Trindel Insurance Fund Poison Oak Survival Information What is poison ivy, poison oak, and poison sumac? The Summer is upon us and so are those nasty rashes from brushing up against poisonous plants such as poison ivy, poison oak, and sumac. Approximately 85 percent of the population will develop an allergic reaction if exposed to poison ivy, oak or sumac, according to the American Academy of Dermatology. Usually, people develop a sensitivity to poison ivy, oak or sumac only after several encounters with the plants, sometimes over many years. However, sensitivity may occur after only one exposure. The cause of the rash, blisters, and infamous itch is urushiol (pronounced oo-roo-shee-ohl), a chemical in the sap of poison ivy, oak and sumac plants. Because urushiol is inside the plant, brushing against an intact plant will not cause a reaction. But undamaged plants are rare. Poison oak, ivy and sumac are very fragile plants, and stems or leaves broken by the wind or animals, and even the tiny holes made by chewing insects, can release urushiol. Reactions, treatments and preventive measures are the same for all three poison plants. Avoiding direct contact with the plants reduces the risk but doesn't guarantee against a reaction. Urushiol can stick to pets, garden tools, balls, or anything it comes in contact with. If the urushiol isn't washed off those objects or animals, just touching them--for example, picking up a ball or petting a dog--could cause a reaction in a susceptible person. (Animals, except for a few higher primates, are not sensitive to urushiol.) Urushiol that's rubbed off the plants onto other things can remain potent for years, depending on the environment. If the contaminated object is in a dry environment, the potency of the urushiol can last for decades, says Epstein. Even if the environment is warm and moist, the urushiol could still cause a reaction a year later. Almost all parts of the body are vulnerable to the sticky urushiol, producing the characteristic linear (in a line) rash. Because the urushiol must penetrate the skin to cause a reaction, places where the skin is thick, such as the soles of the feet and the palms of the hands, are less sensitive to the sap than areas where the skin is thinner. The severity of the reaction may also depend on how big a dose of urushiol the person got. What can you do to avoid poison ivy, poison oak, and poison sumac? Learn what poison ivy looks like and avoid it. While "leaves of three, beware of me, is the old saying, "leaflets of three, beware of me" is even better because each leaf has three smaller leaflets. Wash garden tools regularly, especially if there is the slightest chance that they've come into contact with poison ivy. If you know you will be working around poison ivy, wear long pants, long sleeves, boots, and gloves. Hikers, emergency workers, and others who have a difficult time avoiding poison ivy may benefit from a product called Ivy Block, made by EnviroDerm Pharmaceuticals Inc.. It's the only FDA-approved product for preventing rashes from poison ivy, oak, or sumac. The OTC lotion contains bentoquatam, a substance that forms a clay-like coating on the skin. If you come into contact with poison ivy, oak, or sumac, wash the skin in cool water as soon as possible to prevent the spread of urishiol. If you get a rash, oatmeal baths and calamine lotion can dry up blisters and bring relief from itching. You can also talk to a health care professional about medicines that may help. How can you deal with the rash? 1 If you don't cleanse quickly enough, or your skin is so sensitive that cleansing didn't help, redness and swelling will appear in about 12 to 48 hours. Blisters and itching will follow. For those rare people who react after their very first exposure, the rash appears after seven to 10 days. Because they don't contain urushiol, the oozing blisters are not contagious nor can the fluid cause further spread on the affected person's body. Nevertheless, Epstein advises against scratching the blisters because fingernails may carry germs that could cause an infection. Poison Ivy, Poison Oak, Poison Sumac Prevention (cont.) The rash will only occur where urushiol has touched the skin; it doesn't spread throughout the body. However, the rash may seem to spread if it appears over time instead of all at once. This is either because the urushiol is absorbed at different rates in different parts of the body or because of repeated exposure to contaminated objects or urushiol trapped under the fingernails. The rash, blisters and itch normally disappear in 14 to 20 days without any treatment. But few can handle the itch without some relief. For mild cases, wet compresses or soaking in cool water may be effective. Oral antihistamines can also relieve itching. There are a number