AT 101 Module 2

Question 1

Explain general safety as it pertains to the use of essential oils.

Answer 1

Most essential oils represent little or no risk if used correctly in aromatherapy, however just as other natural products may be toxic (i.e. hemlock) and some essential oils that are considered to be hazardous.
When using essential oils, we must take into consideration the dosage, frequency of use and application of a particular essential oil to determine if it poses a threat

In general, toxicity is dose dependent. The greater the amount of essential oil applied, the greater the risk of toxicity. The degree of toxicity depends on the route of application, and oral administration carries the highest risk.

The main reason an essential oil will pose a toxicity risk is oral overdosing, however similar results may be expected if the same amount of essential oil enters the body topically

Understanding the chemistry of an essential oil is a very useful basis for understanding essential oil toxicity. The chemistry of essential oils is complex and many of the compounds that make up the oils are hard to detect (trace elements).

Question 2

Define the term irritation as it pertains to essential oils.

Answer 2

Irritation is a difficult condition to define. Some essential oils classified as potential skin irritants may not provoke a reaction in everyone. Conversely, a person may have an idiosyncratic reaction to an essential oil that is considered safe for the skin.

It is recommended that a person with sensitive skin do a patch test on a small area of skin before using the essential oil(s). This can be done by applying the essential oils) at double the concentration they would normally be used to the inside of the forearm (place drops on a bandage and then apply bandage to the skin). Leave for 24 - 48 hours. If there was irritation, it will present as redness, itchiness, swelling or blistering.

Essential oils with high proportions of either aldehydes or phenols are often the culprits in provoking irritation.

Question 3

Define the term sensitization as it pertains to essential oils.

Answer 3

Sensitization (allergic skin reaction)
A skin allergy is a systemic reaction and autoimmune response which usually manifests as a rash. A Japanese study showed that the skin of men tends to be more than twice as sensitive as that of women. This study also showed that in situations of severe stress, lack of sleep etc. all skin types become more sensitive. Once a person has experienced sensitization to a particular essential oil, they will likely always have an adverse reaction to that essential oil.

Dermatitis is usually an indication that a person’s skin is sensitive and so avoidance of the essential oils that typically cause irritation should be avoided or used with extreme caution.

Question 4

What is usually a good indication that a person’s skin is sensitive.

Answer 4

Dermatitis

Question 5

Define the term toxicity as it pertains to essential oils.

Answer 5

• Acute toxicity refers to poisoning by way of ingesting or the absorption of too much essential oil at one time.
• Chronic toxicity occurs when a small amount of a potentially toxic essential oil is repeatedly applied over a period of time and is thus damaging the body in some way or when any essential oil is used in excess over a period of time. Toxicity can also occur if a person has either liver or kidney impairment or disease.

Toxicology also includes the study of hazards related to pregnancy and cancer, skin allergy and/or phototoxicity, liver and kidney dysfunction, effects on the CNS and the endocrine system and damage to the eyes.

Although some people may experience idiosyncratic reactions to particular essential oils, in general toxicity is dose dependant. However, there are some instances where even low amounts can produce severe reactions such as allergies and phototoxicity.

The degree of toxicity also depends on the mode of application and oral ingestion carries the highest risk — especially if the essential oil is taken undiluted.

Question 6

Define the term quenching as it relates to essential oils (hint: there are two ways quenching can occur). Give a couple of examples.

Answer 6

1. Individual components in essential oils are known to have certain toxic effects and yet in the whole oil these effects are often quenched by one of the other components contained in the oil. For example, citral on its own is a skin irritant while the whole essential oil of lemon, which contains citral, is not due to the presence of (+)-limonene and its synergistic quenching effects. So, whole or complete essential oils are usually more effective than an individual isolate and have fewer side effects.
2. If an essential oil contains one or more components which are thought to be hazardous in some way, the unwanted action can be “quenched” by adding a nullifying component in a different essential oil. For example, if you were to combine the essential oils of grapefruit or sweet orange with lemongrass in a 50/50 dilution, the citral in the lemongrass will be quenched or nullified the by the limonene in the grapefruit or sweet orange.

