Lesson 13: Safety

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Required Reading

Foundational Aromatherapy 1st edition pages 331-343

Foundational Aromatherapy 2nd edition pages 399-409

Safety and Ethics

Safety First

Treat the essential oils with respect, and they (and you) will be there when you need them.

  • Keep oils out of direct sunlight.
  • Avoid high heat, especially for extended periods of time.
  • Since essential oils can oxidize, do not keep the lids off for periods of time longer than 15 to 20 minutes.
  • Essential oils are very powerful, pure, and highly concentrated so always use in small amounts.
  • Never take  essential oils by mouth unless directed by a qualified practitioner.
  • Do not replace medications except under the guidance of medical practitioner.
  • Aromatherapy is not to be used to replace proper medical care.
  • Under no circumstances are essential oils to be placed in the eyes or ears of any person or pet.
  • When misting with essential oils hold the bottle over your head, close your eyes, and mist all around you. With children and pets you may want to cover their eyes. When diffusing, make sure the mist does not flow in the eyes of those in the room.
  • Keep all essential oils out of reach of children. Always make sure the lids are securely tightened. In case of ingestion, have them drink milk and call your local poison control or health care center.
  • When applying  essential oils, especially any of the “hot” oils, remember that you will also have oils on your hands. Do not use water to clean them; pour liquid dish soap, Grape seed blending oil,  antibacterial foam on your hands first to “lift” the oil then wash your hands.
  • When blending your own, or a classroom blend, always make sure to label the new bottle. Include the oils used as well as the number of drops; in case you want to do it again.
  • Keeping a file of favorite oils, why you like them, what you used them for, as they pertain to you and your family is a good idea.
  • Always make sure to buy from reputable sources to ensure they are not cut or thinned with substances that could be harmful.
Essential Oils and Drug Interaction Safety

Recognizing basic information about drugs.

Drugs cannot alter the natural functions of the body. They only heighten, quicken, block, or decrease physiological activities that the body is already capable of doing on its own. The same principle is applied to any type of healing mediums we offer to the body—whether it be herbs, essential oils, massage, etc. Our bodies are highly intelligent systems that gravitate towards balance or homeostasis. When a physical system gets out of sync, symptoms usually arise. The symptoms then are identified as different ailments or disorders depending on the method being used to diagnose them. Regardless of the type of treatment received, oils can only assist the system to return to balance, as they only support functions the body is already capable of performing.

Drug Interactions and Essential Oils

There is very little research on drug interactions with essential oils. But, we do have some knowledge on how single chemical components of essential oils can affect physiological processes in the body. From the results of testing done with individual components and the knowledge of drug reactions, we can only theorize what the outcomes may be. Common sense recommends using essential oils usually on the exterior of the body, and in small amounts for some people, such as those who are taking several medications, have weakened liver function, compromised kidney function, or who are suffering from chronic diseases. This includes the elderly or very young.

Pharmaceutical drugs frequently hold highly concentrated single components.

As you may know, essential oils and the plants they are derived from are made up of many different chemical components. Researchers often search to discover a single active component in the plant, with the view that the one active component is responsible for a whole function. Once a component is discovered, researchers or scientists look for methods to produce that single element artificially, so they do not have to depend on the plant as the only supply. By manufacturing an element artificially, a single different atom is often added to the molecule, creating a new molecule with a specific function. It is then considered a new molecule and can be patented and sold for profit. With some slight alteration, they copy something created by nature and consider it an invention of their own.

An essential oil is a more specific creation than the complete plant, but it is still a group of several constituents. Specialists who study plants realize that all of the parts of a plant work as a unit to perform its desired function. It is then assumed that the stability of the components produced by the plant matches the human body’s capability to digest them.