of OTC products to help dry up the oozing blisters, including: aluminum acetate (Burrows solution) baking soda Aveeno (oatmeal bath) aluminum hydroxide gel calamine kaolin zinc acetate zinc carbonate zinc oxide How to identify poison oak. Unfortunately, poison oak doesn’t grow with little picture ID badges around their stems, so you have to know what to look for. To avoid these plants and their itchy consequences, here's what to look for. Poison Oak eastern (from New Jersey to Texas) grows as a low shrub; western (along the Pacific coast) grows to 6-foot-tall clumps or vines up to 30 feet long oak-like leaves, usually in clusters of three clusters of yellow berries Poison oak prevention and treatment Sawmillers share thoughts on the best preventions and cures for exposure to poison oak. September 6, 2000 Question Does anyone have a remedy for poison oak, or a way to prevent getting it on one's legs while scaling logs? I'm ashamed to say it, but this is the best revenge a logger ever had on this sawmiller. 2 Forum Responses This may sound silly but trust me, it works for poison ivy: Get a tea bag and have yourself a cup of tea. Save the bag, place it over the affected area and tie it in place, or take a old elastic sock top and slide it over your arm or leg to hold the tea bag in place. Just let the tea bag dry, and as it does it will pull out the oils. DO NOT place a boiling hot tea bag on your body; let it cool first. Poison ivy and poison oak are members of the poison sumac family and affect your skin when you contact the plant resins. The resins are present throughout the plant: on the surface of the leaves, in the leaves and in the stems. Direct contact with any portion of the plant, including its sawdust, can cause an outbreak. The reason not everyone has problems is that the itching, swelling rash is an allergic reaction to the plant resin. The more allergic you are, the worse your outbreak will be. The key to avoiding problems is to keep the resin off your skin. Wear long-sleeved shirts and long pants. If you do get the resin on your skin, wash it off with soap and water as soon as possible. If you break out with the itching, swelling, blisters etc., the best treatment is to visit your doctor for the appropriate medication. This may be in the form of oral medication or shot(s). Learn to identify the plant(s) and try to remember to ask if the logs came from an area with poison oak. The important thing is to keep the resin off of your skin, however you choose to accomplish that. I've had poison oak so many times I've lost count. I finally found a product that works. Go down to your drug store and buy some stuff called TECNU. There are two types of this lotion; one you use AFTER you've unfortunately broken out in a rash, the other (called Tecnu Armor or something like that) is to shield your body if you'll be out where you might be in contact with poison oak. It's awesome stuff. The other lotions just try to ease the itching. This stuff actually makes it GO AWAY. I would thoroughly agree with the last post. The Tecnu products, used as recommended, really work. They dissolve and remove the irritant oils that stimulate the oh-so-annoying symptoms. The oak and ivy cleanser works after you are exposed and right up to "ooze time." The armor helps keep the stuff out of your skin in the first place. Bailey's Logging Supply used to carry the stuff. That's where I first got it, but a lot of drug stores and I think some WalMarts have it now, too. Here's another idea: Use rubbing alcohol to cleanse suspected areas of contact. Alcohol breaks down the resin given of by the Rue family, to which poison ivy, oak and sumac belong. I've noticed myself that I have a few hours of "grace" before I have to clean up, but everybody reacts differently. The tea bags contain tannins, which are useful in drying. 3 The comments below were added after this Forum discussion was archived as a Knowledge Base article (add your comment). Comment from contributor S: I have run into poison oak a lot while clearing land in the Sierra. Whenever I take a "hit" with skin contact from the plant, I try to respond with a simple preventative treatment within 10-20 minutes. Time is important. My favorite treatment is bicarbonate of soda and water, mixed into a paste, spread on the skin and allowed to dry. It seems to work to prevent the onset of irritation. The alternate is alcohol, which seems less effective for me, but soothes the skin a bit. Comment from contributor R: I have had poison oak for three days now and using the alcohol is a good idea to dry it up a little. I also put ice cubes on it and soak it in cool water a few times a day. Putting a cool rag on it and sitting under a fan works well too. If it’s on your face it’s good to change your pillow case every night. I have