Question 7

What is oxidation? What three things are responsible for oxidation?

Answer 7

Oxidation is the addition of oxygen (or removal of electrons or hydrogen) from an organic molecule. oxygen, heat and light.

The effect of oxygen on essential oils is called oxidation and tends to occur in essential oils rich in monoterpene hydrocarbons, such as citrus and pine oils. Oxidation is accelerated by heat and light. Oxidation changes the chemical composition of an essential oil which in turn alters the therapeutic value and can make an essential oil that is usually safe to use hazardous.

Question 8

Describe the term Contamination

Answer 8

Contamination of an essential oil may be by way of pesticides or herbicides. These are used in large scale essential oil crop cultivation to control pests, parasites, diseases and weeds and to raise harvest yields. Steam distillation, solvent extraction and expression do not eliminate biocides contained in pesticides and herbicides. This makes a great argument for using only organic essential oils!

Question 9

Describe the term Adulteration

Answer 9

Adulteration refers to the fact that a substance has been added to modify the composition of an essential oil. Typically, the substance will be a synthetic aroma chemical or an aroma chemical extracted from a less expensive essential oil. A common example of this is geranium oil —Pelargonium graveolens.

Question 10

Describe the term Degradation

Answer 10

Degradation of essential oils is a process by which the quality of the essential oil is reduced over time. This usually occurs with essential oils because of prolonged storage or poor storage conditions. The main factors responsible for degradation are oxygen, heat and light. The effect of oxygen on essential oils is called oxidation and tends to occur in essential oils rich in monoterpene hydrocarbons, such as citrus and pine oils. Oxidation is accelerated by heat and light.

Question 11

Explain the general toxicological risks for the Liver

Answer 11

The liver contains a substance called reduced glutathione, which mops up reactive molecules i.e. free radicals, before they can damage DNA or protein. However, the liver contains only a limited amount of glutathione and if this is depleted (temporarily), reactive molecules are able to attack and seriously damage the liver and blood cells, before the glutathione is replaced. If the damage is serious enough, it can result in liver failure or haemolytic anaemia and possible death.

It is unlikely that any essential oil could be absorbed in a large enough quantity to deplete glutathione through dermal application, however essential oils administered orally could probably do so.

Question 12

Explain the general toxicological risks for the Kidneys

Answer 12

Most drugs are excreted through the kidneys. Many water soluble molecules are secreted into the kidney tubules and reach the urine. The more water soluble essential oil constituents, such as terpenoid alcohols, aldehydes and esters are probably removed in this way

Because kidneys receive the peak plasma concentrations of all substances present in the blood, kidney tubule cells are exposed to higher levels of chemicals than are other body cells. Consequently, the kidney is extremely vulnerable to damage caused by foreign molecules, whether they are from drugs or essential oil constituents. However, there is no evidence to suggest that essential oils can damage healthy kidneys at the doses that are given in aromatherapy.

A diseased kidney is usually less able to handle large quantities of essential oils and so caution should be used when essential oils are given orally to people with kidney disease. In kidney disease, the bloods’ ability to coagulate is reduced and so anti-coagulant essential oils could exacerbate the condition potentially resulting in internal haemorrhage. It is recommended that such oils not be given ~orally in kidney disease or if the person is on blood thinners i.e. Warfarin.

Question 13

Explain the general toxicological risks for the Central Nervous System.

Answer 13

The CNS is particularly sensitive to chemicals and toxicological agents of all types. Because of this it is possible that some essential oil constituents, when given in high doses might have CNS toxicity. Many essential oils, being fat soluble, can probably gain rapid entry into the CNS through the blood-brain barrier.