The measure of a combination of components found in a whole plant is less than a single highly concentrated measure found in pharmaceuticals. This creates a safer mediation, but may take longer to act than a synthetic drug. The reason there are side effects in pharmaceuticals is the fact that the amount of the dose and the molecular structure of the component is not known by the body, and our bodies are not complex enough to handle large amounts of one component. The product of a whole plant is familiar and processed by the body in an easier manner.

Absorption or Cleansing

Any material that goes into the body must be metabolized, or broken down, into smaller particles. An individual cell cannot possibly consume a whole product. Visualize the tiny size it must be reduced to for a cell in your toes to consume. Your body also has a way of filtering out the bad parts of any material and preparing them for elimination. The combined process of breaking down material, and filtering out the contaminated from the useful is metabolism and detoxification.

All pharmaceutical drugs, herbs and essential oils must be absorbed and detoxified. Detoxification primarily takes place in the liver. The liver takes the harmful materials out of the blood, breaks it down into safe parcels and directs the toxins to the kidneys or intestines to be emitted. As the liver takes the toxin out of the blood, the effects of the drug or essential oil is lessened. The purpose of taking an ibuprofen every eight hours is mainly because after that amount of time, your liver has cleared the dosage out of your system.

Contact Between Drugs and Essential Oils

There are three main types of interactions:

  1. An ingredient can disturb the rate of detoxification of a drug. If this happens there are two possibilities: The first is if the rate of detoxification is increased, and the drug will be removed from the body more quickly than the usual eight hour time period between each dose. The second possible outcome is if the rate of detoxification is decreased, and the drug will stay in the blood stream for a longer period than the usual eight hour period. When this occurs taking a medication every eight hours will cause an increase of drugs into their system and they will start to feel the side effects of the overdose of medication.
  2. An ingredient can support a physiological action that is conflicting to the drug. The essential oil may delay a function while a drug is speeding up the same function. This cancels out the drug’s original purpose and basically creates a reduced dose of the drug. The outcome could be a quicker return of symptoms that the drug was originally created to decrease.
  3. Essential oils can create the same physiological function of the drug. If the essential oil supports the same effect as the drug, then an increased amount is applied to that process. This will act as a double dose and the feeling of an overdose.
Cautions to Consider

1. Oils Unsafe Any Route – Antidepressants
The essential oils Lemongrass, May Chang, Lemon Myrtle, and Honey Myrtle should not be used in any form with antidepressants (specifically Buprion) that inhibit CYP2BC. These oils may potentate or make the drugs actions stronger. The risk of this—based on research—is theoretical according to Robert Tisserand in his book Essential Oil Safety.

2. Oils Unsafe Orally – Diabetic Medications
The same essential oils—Lemongrass, May Chang, Lemon Myrtle, Honey Myrtle— should not be taken orally when taking anti-diabetic medications. The reason for this is because these oils contain the constituent citral. Personally, (other than a yummy fish dish which contains a very minute amount of citral) I would not take any of these oils orally.

3. Oils Unsafe Any Route – Other Drugs
The essential oils Balsam Poplar, German Chamomile, Blue Tansy, and Yarrow should not be used while taking Codeine or Tamoxifen. Also, they may increase the effects of the antidepressants quinidine, fluoxetine, and paroxetine. This also is considered theoretical.

4. Oils Unsafe Any Route – Renal Drugs
The essential oils Clove, Thyme Thymol, and West Indian Bay should not be used when taking drug treatments that increase renal (kidney) blood flow or for severe renal (kidney) disease.

5. Oils Unsafe Any Route – Severe Liver or Kidney Issues
Individuals with severe liver or kidney issues will need to be careful to not over use essential oils, to avoid internal use, and to follow dilution recommendations. Because the liver functions to metabolize and detoxify the chemical constituents of essential oils and the kidneys excrete what the body does not use, it is important not to overtax the liver or kidneys. For compromised immune systems, it is important to use essential oils in moderation and always follow the Dilution Chart.

