Aromatherapy

Diffusing in Medical & Dental Offices–Exploring the Dangers and Ethics

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Diffusing in Medical or Dental Offices, the Dangers and Ethics of itOne of the wonderful effects of diffusion is the antibacterial and antiviral effects of essential oils on room air. So, it makes perfect sense to use it in places where lots of germs exist—like hospitals, doctor’s offices, dentist’s offices, and other health care facilities. In fact, there are published accounts in support of diffusing in hospitals.

One such report is of an employee wellness project conducted at Vanderbilt University Hospital in the Adult ER department Vanderbilt Hospital Study. The project was aimed at decreasing employee stress, increasing energy, and decreasing hospital odors. They diffused oils in nurse’s stations, hallways, and triage areas but not patient rooms. The results were impressive: work related stress decreased from 41% to just 3% of participants. Other hospitals and cancer centers have conducted similar studies.

A hospital in England found that diffusing certain essential oils in the burn ward eliminated MRSA infections during the period of use. MRSA levels in the air, and MRSA infection in patients returned to their pre-study levels once the diffusion experiment ended MRSA study.

A couple months ago I wrote about the safety of diffusing in the classroom and why it should not be done. Today I want to talk about health practitioners diffusing in their offices. This is not new (as the date on the above studies indicates), but it is something that I am hearing is happening more and more frequently.

Why health care workers should not diffuse in public places:

One can understand how people would want to diffuse in health care offices as a natural way to keep the air clean and remove odors. The perception abounds that essential oils are natural and therefore safe. Add to that the myth that if you use certified pure therapeutic grade essential oils, they are somehow more safe. If anyone should know better though, it is a health care worker. Why do I say this?

If nothing else, health care workers have been trained to deliver evidence based care. They should recognize enough about the properties and benefits of essential oils to know they warrant a closer look before using around their patients.

Health care workers also know about pharmokinetics—how drugs work in the body. They know about allergies, adverse reactions, toxic reactions to drugs and other substances. If oils have benefits similar to medications, why wouldn’t they also have side effects and contraindications? Furthermore, why are they exposing their patients to essential oils without consent, without consideration of their medical history? It kind of boggles my mind.

Part of the problem is certainly that despite being experts in their particular health care field, they are casual enough users of essential oils to consider them safe alternatives to synthetic scent, nothing more or less than that. That may forgive some, but what about the hospitals whose goals it was to reduce workplace stress, and reduce MRSA infections? It is obvious from the premise of the studies that they knew essential oils could do more than just smell good.

Another part of the problem may be how the FDA classifies essential oils. They fall under similar rules as nutritional supplements and/or cosmetics. This means that unlike drugs, companies do not have to prove with clinical studies the safety and efficacy of the product. It also means that people selling oils (or anyone really) cannot make claims that essential oils can prevent, cure, or treat any disease. As a result, we don’t think of them as drugs. Yet we do. The internet abounds with forums and groups where people are asking what oils they can use for anything from gingivitis to constipation, eczema to cancer.

What does it mean if essential oils are treated like supplements:

I think it makes the most sense to keep with the comparison of nutritional supplements, as the action of essential oils most parallels them. What I mean is, we may take supplements of Vitamin C because we believe it will boost our immune system and help our body fight off a cold. We don’t think Vitamin C will cure us of a cold, it will just help our body do a better job fighting it. Likewise, we may inhale lavender because we believe it will alleviate stress. It doesn’t take away the stress, but it helps our body deal and respond to it and we feel more relaxed.

The parallels don’t end there. Nutritional supplements and essential oils also both carry cautions for some people. Vitamin C, one of the most common supplements, has a long list of cautions including people with diabetes, high blood pressure, or on warfarin. You can read about the rest at the Mayo Clinic site. For an example in the aromatherapy world, Fennel essential oil should be avoided if you have endometriosis, are pregnant, breastfeeding, have epilepsy, or are under 6 years of age. Supplement or essential oil, just because it is natural and not a drug, doesn’t mean it is safe for everyone.

How do essential oils compare to drugs:

We can also draw some parallels between drugs and essential oils. The actions of some essential oils can be as powerful or as effective as some medications. For example, in animal studies, the calming effects of bergamot essential oil were found to be as effective as valium. (Source)

If we think of essential oil more like a drug given the impact they can have on our health, we should expect health care workers to understand that the parallels must also extend to the negative effects.

  • Health care workers know about toxicity of medication—where a larger dose may cause adverse effects. Coriander is one essential oil that can be stupefying in large doses.
  • Health care workers know about idiosyncratic reactions—where some people will have an adverse reaction to a drug in a normal dose. These are unpredictable responses.
  • Health care workers know that some people are allergic or have sensitivities to certain medications. Those drugs should be avoided in those people. Each exposure has the potential to cause an increasingly worse reaction. A severe allergic reaction can be deadly.
  • Health care workers know that children should receive lesser doses of medications in part due to their smaller size and body weight, and in part due to organ immaturity (important in relation to metabolizing and excreting drugs). On the opposite end of the life continuum, we have the elderly whose bodies also don’t handle drugs the same, in part due to their changing muscle to fat ratios. Many essential oils have recommended minimum ages, and some have contraindications for the elderly.

So, even though essential oils are not classified as a drug, they have many similarities to both drugs and supplements. Most healthcare workers would never prescribe a medication or even recommend a supplement without knowing the medical history of that individual patient. When you diffuse oils in a health care setting, you are in a sense medicating everyone who walks through the door with a one size fits all prescription, and without their consent. How do you spell L-I-A-B-I-L-I-T- Y?

But if hospitals are using them?

Finally, coming back to the hospital study mentioned at the outset, I feel compelled to comment that they specify using certified pure therapeutic grade essential oils. This is a telltale sign of one of the major MLM essential oil companies. While I can’t comment on what the company officially tells their reps as I have never been part of those organizations, some of their reps or downline have been known to make claims that the safety rules that usually apply to essential oils (for example not ingesting, always diluting oils, not using some oils on children) do not apply to their oils since they are certified pure therapeutic. This is absolutely false. While impure oils can be more dangerous, pure oils don’t defy safety recommendations .

The second issue I have with the Vanderbilt study is that they diffused in triage areas but not in patient rooms. This seems to imply that they had some concern about diffusing around patients. Do triage areas not have patients? And aren’t the patients in the triage areas not yet fully assessed or diagnosed? Finally, does air not circulate—if I diffuse in my living room, will I eventually not smell it in the adjacent room as well? It would appear these hospitals had some sense that the oils would do more than just smell good, yet they failed to consider the potential for negative effects.

Conclusion

If you are a health care professional, I strongly urge you to dig a little deeper and see for yourself the risks of diffusing in your office or hospital. In short, I ask you consider the potential for harm by blindly diffusing oils that may be contraindicated for some of your patients. I also ask you to consider whether you are prepared to accept the legal ramifications if someone does experience an adverse reaction to oils used in your practice?

Remember, do no harm.

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