found that oatmeal baths from the store help stop the dryness and itching. Is a Poison Plant Rash Contagious? Many people think a poison plant rash can be spread from one part of the body to another or from person to person. In general, this is not true. You can spread the rash only if you have urushiol on your hands. Also, it can take longer for the rash to appear on certain areas of the body, especially areas such as the soles of the feet where the skin is thicker. This may give the appearance that the rash has spread from one part of the body to another. You can also be re-exposed to the urushiol by touching gardening tools, sports equipment, or other items that were not cleaned after being in contact with the plants. Scratching or touching the rash and fluid from blisters will not cause the rash to spread because urushiol is not present in the blister fluid. What Should I Do If I am Exposed to a Poison Plant? If you think you may have been exposed to a poison plant: Remove your clothes. Wash all exposed areas with cool running water. Use soap and water if you can. Be sure to clean under your fingernails. In the woods, the water of a running stream can be an effective cleanser. Wash your clothing and all gardening tools, camping gear, sports equipment and other objects that came into contact with the plants. Bathe pets exposed to the plants. What is the treatment for poisoning from these plants? The best approach to poison ivy dermatitis is prevention. Washing with soap and water can help reduce the severity of the rash, but this is often impractical because it has to be done at once. (After 10 minutes, only 50% of the resin is removable, and by 30 minutes only 10%.) Once it begins, the rash will usually clear on its own by 14-21 days. Treatment is directed at controlling the itching. Oral antihistamines (like diphenhydramine [Benadryl]) may help the itch somewhat, but often they do no more than make people drowsy. Cortisone creams, whether over-thecounter or by prescription, are only helpful if applied right away, before blisters appear, or much later, when the blisters have dried up. Compresses with cool water or Burow's solution (available without prescription) can help dry the ooze faster. When the rash is severe, such as when it affects the face or causes extensive blistering, oral steroids (for example, prednisone) can help produce rapid improvement. This course of therapy should be maintained, often in decreasing doses, for 10-14 days or even longer in some cases, to prevent 4 having the rash rebound and become severe again. Patients who are given a six-day pack of cortisone pills often get worse again when they complete it, because the dose was too low and administered for too short a time. Folklore, medical and otherwise, endorses many other agents, from aloe leaves to tea bags to meat tenderizer as treatments for poison ivy and related plant poisonings. Though these remedies are generally harmless, they are of questionable value. THE SEASON OF THE ITCH Ah, summer. Time to go explore the great outdoors. Time to go camping and hiking. Time to become one with nature. Time to get poison oak. Poison oak isn't a poison: it's an allergic contact dermatitis caused by contact with the oil of the poison oak plant. One characteristic is the pattern of the blisters on the skin. The oil on the leaves is typically streaked onto the skin, resulting in blisters in a linear pattern. If you know you're sensitive, avoid contact with the plant. Tech-Nu before exposure helps. If exposed, do your best to wash (with soap) within half an hour. Using pre-moistened wipes, like those used for babies, is another alternative, and you can carry them in your shirt pocket or bag. If you remove the oil in a half-hour or so, you can often prevent a reaction. You should also clean off anything else that contacted the plant. This includes shoes, belts, backpacks, bikes, dogs, tents: anything that could have touched it at any time in the past. Don't say "well, it's been three weeks since I was out in the woods - I don't *really* need to clean all this stuff." Not true. There have been cases where folks got poison oak from touching things that were in storage for THIRTY YEARS! It'll take a good wiping with a damp rag to remove the oil. Be sure to wear good rubber gloves as hand protection, and then wash your hands with soap and water as soon as you're done. Remember that you have a half-hour "grace period." Okay, you've washed your boots, belt, mountain bike, and dog. You're still itching. What do you do? Caladryl Lotion, or any other skin preparation that has the ingredient pramoxine may help control the itching, and is safe to use. Keep in mind that using Benadryl (diphenhydramine, which used to be in Caladryl) on the skin is NOT a good idea. Calamine lotion can be soothing. Also helpful are Domeboro tablets, which you can buy at the drugstore. Dissolve them as directed in water, and soak frequently. This will help dry up the blisters and stop the itching. Benadryl by mouth can help itching, though it causes drowsiness. The usual dose is 25 to 50 milligrams every 6 hours or so. It's not a good idea to drive or operate heavy machinery after taking antihistamines like Benadryl. Valium also works well at bedtime. 