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Plant Causes
Who Is At Risk?
6.0 Who In The Industry Is Affected

6.1 Nurseries and Greenhouses
Greenhouse Workers, Nursery Workers, Delivery Staff, Garden Centre Staff

People in this industry often have to work with a wide variety of exotic plants, often in cramped hot, and humid conditions, which predisposes them to dermatitis from contact with plants  when potting, pricking out, moving of plants, or polishing and attending to leaves. Airborne contact from pollen is common, which is worse in the interior. Many have not been educated in this field, and do not wear protection, many of the workers are part time, low skilled and do not report the affliction. Even though many do wear gloves, the forearms are commonly affected.
Primula obconica continue to be sold and cultivated  as a popular houseplant, and causes widespread dermatitis throughout Europe. Philodendron Pyrethrum and Chrysanthemeum are serious causes of dermatitis. Tagates patula, eraecta, minuta, indica causes skin lesions in many nursery workers, and in African farmers where it occurs as a weed.

Cases: Fremontedendron mexicanum, californicum caused eruptions on the hands of a 74, 56 year old gardener after pruning the plant after 2 weeks.[13.1] A Dahlia specialist and a Dahlia grower developed recurrent dermatitis all over their bodies for over 20 years but never gave up the trade, despite being in severe pain.[5 ] Primula obconica: Notorious sensitiser. Has invisible hairs producing irritant when ruptured. Condition worse in summer. Contact from removing dead leaves. Incidence increasing. [11] Ludwiga repens caused allergic dermatitis in 28 year old packer from handling. [13.2] 12 cases of middle aged workers, 10 years exposure, caused by all above plants. Contracted contact utricia, phytodermatitis from handling plants. Research technician is reported to have handled 9 million bulbs in one year. A survey of Italian Floriculture centres reported 30 % of workers had dermatitis. [13.3]

6.2 Florists [14] [15]  [5 ]  [13.4]
Flower arrangers, Growers, Handlers, Distributors Florists

are at a great risk because they work with a wide variety of exotic plants, they often work in unhygenic conditions and poorly designed shops, and do not wear protective clothing. The majority
of workers are poorly trained. 90 % have  a rash or suffer permanent dermatitis, do not wear protection and are seldom treated. Working  with wet plants exacberate the condition. Florists tend
to have hyperkeratosis, fissuring erythremos ash, tenderness of tips. Onycholysis may also occur. Depigmentation may also be observed. They  are at risk from
Cypresses, Hyacinth, Lilly, Rose,
Lilly, Ruscus, Gerbera, Carnations, Gypsophilla, Gloxinia, Broom, Limosa, Euphorbia.

Cross sensetivity is common. 

Cases: Florist 20 month history of eczema from handling Trachelium caeruleum and
Chrysanthemum. Gradual swelling and erythrema of forearms and hands occurred.[14] Florist contracted utricaria from wreathmaking. [15] Florist 20 month history of eczema from handling Trachelium caeruleum and Chrysanthemeum. Gradual swelling and erythrema of forearms and
hands occurred.
Parthenium hysterophorus causes epidemic phytodermatitis in Indian florists,
and in Western Germany
[5 ]  Euphorbia marginata caused dermatitis in a female flower arranger
28, from milky latex.
[13.5] Male florist with 20 month history of dermatitis from contact
Trachelium caernuleum. [13.6]

6.3 Bulb Industry [15 ] [11]
Bulb packers, Harvesters, Handlers, Distributors, Growers

This condition is commonly found in the Bulb and Corm growing areas of England and Netherlands.
Amaryllidaceae, Galanthus, Daffodil, Narcissus and Jonquils have been cultivated for 300 years and are grown commercially in the Isles of Scilly, and Cornwall on a large scale. Tulips have been grown for 400 years in the Netherlands. Tulipa 'Keisekroon' and 'Rose Coperland' were found to be worst. It also occurs from Alstromeria and Peruvian Lilly. The bulbs have abrasive skins, and sharp oxalate crystals in the leaves. It occurs in those who handle, divide and pack bulbs. Wet work and bad weather can contribute to the condition.