Question 14

Explain the general toxicological risks for the Endocrine System

Answer 14

Together with the nervous system, the endocrine system constitutes the internal communication mechanism of the body. This is done by a group of ductless glands whose function is to synthesize and store chemicals called hormones and then to release them into the blood supply. Once in the bloodstream, hormones are recognized by their specific target tissues, which then respond accordingly. Some essential oils are listed as having estrogen-like properties however this is considered to be significant only when the essential oils are ingested orally.

Question 15

Explain the general toxicological risks for the Endocrine System

Answer 15

Together with the nervous system, the endocrine system constitutes the internal communication mechanism of the body. This is done by a group of ductless glands whose function is to synthesize and store chemicals called hormones and then to release them into the blood supply. Once in the bloodstream, hormones are recognized by their specific target tissues, which then respond accordingly. Some essential oils are listed as having estrogen-like properties however this is considered to be significant only when the essential oils are ingested orally.

Question 16

Explain the general toxicological risks for the Reproductive System and Reproduction

Answer 16

Studying the effects of essential oils during pregnancy is very difficult. Most tests for drugs and other foreign materials during pregnancy are conducted on animals and correlate very poorly with the human situation It is estimated that substances with a molecular weight of less than 1000 amu can cross the placenta and since all essential oil constituents have molecular weights below 500 it can be assumed that they are all capable of crossing the placenta. The blood-brain barrier is underdeveloped at and before birth which makes it likely that the compounds which do cross the placenta will reach the fetal central nervous system. This does not necessarily mean that there is a risk of toxicity to the fetus, however in my opinion, care should be taken with specific, potentially harmful essential oils

Question 17

Explain the general toxicological risks for the Circulatory System

Answer 17

According to Tisserand, there are very few known effects of essential oils on the heart. Cardiovascular consequences of human poisoning from various essential oils include irregular heartbeat (tansy); rapid heartbeat (wintergreen); cardiovascular collapse (eucalyptus); and congestive heart failure (wormwood). (Eimas 1938; Gurr & Scroggie 1965; Grieve 1978; Weisbord et al 1997).

Damage to the heart has been seen after fatal doses of wintergreen and wormwood oils. With the exception of eucalyptus, the above essential oils are not recommended for use in aromatherapy.
Nasal inhalation of liquids containing menthol and peppermint can be hazardous for children. Menthol rich essential oils should be avoided or used in small dosages in cases of cardiac fibrillation

Question 18

Explain the general toxicological risks for Cancer

Answer 18

There is no evidence that tumours in humans have ever been caused by the use of essential oils. Nevertheless, some essential oils do contain high concentrations of carcinogenic compounds and it would be prudent to avoid these essential oils for any aromatherapy use.

Question 19

Explain the general toxicological risks for Children

Answer 19

The dosage of essential oils in children is based on age. For dermal application, caution is required because the skin is especially thin and more sensitive and more permeable to essential oils.
Children and Poisoning:
Ingestion: Although we do not know the consequences of drinking large amounts of essential oils, there have been documented cases of poisoning with the essential oils of citronella, clove, eucalyptus, pennyroyal, sassafras, wintergreen and wormseed. In most cases, the drops were given accidentally, by mistaking it for another, safer preparation.

Inhalation through the nose has been reported to have non-fatal but serious toxicity in children who had solutions containing either menthol (4 cases) or cineole (9 cases). The ages in these cases ranged from 1 month to 3 years. The effects of poisoning included irritated mucous membranes, tachycardia, dyspnoea, nausea, vomiting, vertigo, muscular weakness, drowsiness and coma. The most serious case was that of a child under 2 months of age who had one millileter of a menthol solution introduced into his nose.

Essential oils used in humidifiers or diffusers are usually safe for children —taking into consideration dosage/age amounts and avoiding essential oils listed above.

Dermal: Avoid the use of essential oil listed above. Do not use essential oils high in 1,8-cineole on or near the face of children under the age of 5 years (this applies to dermal and inhalation methods). Also, follow the recommended dilutions listed above).