5 The best treatment for poison oak is steroids. They're not the kind of steroids that make bodybuilders look like Gonad the Barbarian (anabolic steroids); they're corticosteroid creams, gels, ointments, pills, or injections. Most are prescription only, except for hydrocortisone cream or ointment, which usually isn't strong enough. Pills are usually given in decreasing amounts over a week or so; the injection's a one-shot kind of deal. So to speak. If you've had TB, or have a history of ulcers, or have a history of bipolar disorder or other kinds of psychiatric problems, tell your doctor before taking steroids. You also should watch your poison oak for local infection, which may look red, painful, and oozing. If it's causing honey-yellow crusts on the infected areas, it may be impetigo. Infections often require antibiotics. Don't wait for it to cure itself, since it can lead to some nasty complications, including (rarely) death The nagging itch and telltale red rash are caused by the toxin urushiol oil, which is found in both poison ivy and poison oak. Some people are more sensitive to it than others. And some are not sensitive to it at all—they can literally roll in the stuff and not get a reaction. But our experts don't advise those of you lucky enough to be immune to give it a try. A sensitivity to urushiol can develop at any time. The solutions to poison ivy or poison oak are substances that annihilate urushiol. But remember—what works for someone else may not work for you, and in severe cases may not work at all. Urushiol Oil: Evil and Persistent Urushiol oil, the active ingredient in poison ivy and poison oak, is "one of the most potent external toxins we know," says William L. Epstein, M.D. "The amount needed to cause a rash in very sensitive people is measured in nanograms, and it could take as little as 1 nanogram. But most sensitive people will react in the 100-nanogram range." Consider that a nanogram is a mere billionth of a gram; that means it would take less than 1/4 ounce of urushiol to cause a rash in every person on earth. Five hundred people could itch from the amount covering the head of a pin. "I'm surprised it hasn't been used as a nonlethal chemical warfare weapon," says James A. Duke, Ph.D., whose interest in "this evil plant" was sparked by "an early ethnobotanical application of poison oak as a substitute for toilet paper." Its itch torments you; its long life can fool you. Dr. Duke says "specimens of poison ivy several centuries old" have caused dermatitis in sensitive people. "When the Japanese restored the gold leaf on the golden Temple in Kyoto, they painted urushiol lacquer on it to preserve and maintain the gold," Dr. Epstein says. "The main message for American tourists there is, 'Don't try to steal the gold.' " You'll be caught red-handed. Literally. KILLING THE ITCH If you've been messing around in a poison patch, you'll soon know whether you're immune or not. And as ugly as the rash looks, it's the itch that'll do you in. Here's what you can do about it, starting with the universal remedy. Get cozy with darlin' calamine. The time-honored mainstay in poison treatment is calamine lotion, a popular skin protectant with a soothing action "that produces cooling and distracts your skin from the itching sensation," says Robert Rietschel, M.D., chairman of the Department of Dermatology at New Orleans' Ochsner Clinic in Louisiana, and clinical professor of dermatology at Louisiana State University School of Medicine. "In poison ivy and poison oak, the blood 6 vessels develop gaps that leak fluid through the skin, causing blisters and oozing," he explains. "When you cool the skin, the vessels constrict and don't leak as much." Calamine lotion also leaves a powdery residue that absorbs the oozing, develops a crust, and keeps it from sticking to your clothes, Dr. Rietschel notes. He suggests applying calamine lotion three or four times a day. To keep your rash from getting too dry and making the itch even worse, stop using calamine when the oozing stops, he says. MEDICAL ALERT Signs of an Emergency About 15 percent of the 120 million Americans who are allergic to poison oak and poison ivy are so highly sensitive they break out in a rash and begin to swell in 4 to 12 hours instead of the normal 24 to 48. Their eyes may swell shut and blisters may erupt on their skin. "This