6. Oils Unsafe Topically – Medical Patches
If using a medical patch to transmit drugs into the body, avoid using essential oils at the site or near the area where the patch will be. Essential oils could possibly interact with the absorption of the drug, either by speeding up or slowing down the rate of absorption changing the dosage of the drug.

7. Oils Unsafe Orally – Antidepressants or Ephedrine
Clove or Nutmeg, if used with antidepressants or ephedrine, could cause dangerous blood pressure changes resulting in tremors or confusion or other serious cardiovascular symptoms.

8. Oils Unsafe Orally – Bleeding Disorders
Clove, Thyme Thymol, Oregano, Birch, and Wintergreen tend to thin the blood and should not be used orally by individuals with clotting or bleeding disorders, peptic ulcers, during childbirth, major surgery, or by anyone on blood thinners. These oils could cause internal bleeding.

9. Oils Unsafe Any Route – Aspirin Sensitivity
Aspirin-sensitive people should not use Birch or Wintergreen. Both have a component (methyl salicylate) that acts like aspirin in the body.

10. Oils Unsafe Any Route – Anesthetic Drugs
Barbiturates, benzodiazepines or anesthetics may have possible interaction when used with any oil that is considered a sedative. Be sure to check the properties on the Single Essential Oil profiles for the term sedative.

11. Oils Unsafe Orally – High Blood Pressure Medications
Peppermint should not be used by individuals taking high blood pressure medications or calcium channel blockers; it may alter the effects of the drugs. Peppermint should also be avoided by individuals taking medication for gastro esophageal reflux disease (GERD).
A Special thank you to Andrea Butje and Aromahead Institute.

AIA Safety Statement

(Used with permission of Alliance of International Aromatherapists)

Internal Use Statement

AIA does not endorse internal therapeutic use (oral, vaginal or rectal) of essential oils unless recommended by a health care practitioner trained at an appropriate clinical level. An appropriate level of training must include chemistry, anatomy, diagnostics, physiology, formulation guidelines and safety issues regarding each specific internal route (oral, vaginal or rectal). Please refer to the AIA Safety Guidelines for essential oil use.

Use of Essential Oils in Pregnancy

There are differing opinions regarding the use of essential oils during pregnancy, labor and delivery. AIA recommends that schools of aromatherapy include an educational component regarding the appropriate and safe uses of essential oils during pregnancy including patho-physiology, risks and benefits. This will include, but is not limited to, emmenagogue and abortifacient essential oils.

Including a safety-based educational component relating to pregnancy will prepare the qualified aromatherapy practitioner to determine safe oils for each trimester, appropriate dilution and a variety of uses of essential oils to complement routine maternity care. Aromatherapy practitioners will avoid using any essential oil when safety issues are uncertain.

Is it safe to use essential oil “neat” (undiluted) on the skin?

Essential oils are concentrated substances, and because of this we do not recommend using them without diluting them first. Add essential oils to a carrier oil such as jojoba, coconut, almond, or others, before using. Diluting them in this way provides a measure of protection from skin irritation, allergic reactions, and even sensitization.

A general rule of thumb for diluting is to use a 1% dilution for children (aged 6 years and older); pregnant women; elderly adults; those with compromised immune systems, sensitive skin, or other serious health issues. A 2% dilution is acceptable for the average adult with no health issues. Higher dilutions can be used, depending on the situation and the health of the person they will be applied on. We recommend that you use the lowest dilution possible that provides effective results.

Note: A 1% dilution would be adding 3 drops of essential oil per tablespoon carrier.

Statement on Raindrop Technique

Raindrop Technique (RDT), Aroma Touch and similar techniques do not meet the criteria for safe practice, as defined by the AIA Standards of Practice. There have been reported adverse effects regarding RDT, in particular. These techniques are typically practiced as a one-size-fits-all technique, and may not be suitable for people with compromised liver or kidney function, those with heart disease, those on blood thinning medication, those with allergies to aspirin, and other disorders. Janice Gagnon-Warr has given AIA permission to reprint the paper on RDT.