Many school children and temporary workers are employed in this industry, without contracts
or protective clothing. Berstwile
[11 ] reported in 1985 that 80% of all workers suffer from minor dermatitis, but seldom report it. 30% of all workers are affected seriously but few receive treatment, as they do not qualify. The condition is a dry painful dermatitis. Skin will become macerated,
abraded, and if sensitisation develops, thighs and genitals may be affected. Fissuring may occur
under the free edges of the fingernails, spreading to periungal regions of the fingers and hands.
Nails often separate painfully. The face can also inflames from wiping hands on the face. In
severe cases the whole body can inflame in Tulip Fire. Full time workers may develop 'Tulip Fire' after years of handling, this includes tingling of the fingers, tenderness, erythrema, painful skin
and fissuring. Nails may fall off from exudation and abscess. Hyacinth itch may cause violent
puritus with erythrema, papules and vesicles. Secondary disorders are common.  They will react
to the bulb in 20 years time if sensitised. It is less common in florists. Washing in weak acid seems
to cure. It was first noticed in 1910 in the Scilly Isles in those who handle flowers stems. In a
day a worker may handle 2000 plants. Allium species
[5] : The allergen of this plant has not
been isolated.  It causes irritant dermatitis and hand dermatitis, not unlike Tulip finger.

Cases:[5] Man developed rash on hands face from handling the plants. Alstroemeriaceae and
Lily species contain tulip compound allergens. It affects employees in  large floriculture centres,
through handling of stem and leaves.

6.4 Timber & Woodlands Industry [9] [11]
Tree Nurseries, Aboriculturists, Forestry Workers

These workers come into contact with irritant chemical in very large quantities, because of the large size of the plants they are working with. Sawing, cutting and pruning may cause quantities of sap or sawdust to become airborne and get into all part of the clothing. Huge amounts of pollen may be encountered in woodlands, which will cause irritant reaction internally and out.. Also handling of the leaves from potting, pricking or moving will elicit a reaction. Although people in his industry wear full protective clothing, especially when sawing trees, the sawdust and pollen enter through the neck sleeves. Common chemicals encountered may be alkaloids, phenols, saponins, glycosides, commonins. The reaction usually occurs on the face neck and limbs. The condition is largely ignored, and improves during holiday periods. These workers may come into contact with a condition known as Pine and Cedar poisoning. This is due to contact with
Frullania and Liverwort plants, which grow on trees. Slashing, cutting and burning of these plants will elicit reactions.

The worst cases are seen in forestry workers who help to combat fires, and are subject to the urishols released by the burning of these plants. It causes a sensitive reaction, that may inflame in 15 years time.
Rhus Dermatitis [5] : In the USA Rhus species is a common cause : Blacks are not susceptible.  70% of the population of USA would be affected if exposed. It is due to a milky sap which occurs in the leaves, stems, and turns black in Oxygen. The eruption caused is an allergic eczematous dermatitis characterised by redness, papules, vesicles. erythrema and morbilliform and scaratiniform eruptions.  The antigens may brush off onto clothing , and effect people indirectly. Soap and water is effective in negativising the compound. It is a most serious condition and can lead to kidney damage, leukaemia. 50 % of people in this industry have been sensitised to Poison Ivy.

Cases: Poison Ivy dermatitis eruption on arms of a man after pruning the plant in summer. He was wearing gloves but his sleeves were rolled up.[ 9 ] An Elm tree caused dermatitis from brushing against the leaves in a gardener, which developed in 24 hours.[13.7] Student pulled up Ailanthus altissima The Tree Of Heaven as a weed, the sap of which soaked his arms, which developed into a rash.[13.8] A 57 year old developed an itchy dermatitis after 9 years of transplanting Pinus paulustris She never wore gloves.[13.9] A tree surgeon 24 developed a rash under his helmet from Poplar species buds and leaves.[13. 10] 55 year old woman developed dermatitis from Eucalyptus pollen whilst gardening.[13.11] Seven subjects developed scaly dermatitis after walking through woods and fields, contact with Frullania dilata and Tamariscis suspected [13.12] Dermatitis in rural workers and forestry workers in wet weather work from dust caused by rain falling on Evernia, Cladonia, Usnea, Parmelia lichens.[13. 13]