is one of the few true emergencies in dermatology," says William L. Epstein, M.D. "Get to a hospital as soon as possible. A shot of corticosteroids will bring the swelling down." Subtract the additives. Antihistamines like Benadryl and painkillers like benzocaine and lidocaine are often added to certain calamine lotion products. "They may work for some people," says William L. Epstein, M.D., a professor of dermatology at the University of California, San Francisco, School of Medicine, "but they don't add much relief vis-ˆ-vis the cost, and you run the risk of developing an allergic rash from the additives." Pop a pill. Oral antihistamines, however, are a different story. In fact, they're high up on Dr. Rietschel's list. There are two over-the-counter brands to choose from: Chlor-Trimeton, which contains the active ingredient chlorpheniramine maleate, and Benadryl, which contains the active ingredient diphenhydramine hydrochloride. "You could take your hay fever medicine if it happens to be an antihistamine," Dr. Rietschel says. Try other drying agents. "Although not as popular and soothing as calamine, there are other skin soothers that can be just as effective. Some of them, however, often have a lot of alcohol and tend to sting," Dr. Rietschel warns. Use them as you would calamine—until the oozing stops. Otherwise you can get the rash too dry, and it will crack and cause more itching. Zinc oxide, witch hazel, Burow's solution (aluminum acetate), and baking soda are common topical drying agents. 7 The following comments are from a number of California County Safety Officers and Road Departments Treat early and often with Technu - apply for 2 minutes straight to the affected area every two to three hours. If applied as directed, it will work to reduce the size, severity and duration of the rash and itching symptoms. There is a barrier cream called "Ivy Block" that is said to prevent contact with the plant from causing the rash to begin with. I have tried it but it's hard to gauge results - did I avoid contact or did the barrier cream work? Hard to say. When it gets out of hand, oral or intramuscular cortico steroids are the only real treatment. Josh Reilly County Safety Officer 831-454-4820 ph 831-454-4708 fax Generally the best treatment is just to avoid the stuff, but we do recommend frequent bare skin washing, long sleeve shirts, with sleeves down, gloves and members of the crews who are ultra sensitive try to do other jobs. We make no other recommendations. If individuals take medical precautions those things are paid for under health care plan. Mark Hilliker hillikem@co.mendocino.ca.us I like to think all things are preventable, but I am learning to live with a few of these claims. The education is the most helpful piece. I sent out photos of poison oak in the various stages to put up on the bulletin boards so folks know what it looks like, but this doesn't help in the winter when it doesn't have any leaves. There are some good educational pieces out on the web that talk about the oil and how cross contamination can occur. Long sleeves, pants, gloves. We found that we need to be careful with the wind. Both smoke and wood chip fragments blowing in the workers direction can cause problems and even respiratory issues. Peter Peter Cheney, ARM-P CECD County of Nevada California - Risk Manager (530) 265-7196 John Herbal remedy from one of our crew. Call (707) 496-4678 email flyingcow@udderlyherbal.com Poison Oak Antidote Organic Herbal Liniment. 8 Our road crews receive annual awareness training for poison oak around this time when it is most dominate. The training includes: What is poison oak, prepare for task, dispose of gloves/coveralls, and wash. We also provide for our road crews such as; Ivy Block, that helps prevent Poison Ivy, Oak, Sumac rash. Also provide Block wipes and disposable gloves/coveralls. of year the lotions Ivy Hope this helps, Sincerely, Phil Raba Health & Safety Manager Emergency Coordinator County of Ventura Public Works Agency 800 S. Victoria Ave. Ventura, Ca. 93009-1600 (805) 650-4074 All road workers use Tyvek full coverage suits, gloves, and eye protection when working in areas that could expose them to noxious weeds. Thanks, Kenneth Nattell Facilities and Grounds Manager 831-636-4170 ext. 23 831-207-8343 Cell E-Mail Knattell@pw.co.san-benito.ca.us Unfortunately once a reaction to poison oak has begun there is no “cure.” At this point, treating symptoms is the only option. Several sources suggested over the counter lotions to relieve the itching associated with poison oak reactions as well as cleansing products. There are several commercial products available for these purposes. If the reaction is unbearable or mucus membranes are affected, the affected individual should see a physician. In