Understanding Chemical Sensitivities in Aspergillosis, Asthma, and Chronic Lung Conditions

Many people living with aspergillosis, asthma, bronchiectasis, or other long-term respiratory illnesses report that they react badly to cleaning products, air fresheners, perfumes, and even strong-smelling personal care items. These reactions are real and can be distressing. This article explains what’s happening, why it affects some people but not others, and what you can do to reduce your risk and feel more in control.

Why Do Some Chemicals and Perfumes Trigger Symptoms?

Many cleaning products and scented items contain volatile organic compounds (VOCs) — chemicals that easily evaporate into the air. These can include:

• Limonene (used in citrus-scented products)
• Formaldehyde
• Ammonia
• Alcohols and solvents
• Synthetic perfumes (labelled as “fragrance” or “parfum”)

When inhaled, VOCs and other airborne chemicals can irritate the lining of the lungs, especially in people with underlying inflammation, scarring, or hyperresponsive airways. This can lead to symptoms such as:

• Coughing
• Wheezing
• Shortness of breath
• Chest tightness
• Brain fog or fatigue in some cases

You don’t need to be allergic to these substances to be affected — in many cases, it’s an irritant or hypersensitivity reaction.

Why Does It Affect Some People But Not Others?

Not everyone reacts the same way to airborne chemicals. Here’s why some people are more sensitive:

1. Existing Lung Conditions

People with asthma, aspergillosis (ABPA or CPA), bronchiectasis, or COPD often have airways that are already inflamed or structurally damaged. This makes their lungs more reactive to airborne triggers.

2. Airway Hyperresponsiveness

Some individuals have airways that spasm or swell more easily when exposed to irritants. This may be linked to genetics, prior infections, or chronic inflammation.

3. Sensory or Central Sensitisation

In some people, the nervous system becomes sensitised to strong smells or chemicals — even at levels others might not notice. This can overlap with conditions like fibromyalgia, chronic fatigue syndrome (ME/CFS), or post-viral syndromes.

4. Chemical Intolerance or Multiple Chemical Sensitivity (MCS)

MCS is a controversial but increasingly recognised pattern where people react to small amounts of everyday chemicals. It may involve a mix of biological and neurological factors, but there is no definitive test, and diagnosis remains complex.

5. Environmental History

People who’ve been exposed to mould, solvents, or occupational dust and fumes may become sensitised over time.

6. Anxiety and Conditioned Responses

In some people, particularly those who have previously experienced frightening episodes triggered by smells (such as perfumes or cleaning chemicals), even the scent alone can trigger anticipatory anxiety. This can cause symptoms like breathlessness or tightness even in the absence of a strong chemical exposure. This does not mean the reaction is “in your head” — anxiety can produce real physical effects, especially in people whose airways are already compromised.

Can We Screen for Who’s Most at Risk?

There’s no single test, but risk can be estimated by asking the right questions:

• Have you had asthma, ABPA, CPA or bronchiectasis?
• Do you react to air fresheners, perfumes, or cleaning sprays?
• Do your symptoms worsen in certain environments?

Some clinical tools like FeNO testing, peak flow monitoring, and validated questionnaires (e.g. QEESI) may help identify those at higher risk.

Genetic markers like HLA subtypes are under research but not routinely used.

Practical Steps to Reduce Exposure

• Choose fragrance-free products (not just “unscented,” which may still contain masking agents).
• Use microfibre cloths and hot water for everyday cleaning.
• Avoid aerosols, bleach, ammonia and pine-scented products.
• Open windows or ventilate well during and after cleaning.
• Ask family or carers to clean while you’re out of the house if possible.
• Wear a mask (such as an FFP2/FFP3 or carbon-filter mask) during necessary exposure.

What About Carpet Cleaners and Other Equipment?

Some carpet cleaners or shampoos list ingredients like “amphoteric surfactants.”

• This term refers to how the chemical behaves (can act as an acid or base) — it has nothing to do with amphotericin, the antifungal drug.
• However, the perfume or preservatives in these products are more likely to cause symptoms.

If you’re sensitive:

• Stay out of the area while carpets are being cleaned.
• Ask someone else to do the cleaning.
• Air the space thoroughly afterwards.

Summary: You’re Not Imagining It

Chemical sensitivity is real. Even though terms like “MCS” remain medically controversial, the impact on daily life is well recognised, especially in people with underlying lung conditions.

You don’t have to justify your symptoms — your body is giving you valid signals. It’s okay to set boundaries and make your home and surroundings safer for your health.

Path: Start » Living with Aspergillosis » General interest » Understanding Chemical Sensitivities in Aspergillosis, Asthma, and Chronic Lung Conditions