Fragrance-Free Policies: A Scoping Review of Definitions, Implementation, and Gaps.

BACKGROUND: Fragrance-free policies are increasingly adopted to improve indoor air quality and reduce fragrance exposure linked to adverse health outcomes and accessibility barriers. This scoping review mapped the evidence on fragrance-free policies across sectors. METHODS: Following Arksey and O'Malley's framework and PRISMA-ScR guidelines, we searched five peer-reviewed databases and grey literature sources. Documents describing formal scent-free or fragrance-free policies or guidance in workplaces, healthcare, educational, or public settings were included. Data were charted on policy characteristics, enforcement mechanisms, implementation supports, and governance features. RESULTS: Sixty-three documents were included. Findings revealed substantial variability in terminology, scope, and enforcement. Many policies relied on voluntary compliance and awareness-based strategies, with limited integration of structural supports such as procurement controls, staff training, and evaluation frameworks. Enforcement mechanisms were predominantly reactive, responsibilities were inconsistently defined, and consequences for non-compliance were limited. Although many policies referenced multiple chemical sensitivity or fragrance sensitivity, accommodation pathways and accountability structures were frequently lacking. Four key themes indicate that many fragrance-free policies function as accommodation tools rather than integrated environmental health interventions. CONCLUSIONS: Strengthening definitional clarity, institutional accountability, and structural integration may enhance effectiveness and support more consistent, equitable, and evidence-informed approaches to reducing fragrance-related exposures in indoor environments.