There cannot be a problem with unhygienic macros. I have 527 of them across 103 Common Lisp source files (I like small source files) and have not once ever had a problem with unintended capture, Not even when I was new to macros. QED.
Hygiene is a solution without a problem. Bad solution, bad!
btw, 2800 defuns and 800 defmethods (OO defuns, in brief) in the same source.