Question 20

Explain the general toxicological risks for Children

Answer 20

The dosage of essential oils in children is based on age. For dermal application, caution is required because the skin is especially thin and more sensitive and more permeable to essential oils.
Children and Poisoning:
Ingestion: Although we do not know the consequences of drinking large amounts of essential oils, there have been documented cases of poisoning with the essential oils of citronella, clove, eucalyptus, pennyroyal, sassafras, wintergreen and wormseed. In most cases, the drops were given accidentally, by mistaking it for another, safer preparation.

Inhalation through the nose has been reported to have non-fatal but serious toxicity in children who had solutions containing either menthol (4 cases) or cineole (9 cases). The ages in these cases ranged from 1 month to 3 years. The effects of poisoning included irritated mucous membranes, tachycardia, dyspnoea, nausea, vomiting, vertigo, muscular weakness, drowsiness and coma. The most serious case was that of a child under 2 months of age who had one millileter of a menthol solution introduced into his nose.

Essential oils used in humidifiers or diffusers are usually safe for children —taking into consideration dosage/age amounts and avoiding essential oils listed above.

Dermal: Avoid the use of essential oil listed above. Do not use essential oils high in 1,8-cineole on or near the face of children under the age of 5 years (this applies to dermal and inhalation methods). Also, follow the recommended dilutions listed above).

Question 21

Explain the general toxicological risks for the Elderly

Answer 21

With older people, there may be a higher incidence of health problems and so it is imperative to check the profiles of each essential oil to ascertain that it is not contraindicated for a particular health problem, and that there are no contraindications with certain medications.

Shirley Price recommends that with older people whose bodily systems have started to slow down, only half the normal concentration of essential oils should be used. Aromatherapy can be used to release physical and emotional stress, increase circulation, assist in the removal of toxins and inflammation, increase delivery of oxygen to the cells, reduce heart rate and blood pressure, reduce swelling and stimulate metabolic function.

Although the sense of smell diminishes with age, it remains the strongest sense in the elderly. In cases of dementia, essential oils have the ability to act as a trigger to help patients remember some of their past experiences. Essential oils may also help alleviate the symptoms of dementia including forgetfulness, anger, aggression, mood swings and confusion. The essential oils of peppermint and rosemary are recommended to stimulate the mind and memory.

Question 22

List and explain how one can prevent exposure to blood and bodily fluids both to the practitioner and the client.

Answer 22

Disease causing bacteria or viruses that are carried through the body in the blood or body fluids such as hepatitis and HIV are called bloodborne pathogens.
How can you prevent exposure to blood and body fluids to yourself and to your client?
• Hand hygiene is the single most important measure in preventing the spread of infection.
• Injury prevention. If you have any cuts or abrasions on your hands, finger cots or gloves should be worn.
• Proper disposal or sterilization of equipment, product and supplies.
• Never touch a client’s open sore or wound.
• Make sure all equipment, the massage table and door knobs are cleaned and sanitized between clients.

Question 23

List and explain the safety guidelines for aromatherapists.

Answer 23

The exposure of an aromatherapist who is either massaging a client or blending and bottling essential oils for clients tends to be more prolonged than that of the client. Inhalation of essential oils over an extended period of time may cause headaches, nausea or fatigue. The following recommendations help to ensure the safety for the aromatherapy practitioner:
• Work in a well-ventilated area.
• Air treatment room thoroughly between clients or between blending essential oils.
• Minimum of 5-minute fresh air break every hour or so.
• Wash hands between treatments or blends.
• Keep and dispense essential oils in a separate room (from the treatment room).
• Avoid essential oils contraindicated for the practitioner.

Question 24

The chemical element furanocoumarins is responsible for photosensitivity —True or False?

Answer 24

True

Question 25

Define the term Universal Precautions

Answer 25

Universal precautions are infection control guidelines designed to protect workers from exposure to diseases spread by blood and certain body fluids.

Question 26

Explain what bacteria are, how they can be spread and how they can enter the body.