addition, tools, clothing, boots, seating, etc… should be thoroughly cleaned after usage to prevent spreading the oil that causes the reaction. Here are some links to articles that you may find helpful: http://www.webmd.com/allergies/guide/poison-ivy-oak-sumac?page=2 http://poisonivy.aesir.com/view/welcome.html http://www.emedicinehealth.com/allergy_poison_ivy_oak_and_sumac/article_em.htm http://www.medicinenet.com/poison_ivy/article.htm I hope this helps some. Let me know if have any questions. Travis Clemmer Loss Prevention Specialist CSAC Excess Insurance Authority 9 I am the safety representative for Shasta County Department of Public Works. Many of our outdoor workers are exposed to poison-oak as part of their job duties, so we have implemented a program that involves clothing, barrier protection and annual training. We supply our employees with a choice of long or short-sleeved shirts, and we require that they wear long pants and heavy gloves whenever they are asked to perform brush clearance. In addition we supply Ivy-X® pre-contact solution for use before potential exposure and tecnu® outdoor skin cleanser for use after any potential exposure to poison-oak. I provide annual training to employees on poison-oak and its risks. I’ve attached a copy of my current program (I try to update all my training programs annually) for your use. If I can be of any additional assistance, don’t hesitate to contact me. Paul Young Safety Technician Shasta County Department of Public Works Desk: 530-245-6793 Cel: 530-604-5997 Hi Gene, Here is a response to your question from one of our Road Yards: IVYX Professinal Skin Protection - The company is Caretex Products Inc >>> Chris Zimmermann 5/4/2009 10:11 AM >>> Shirley, what's the name of pre-contact solution and cleaner? >>> Shirley Ito 5/4/2009 10:09 AM >>> Chris, we have a pre-contact soulution and a cleanser to use to remove the sticky oils of poisonous plants. We let all the employees know we have the creams to use and encourage them to be aware of their surroundings. Justin @ Badger just got over being exposed to poison oak/ivy. Shirley The road crew is provided with TecNu. You have to use this as soon as you come in contact with poison oak to get the oil off. Thanks, Robert Rabago Risk Analyst Risk Management Div. County of Humboldt 10 Public Works provides/offers barrier cream, and Oral Ivy, disposable gloves and Tyvex suits to employees as a preventative measure. We also provide our trucks with tool cleaner to remove residual poison oak oils from tools. As far as medical treatment after the fact - employees go to our workers' comp medical provider and they usually receive topical anti-itch creams or sometimes a treatment of steroids. We do not provide after the fact topical treatments here at work. Let me know if you have additional questions, Marney Taylor Safety & Training Manager San Mateo County Public Works 555 County Center 5th Floor Redwood City, CA 94063 (650) 599-1451 I hope this helps. We do stick this in our warehouse and make it available to employees. I believe the biggest issue is that many times they do not realize they have come in contact with poison oak, ivy or sumac. They also have safety tailgates yearly about this topic. Type: CHEMICAL Make: ENVIRODERM Model: IVY BLOCK LOTION URL: http://www.enviroderm.com/ Description: As long as it is applied at least 15 minutes BEFORE exposure. It should be reapplied every four hours for continued protection. It will not work if a rash has already developed. Type: CHEMICAL Make: ZANFEL LABORATORIES Model: ZANFEL POISION IVY, OAK, AND SUMAC WASH URL: http://www.zanfel.com/ Description: For use AFTER exposure to poison ivy/oak/sumac. Follow directions on the box. They are sold in 1 oz. tubes, good for 15 applications the size of an adult hand or face. Shelf life is 10-years. Luana Enriquez, Safety Inspector Employee Health and Safety Tel: (626) 458-5943 P Please do not print this email unless it is absolutely necessary. awareness. Spread environmental 11 Mariposa County uses a product called "Tecnue". It removes poison oak and ivy oils from the skin. All of the Road vehicles carry it as standard equipment. Another one that I have heard about is called "Maria's Poison Oak Soap". Marty We've approved 1.04 Technu for our 11st aid kits. Long sleeves and pants. Thank You. Ulis G. Redic, Risk Analyst County Administrator's Office 125 12th Street, Third Floor Oakland, CA 94607 510.271.5183 QIC 28505 ulis.redic@acgov.org Hi Gene, We include poison oak exposure as a hazard in tailgate meetings and provide a product called techno that limits or prevents symptoms if used correctly. We generally have it in all the trucks. Steve Weston Butte County Administration Safety Officer (530) 538-7173 office (530) 693-1962 cell 25 County Center Drive, Suite 213 Oroville, CA 95965 12