6. 5 Horticultural Field Workers
Vegetable, Fruit, Herb, Crop Growers & Workers

Those working in the field may come into contact with a wide variety of weeds or cultivated plants, from general handling, weeding or cutting, lifting or planting. The most common occurrence is Photodermatitis, from Foumocumarins contained in many fruits and vegetables. such as celery, onion and carrot. Cases also from potatoes leaves, tomato.  Many weeds occur in the field, notably
Taraxacanum, Achillea, Tansy, which the workers may have to hand pull. Bromeliaceae Pinnaple Family: The juice of the fruit on the skin causes considerable damage. It is destroyed by heating for consumption. Pinnaple handers in the absence of protective clothing and mechanisation often sensitise. After a few days work with 'Mauritius Pine' species, the skin will become raw red and fissured,  the person will then be unable to work. [11]
Hop Pickers Rash
Humulus lupus: A climbing plant widely cultivated to provide hops for the brewing industry. The hands of pickers are subject to irritations from the spines when removing hop cones from the stalks. The condition is often exacerbated in wet weather, because the spines are made firmer  Thousands of people in the industry are affected, but leave the work before the condition can be treated or reported, and is often mistaken for other diseases. [9] [13.14 ]

Harvesting Lovage: White female 27, harvesting Lovage on a farm of herbs in Canada experienced itching, vesicles due to extensive handling of Levisticum officionale in sunny conditions, when the bristly hairs becomes sharpened. A case of photodermatitis. [14]  Mushroom Growers experienced cutaenous dermatitis which was itching and spreading from handling Lentinus edoles the Shiitake mushroom. 
51 patients treated by one dermatologist in 10 years.
Pleurotus ostreatus harvester experienced Chronic dermatitis in September to June. [14] [13.16 ]
Phytodermatitis occurred from Celery, a cash crop in South Hertfordshire in a gang of harvesters, who developed rash, swelling and redness of light exposed skin
Kiwi Fruit Vine: A 52 year old orchadist had a two year history of hand and face dermatitis from handling the vine
[13.18] Pastanaca sativa: caused phytodermatitis in a group of harvesters on an organic baby food farm. Itching and redness developed on light exposed areas. Fruit pickers are susceptible to Mango magnifera induce., which will affect all body. and genitals. Anacardium occidental Cashew nut oil form the nut in nut pickers and breakers may cause widespread dermatitis. [9 ]
Chicorum endiva is a widely grown food crop. A produce manager reacted violently to the leaf.[5] Ragweed Oil Dermatitis : Many men in the industry suffer from contact with the plant, the condition may worsen each year. [11 ] Citrus Fruit Growers: Fruit and thorns cause trauma and irritation in wet work. Due to alkalis drying on skin. [11 ]

6.6 Groundsmen [6]
Golf Courses, Amenity Parks, Pitch Workers

These workers seldom touch any plant at all, and frequently are well protected on top of their mowers. However, they may often come into contact with airborne particles of pollen and grass from the churning of the mower, which may get into all parts of the clothing, and is frequently inhaled, causing pollen dermatitis, phytodermatitis and allergic reactions.. Also, contact from hand weeding, and contact with grass mowings may elicit a reaction. Airborne particles of Yarrow, Achillea millefolium, Taraxaceum officionale, Sysumbrium officionale, Chamomiles, may land on face and arms neck causing erythremous rash. These workers are particularly vulnerable because they do not often wear protective equipment when mowing or strimming.