Answer 26

Bacteria are one celled organisms with both plant and animal characteristics. Also known as germs or microbes, bacteria can exist almost anywhere: in and on our bodies; on our clothing; in water; on surfaces of objects and in the air.

Most bacteria are non-pathogenic, which means they are helpful or harmless and do not cause disease.
Nonpathogenic bacteria perform many useful functions, such as decomposing garbage and improving soil fertility. In the human body, they help digest food and stimulate immune response.

Pathogenic bacteria, also called germs or microbes are harmful and although the minority, cause disease when they invade plant or animal tissue. To this group belong parasites which require living matter for their growth.

Pathogenic bacteria cause disease in humans and can also infect other animals and plants. Some notable pathogenic bacteria include Streptococcus, Staphylococcus, Tuberculosis, and Escherichia coli, among many others. Worldwide, these bacteria account for many illnesses and disease epidemics.

Intracellular bacteria are pathogenic bacteria which always cause disease when they enter the human body. This is in contrast with conditional bacteria, which can cause infections and disease in certain circumstances.

Many pathogenic bacteria are conditional, taking advantage of something such as an open wound, to duplicate themselves and spread disease.

Opportunistic bacteria are bacteria which do not normally cause disease, but will if a patient has a compromised immune system.

Question 27

Explain what a virus is, how it can be spread and how they can enter the body.

Answer 27

Viruses are intracellular parasites that consist of a nucleic acid (DNA or RNA) core, surrounded by a protein coat and sometimes a lipoprotein envelope. Although they are not technically living organisms, viruses have a genetic code and, like living organisms, they multiply. They invade cells and insert their own genetic code into the host cells’ genetic code, causing the cell to produce viral DNA or RNA and protein coats. They pirate the host cell’s nutrients and organelles to produce more virus particles. New viruses may leave the cell to infect other cells by secretion or by bursting the cell membrane. You could compare this to your computer being hacked.

The symptoms of viral infections may not appear right away. The viral genetic code may not become active for some time, or viral multiplication may not immediately cause significant cellular damage. In any case, the effects of the intracellular viral parasite eventually take their toll and thus produce the symptoms of the disease.

Viruses are a diverse group and are usually classified according to their shape, DNA or RNA content or their method of multiplying.

Question 28

List and explain contraindications to massage.

Answer 28

1. Infectious or contagious disease.
2. Running a fever.
3. Recent fractures and large areas of scar tissue — no massage over that specific area for about 2 months. Gentle application of essential oils in a carrier can help with scar healing, minimizing the scar and keeping skin supple.
4. Varicose veins —very gentle massage using only upward effleurage.
5. Cancer and serious heart conditions, no full body massage without doctor’s permission. Gentle massage on shoulders, arms, hands, feet and face.
6. Broken skin boils and cuts — if small, cover with a clearbandage.
7. Recent inoculations —wait 24 hours.
8. Recent alcohol intake —massage and essential oils can heighten the effect ofalcohol.
9. Immediately after a heavymeal.
   10 Immediately after sports, a hot bath or sauna.
10. Menstruation —during the first 2 days, blood loss could be accelerated. Individual areas maybe massaged to soothe menstrual cramps.
11. If a person is on strong medications full body massage should be done only with doctor’s approval. Individual areas can be massaged

Question 29

Explain how pathogenic bacteria or viruses can enter the body.

Answer 29

Pathogenic bacteria or viruses can enter the body through:
• A break in the skin, such as a cut, pimple or scratch.
• The mouth (contaminated food or water).
• The nose (inhalation).
• The eyes or ears.
• Unprotected sex.

Question 30

Explain the way the body fights infection.

Answer 30

The body fights infection by means of:
• Unbroken skin, which is the body’s first line of defence
• Body secretions such as perspiration and digestive juices
• White blood cells within the blood that boost immunity
• Antitoxins that counteract the toxins produced by the bacteria and viruses

Question 31

Define the terms infection and immunity.

