasoned guidance on safe dosing, application sites, or self-assessment methods. This paper proposes a balanced, patient-centred framework that permits respectful fragrance use while prioritising patient safety and infection control. It introduces two practical concepts—hospital-appropriate dosing and micro-dosing zones—translating perfumery fundamentals (concentration categories, projection, sillage, longevity, top/heart/base notes, and fragrance families) into measurable clinical behaviours. The framework includes quantified spray guidance, application-site recommendations relevant to bedside practice, strategies for “taming” heavier perfumes through layering, and detailed self-assessment methods that healthcare workers can use for real-time safety checks. Finally, the paper outlines implementation strategies for hospitals, including staff education, patient-facing communication, and visitor guidance, without advocating blanket bans.