Safety and Ethics of Undiluted Oils

This is a special paper written by Tony Burfield and Sylla Sheppar-Hanger in 2005. Sylla Sheppard-Hanger has given AIA permission to reprint this article.

General Safety Guidelines (Storage, Dilutions, How Used)

Essential oils are highly concentrated substances and should always be diluted before applying to skin. It is important to be aware of the chemistry and the quality of the oils being used. Use only high quality oils from reputable sources. Store oils in a cool, dark place. Dosage is another important factor in aromatherapy. Too much of certain oils can irritate skin or cause other side effects. Essential oils are always applied to the skin in combination with vegetable and nuts oils, gels, lotions, butters, salts or other herbal ingredients. Always lower the dosage for children, elderly, pregnant women or anyone with serious health conditions.

 
Code of Ethics

(Used with permission of Alliance of International Aromatherapists®)

  • As a member of the Alliance of International Aromatherapists, I shall:
  • Conduct myself in a professional and ethical manner in relation to my clients, health professionals, and the general public.
  • Recognize that the public has the right to share in decisions pertaining to their health care. I shall educate and guide clients toward this goal and actively encourage them to take responsibility for their care and well-being.
  • Represent my education and qualifications honestly in advertising and practice and acknowledge the limitations of my skills, as indicated.
  • Provide the highest quality of aromatherapy products available.
  • Provide services within the scope and the limits of my training and to refer to appropriate qualified professionals as indicated.
  • Maintain professional confidentiality except when failure to take action could constitute a danger to others.
  • Refrain from guaranteeing a specific wellness outcome, acknowledging that aromatic extracts support self-healing and that holistic health outcomes are influenced by many factors.
  • Visibly display a copy of the AIA code of ethics for the benefit of employees and the public.
  • Avoid discrimination against individuals on the basis of race, creed, religion, gender, age and national origin.
  • Appreciate the importance of thoroughness in the performance of duty, compassion with clients, and the significance of the tasks I perform.
  • Respect the law and avoid dishonest, unethical, or illegal practices.
  • Refuse primary responsibility for health care for any client. Individuals who are licensed or otherwise authorized to provide primary health care are excluded.
NAHA Safety

National Association for Holistic Aromatherapy

(Used with permission from NAHA.org)

For NAHA’s safety page, please visit: http://www.naha.org/explore-aromatherapy/safety/

NAHA is frequently asked about techniques such as “drop therapies” which commonly use undiluted, dermal sensitizing essential oils, internal use, undiluted application as well as questions about companies who recommend the indiscriminate use of essential oils. Here are our safety statements regarding each of these modalities.

Certain essential oils are unsuitable for internal use and application on the skin, or contain constituents which may irritate or sensitize the skin if applied without first being properly diluted in a carrier. NAHA does not condone the indiscriminate use of such essential oils.

  1. Internal Use: Do not take essential oils internally without appropriate advanced aromatherapy education and understanding of the safety issues involved in doing so. To learn more, we recommend you receive education from a NAHA approved school. Many individuals throughout the United States and the world are utilizing essential oils internally. Most are doing so without appropriate knowledge or understanding of how, when, how much, what essential oils, for what purpose, safety concerns, etc. Whilst NAHA does not support the uneducated use of essential oils internally, we are dedicated to providing education in this area so that internal use is better understood and if done, is performed safely and effectively.
  2. Undiluted Application: Certain essential oils are unsuitable for undiluted application on the skin, or contain constituents which may irritate or sensitize the skin if applied without first being properly diluted in a carrier. NAHA does not support the use or application of undiluted dermal sensitizing essential oils. NAHA recommends diluting essential oils down in a suitable carrier (e.g. vegetable oils, full fat milk, etc.). To learn more, we recommend you receive education from a NAHA approved school.