Answer 31

An infection occurs when body tissues are invaded by pathogenic microorganisms.
Immunity is the ability of the body to destroy any bacteria that have gained entrance and to resist infection in general. Immunity against disease can be natural or acquired and is a sign of good health. Acquired immunity is developed after the body overcomes a disease or through inoculation. Natural immunity, also called innate immunity, is naturally present in the body and not the result of prior sensitization of a particular antigen.

Question 32

Explain what fungi are.

Answer 32

Fungi are a group of simple organisms similar to plants but without chlorophyll (green pigment). Without chlorophyll, pathogenic fungi cannot produce their own food so they must consume or parasitize other organisms.

Most pathogenic fungi parasitize tissue on or near the skin or mucous membranes, as in athlete’s foot or vaginal yeast infections. A few systemic fungal infections, such as San Joaquin fever, can disrupt the entire body. Yeasts are small, single-celled fungi and molds are large, multi-cellular fungi. Fungi or mycotic infections often resist treatment and so can become quite serious.

Question 33

List and describe some conditions caused by fungi.

Answer 33

Most pathogenic fungi parasitize tissue on or near the skin or mucous membranes, as in athlete’s foot or vaginal yeast infections. A few systemic fungal infections, such as San Joaquin fever, can disrupt the entire body. Yeasts are small, single-celled fungi and molds are large, multi-cellular fungi. Fungi or mycotic infections often resist treatment and so can become quite serious.

Question 34

Explain the role of aromatherapy in terms of dealing with bacteria, viruses and fungi.

Answer 34

Essential oils have many positive properties and very few drawbacks. They are capable of being antiseptic and antimicrobial agents to ward off bacteria, viruses and fungi. The molecules support the immune system and are considered pro- and eubiotic (refers to a healthy balance of the micro-flora in the gastrointestinal tract) as opposed to the synthetic antibiotics.

Essential oils are especially valuable as antibiotics because their aggression toward microbial germs are matched to their total harmlessness to tissue. Chemical antiseptics not only destroy the micro-organisms but also the surrounding cells. When using essential oils, one avoids developing resistance to microbes as experienced with antibiotics. There are many essential oils that are effective on bacteria, viruses and fungi.

Question 35

What are the characteristics of the essential oils listed to fight pathogenic bacteria, viruses or fungi?

Answer 35

Essential oils have many positive properties and very few drawbacks. They are capable of being antiseptic and antimicrobial agents to ward off bacteria, viruses and fungi. The molecules support the immune system and are considered pro- and eubiotic (refers to a healthy balance of the micro-flora in the gastrointestinal tract) as opposed to the synthetic antibiotics.

Essential oils are especially valuable as antibiotics because their aggression towards microbial germs are matched to their total harmlessness to tissue. Chemical antiseptics not only destroy the micro-organisms but also the surrounding cells. When using essential oils, one avoids developing resistance to microbes as experienced with antibiotics. There are many essential oils that are effective on bacteria, viruses and fungi.

Question 36

Define Phototoxicity

Answer 36

Phototoxicity - also known as photosensitivity, is when the skin is more responsive to light due to the presence of a radiation-absorbing substance, such as sunlight; in humans, it is thought that the presence of the chemical element furanocoumarins is responsible for this reaction. Certain essential oils contain this chemical and therefore increase the risk of sunburn when applied topically.

Question 37

Define Contraindication

Answer 37

Precautions pertaining to a particular essential oil

Question 38

What essential oils may render a homeopathic treatment ineffective?

Answer 38

Eucalyptus, peppermint, spearmint and cornmint essential oils should not be used with homeopathy because they are thought to antidote at least some of the homeopathic remedies.

Question 39

Explain Antibacterial

Answer 39

An antibacterial substance will prevent the development of bacteria

Question 40

Explain Antimicrobial

Answer 40

An antimicrobial substance will prevent the spread of bacteria, fungi and some viruses.

Question 41

Explain Disinfectant

Answer 41

A disinfectant is a substance that can be applied on non-living objects to kill microorganisms.