Cases; 74 year old facial dermatitis after mowing the lawn. 57 year old, from mowing the grass each summer, developed a facial erythremous rash. 63 year old dandelion picker. 54 Year old council worker from mowing the lawn. 63 year old golfer from mowing the lawn. [6] Cases with Taraxacanum officionale: 74, 57, 63 year old gardeners affected after mowing of the lawn.[13.9] Compositae dermatitis is common in golf green keepers. Many encounter it from secondary exposure to oleoresins on clothing. These may aggravate pollen dermatitis. Most are 40 to 50 years old.[5 ]
54 and 63 year old experienced flare up on face after weeding in grass
[9 ]

6.7 Professional Horticulturists
Gardeners, Parkeepers, Landscapers, Botanists.

People employed in this profession come into contact with the widest variety of plants in all the industry, and are often working out of doors without protective clothing. They often have to undertake the activities of all the above professions in confined spaces, and carry out a wide variety of tasks, such as pruning, propagation, moving, potting, which causes contact with many plants. Common cases come from the weeds of the Compositae family,  Taraxacanum, and exotic evergreens.

44 year old contracted itchy dermatitis and vesiculation from handling Hedera helix.[13. 20] Landscape architect Presented eruptions from cutting Agave americanum variagata. [13. 21] Gardener, 43, developed swelling in arms, hands and neck after cutting a hedge of Cotoneaster horizontalis.[13. 22] Codiaeum The Crotons family, and  cultivars of Codaeum varigatum, are widespread. Croton tiglium is highly irritant, and contact is by brushing or crushing the leaves. Florists, nursery workers and delivery drivers have been affected. Anarcadium Family, includes  Toxidendron; radicans; diversilobum; querquifolium; vernix: Allergens occur throughout the plant. It produces the most potent chemicals known, urishol, which blackens from contact with Oxygen. Brief contact will sensitise a large portion of the body.  The same is seen in Smodingium argutum the Cashew Nut. Allergy is widely seen in people 10 to 40 years old, most  occur in spring. Gardeners, weeders and groundsmen are at risk. A few seconds contact can cause eruptions. Itch and erythrema precede streaky papules and vesicles.. In severe attacks, oedema and bullae occur with facial upset. Scindapsus aureus sensitises nurserymen commonly and florists.[9 ] Araliaceae:Hedera canariensis: causes more cases of dermatitis, because it needs more pruning, sap causes dermatitis among gardeners. After exposure the wrists and face have urticario papular lesions with linear streaks. In severe cases pruritus is common, and eruption  is vesiculous, bullous with prominent striae and streaky markings.[9 ] Interior Plants: Chrysanthemum: asters, daises,  Dermatitis occurs in the late fall and early winter, during the blooming season.  The blooms also emit a pollen, infecting the face. It is a widespread condition. Diffenbachia & Philodendron: many types will cause dermatitis. Hands and arms are most affected. Exposure from touching, washing or plucking the leaves. Oleander: Causes sensitisation and subsequent dermatitis. Children are often affected. Castor Plant Oil : Occurs from the juice of the bean, leaf and stem. farmers often affected. [5] Deramtiis From Aqueous Plants: An irritant from contact to algae has been reported., caused by the blue green algae. A seaweed, Lyngbya majuscula has also caused it, and is commonly distributed throughout Tropical Pacific and Indian Oceans. The eruptions are seasonal. Humea elegans is reported to cause violent dermatitis in gardeners. Lacttua sativa also caused widespread dermatitis in a gardener [5] Greenhouse gardener let latex drip onto his arm when pruning Synadenium grantii. He experienced burning of his face
and neck
[11 ] Ginko biloba fruits fell on grassed area, gardener received eruptions from squishing juice onto his legs.[11] Vertena elegans 'Cleopatra' affected a 23 year old Danish gardener. 16 year old apprentice gardener developed dermatitis which worsened after many years causing rhinitus, and itchy anterior rhinorhhea

       Dermatitis In the Horticulture Industry By James M. Burton In Association With Pencoed College Copyright 1997..
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Plant Causes Who Is At Risk?