General Safety Precautions

  1. Keep all essential oils out of reach of children and pets.
  2. Do not use or recommend the use of photosensitizing essential oils prior to going into a sun tanning booth or the sun. Recommend that the client stay out of the sun or sun tanning booth for at least twenty-four hours after treatment if photosensitizing essential oils were applied to the skin.
  3. Avoid prolonged use of the same essential oils.
  4. Avoid the use of essential oils you know nothing about on your clients. Research and get to know the oil prior to using it on others.
  5. Avoid the use of undiluted essential oils on the skin, unless otherwise indicated.
  6. If you suspect your client may be sensitive to specific essential oils or if your client has known allergies or sensitivities, it may be wise to perform a skin patch test.
  7. Know the safety data on each essential oil and place into context of use and knowledge.
  8. Use caution when treating a female client who suspects she is pregnant or has been trying to become pregnant.
  9. Keep essential oils away from the eyes.
  10. Essential oils are highly flammable substances and should be kept away from direct contact with flames, such as candles, fire, matches, cigarettes, and gas cookers.
  11. Make sure your treatment room has good ventilation.
  12. Do not use essential oils internally unless properly trained in the safety issues of doing so. Please visit NAHA’s approved schools to explore education in aromatherapy.
Safety Measures
  1. If an essential oil accidentally enters the eye, apply a vegetable oil (e.g., olive or sunflower, et al) or milk to a cotton cloth or similar material, and carefully swipe over the closed lid.
  2. If an essential oil causes dermal irritation, apply a small amount of vegetable oil or cream to the area affected and discontinue use of essential oil or product that has caused dermal irritation.
  3. If a child appears to have drunk several spoonfuls of essential oil, contact the nearest poison control unit (often listed in the front of a telephone directory). Keep the bottle for identification and encourage the child to drink whole or 2% milk. Do not try to induce vomiting.
Safety Information

Safety involves a state of being free from risk or occurrence of injury, harm, or danger. Individuals who practice aromatherapy need to be aware of the safety issues involved with using essential oils in order to avoid potential adverse effects. According to Burfield, “Although many essential oils are potentially hazardous materials, if handled in the appropriate manner, the risks involved in their use can be very small. So therefore, most commercially offered essential oils are safe to use for the purpose intended in a domestic/ professional or clinical environment.”1 The informed use of essential oils may create occasional irritation or minor discomfort, but it is extremely unlikely to create serious injury or lasting physical problems, particularly when basic guidelines are followed.

Factors that Influence the Safety of Essential Oils Include
  1. Quality of essential oil being utilized: Adulterated essential oils increase the likelihood of an adverse response and hence the need for pure, authentic, and genuine essential oils is of the utmost importance.
  2. Chemical composition of the oil: Essential oils rich in aldehydes (e.g., citronellal, citral) and phenols (e.g., cinnamic aldehyde, eugenol) may cause skin reactions. Essential oils rich in these constituents should always be diluted prior to application to the skin. According to Schnaubelt, “diluting such oils so that the resulting solution becomes non-irritant, may require diluting them to concentrations much lower than in normal circumstances. Another option is to blend such irritant oils asymmetrically with other essential oils, which mitigate their irritant effects.”
  3. Method of application: Essential oils may be applied on the skin (dermal application), inhaled, diffused or taken internally. Each of these methods have safety issues which need to be considered. The potential safety concerns with dermal application will be discussed below. With regard to inhalation, inhalation, from a safety standpoint, presents a very low level of risk to most people. Even in a relatively small closed room, and assuming 100% evaporation, the concentration of any essential oil (or component thereof) is unlikely to reach a dangerous level, either from aromatherapy massage, or from essential oil vaporization. Tisserand and Balacs further point out that “the only likely risk would be from prolonged exposure (perhaps 1 hour or more) to relatively high levels of essential oil vapor which could lead to headaches, vertigo, nausea and lethargy”. With regard to internal use, the safety concerns of this method of application will be explored in more depth by the National Association for Holistic Aromatherapy over the next two years.
  4. Dosage/dilution to be applied: Most aromatherapy oil based blends will be between 1 and 5 percent dilutions, which typically does not represent a safety concern. As one increases dilution, potential dermal (skin) reactions may take place depending on the individual essential oil, the area in which the oil is applied, and other factors related to the client’s own sensitivity levels. Any excessive usage of essential oils may cause irritation or other undesired effects due to their lipophilic nature.
  5. Integrity of skin: Damaged, diseased, or inflamed skin is often more permeable to essential oils and may be more sensitive to dermal reactions. It is potentially dangerous to put undiluted essential oils on to damaged, diseased or inflamed skin. Under these circumstances the skin condition may be worsened, and larger amounts of oil than normal will be absorbed. Sensitization reactions are also more likely to occur.
  6. Age of client: Infants, toddlers, and young children are more sensitive to the potency of essential oils and safe dilutions include .5 – 2.5% depending on condition. Also, some essential oils should simply be avoided for this population, e.g. Sweet Birch or Wintergreen, which are both rich in methyl salicylate and Peppermint. Elderly clients may have more skin sensitivities so a reduced concentration/dilution may be indicated.
Pregnancy Safety

(Used by permission of NAHA.org)

The use of essential oils during pregnancy is a controversial topic and one that is yet to be fully understood. The main concern during pregnancy appears to be the risk of essential oil constituent’s crossing over into the placenta. According to Tisserand and Balacs, crossing the placenta does not necessarily mean that there is a risk of toxicity to the fetus; this will depend on the toxicity and the plasma concentration of the compound.9 It is probable that essential oil metabolites cross the placenta due to the intimate (but not direct) contact between maternal and embryonic or fetal blood. Tony Burfield goes on to say, “to my thinking the responsible attitude is to discourage the use of essential oils completely during the first few months of pregnancy”.

Jane Buckle comments “the use of essential oils in pregnancy is a contentious subject, especially during the vital first 3-month period. It is extremely unlikely that a nightly bath containing a few drops of essential oils will cause any problems for the unborn child” and later states “there are no records of abnormal fetuses or aborted fetuses due to the ‘normal’ use of essential oils, either by inhalation or topical application.”

According to Wildwood, “A common myth in aromatherapy is that massage oils containing essential oils such as Clary sage, rose or even rosemary can cause a miscarriage and hence should be avoided throughout pregnancy. Authors such as Ron Guba, Kurt Schnaubelt, and Chrissie Wildwood have all pointed out that there have been ‘no recorded cases of miscarriage or birth defect resulting from aromatherapy massage using therapeutic applications of any essential oil.”

Ron Guba points out that toxicity during pregnancy is almost exclusively due to pregnant women taking large, toxic doses of essential oils, notably pennyroyal (rich in the ketone, pulegone, which is metabolized to the highly toxic furan epoxide, menthofuron) and parsley seed (rich in the dimethyl ether, apiol) in an attempt to abort the fetus. And Battaglia shares this insight: “the judicious use of essential oils together with appropriate forms of massage by a skilled therapist can help ease the discomforts of pregnancy and provide a sense of nurturing that will comfort the mother at times she is likely to be feeling rather fragile.”

Due to the lack of clear information regarding the toxicity of essential oils during pregnancy, it would be best to adhere to general safety guidelines. According to Tisserand and Balacs, the following essential oils should not be used during pregnancy: wormwood, rue, oak moss, Lavandula stoechas, camphor, parsley seed, sage, and hyssop.

Essential oils that appear to be safe include cardamon, German and Roman chamomile, frankincense, geranium, ginger, neroli, patchouli, petitgrain, rosewood, rose, sandalwood, and other nontoxic essential oils. It would also be prudent to avoid the internal or undiluted application of essential oils throughout pregnancy.

Essential Oils to Avoid throughout Pregnancy, Labor, and While Breastfeeding

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