Photo Credit: True or false: Poison oak produces poisonous smoke when burned? Lenya Quinn-Davidson takes a dive into the research on a quest to find out. Photo by David Dennis shared via Flickr Creative Commons.
I came out of last week looking like someone who’d just been released from a hard labor camp. My hands were covered in blisters from digging soil pits for a research project, and my arms were covered in bruises from hauling t-posts and hog panels to those same research sites. (So many bruises, in fact, that I’ve been too embarrassed to wear short sleeves for the last five days.) To add insult to injury, I had “White bites” from my fire boots on the fronts of both ankles, and I was dehydrated and sore from two full days of burning and hiking across hundreds of acres in Humboldt County’s steep coastal rangelands. In short, I felt amazing. There’s no better feeling than being truly tired and sated — body and soul — after a week of inspiring work.
Credit: Thomas Stratton, University of California Cooperative Extension
Saturday morning brought an added (and less welcome) complication. I brushed a hand across my arm and felt a familiar pattern before I saw it: an invisible line of small bumps that eagerly jumped at my touch, excited to be itched. Poison oak.
I had been musing over poison oak only a few weeks prior, as my co-worker and I were putting the final touches on our burn units. Both units are in coastal rangelands encroached by coyote brush, poison oak and Himalayan blackberry, and after many decades without fire, those three shrubs had formed an impenetrable thicket, dense and unpleasant enough that ranchers use it like a cattle fence. The poison oak was roughly 15 feet tall — thick, ropy vines whose oily leaves were just showing the first tints of fall. Poison oak, with its electric pinks and oranges, happens to be one of my favorite fall plants, but I appreciate it like I would a mountain lion or a rattlesnake: with great respect for its power and beauty, but no desire to be more intimate.
Recall that poison oak, Toxicodendron diversilobum, is in the same genus as poison ivy (T. radicans) and poison sumac (T. vernix), and all of them are in the larger plant family Anacardiaceae, along with mangoes, cashews, ginkgo and many other species. Plants in this family contain varying amounts of urushiol, a highly allergenic compound to which only humans and a few other primates are sensitive (Gladman 2006). Contact with urushiol can cause contact dermatitis, which at its best looks something like what I have (small itchy bumps) and at its worst can result in painful, weeping sores and even infection (Lee and Arriola, 1999, PDF, 698KB). A majority of people in the United States are clinically sensitive to urushiol, but many people, especially in urban areas, never have the opportunity to realize their sensitivity.
In the fire field, the effects of Toxicodendron dermatitis are very real. Research shows that urushiol-caused dermatitis is responsible for 10 percent of USDA Forest Service lost-time injuries, and treatment has, in some years, absorbed 1 percent of California’s workers’ compensation budget (Gladman 2006).
When I was younger, I thought that I was in the 10–15 percent of people who are genetically tolerant of urushiol. I grew up in an area where it abounded, and the longer I went without getting the rash, the more brazen I became. I’d walk through it, move it out of the way for people, and do other things that, in hindsight, seem a bit unwise. At 22, I clumsily moved a cut vine, and it swung around and broke the skin on my back. Turns out, I’m not in the top 10 percent when it comes to poison oak! And now I forewarn other emboldened people: literature shows that for some people (like me), sensitivity only shows itself after many repeated exposures — sometimes after years or decades. Also, children are more tolerant than adults, so not getting it as a kid doesn’t mean you’re in the clear for adulthood.
Like many parts of rural life, poison oak has an almost mythical quality. People have strong beliefs about how it spreads, how to prevent it, and how it affects them personally. Some people swear that by itching their rash, it can spread it to other body parts, or to other people. Others brag that they are not susceptible at all, presumably because they are genetically superior, or perhaps because they have built up resistance by eating poison oak buds in the early spring or otherwise inoculating themselves. And other people avoid it at all costs, insisting that even looking at poison oak will cause them to break out. (Note: these claims have mostly been proven wrong, with the exception of poison oak inoculation, which remains unproven and contentious.)
Credit: sfbaywalk shared via Flickr Creative Commons 2
Last week before we burned, I received a call from a woman who’d read my prescribed fire press release. She was inquiring about the likelihood of our burns producing urushiol-laden smoke that would affect her where she lives, nearly 15 miles away. I have to admit that made me chuckle, because my co-worker and I had just been saying that stories about poison oak smoke are like urban (or rural) myths: everyone has heard of someone else who’s been affected by poison oak smoke, but it’s hard to find firsthand accounts of smoke-induced dermatitis, especially ones that aren’t confounded by physical contact with the plant.
So when Sunday morning came and my thighs, back and arms were covered in a light but irritating poison oak rash, I had to wonder. I had been wearing boots, gloves, long pants and a long-sleeve shirt under my Nomex, so how did this rash come to be?
Sometimes in science, you find a point that is well referenced in the literature, but its citation trail seems to lead nowhere. That’s how my review of the effects of poison oak smoke has been. I can find any number of papers claiming that inhalation of poison oak (or ivy or sumac) smoke can cause systemic dermatitis, but the citations are sketchy. For example, a paper in the International Journal of Vaccines and Vaccination (PDF, 626KB) claims “a severe reaction may happen if a sensitive person inhales this smoke, or even death.” Wow! That’s certainly cause for alarm, until you check their reference and see that they’ve simply referenced the scientific name of the plant — no scientific literature whatsoever.
One of the most detailed descriptions of the effects of poison oak smoke is in a Pacific Northwest (PNW) Extension paper, which states:
“Smoke from burning poison ivy and poison oak has poisoned people who were otherwise immune. Inhalation of such smoke causes lung poisoning that can require hospitalization and intensive care. The oil is not volatile at bonfire temperatures. Any transmission in smoke is by droplets on particles of dust and ash in the smoke, rather than from vapors.” (Burrill et al., 1994)
This publication provides no references. Another dead-end street.
Oddly enough, some of the only original research I found came out of India, where researchers looked at urushiol-caused dermatitis resulting from ceremonial traditions that involve burning the seeds of Semecarpus anacardium, another plant in the poison oak family (Bhatia et al., 2014). In some parts of India, these seeds are used to purge the curse of the “evil eye,” a malevolent expression that can cause injury or misfortune to others. Those who were treated with smoke from the burning seeds consistently developed dermatitis on their hands, arms and faces — areas in close proximity to the smoke and to the burning seeds.
In writing this blog, I’m not claiming that smoke can’t cause a poison oak rash; in fact, I’m sure many of you have stories to share. However, I am noting that even the peer-reviewed literature on the topic is in some ways furthering the mythical status of the plant and its family. And for good reason! Urushiol — this ever-powerful and internationally feared oil — is mostly invisible. You never quite know if you were exposed, partly because you can’t see the oil, but also because the plant tissue has to be injured for the oils to be released, so lightly brushing vines or leaves can be OK (Gladman 2006). Likewise, if you are exposed, you can’t really tell if you were able to wash it off in time, or if it’s still on your boots and clothes (urushiol can persist indefinitely in a dry state!). And its smoke is even more elusive. In my case, did I breathe poison oak smoke and have a systemic reaction, or was it on my clothes when I undressed that evening? Or maybe it was all over Millie, the cute cattle dog that I cuddled on the fireline? There’s no sure way to know, and in some ways, I like that. Poison oak keeps us in check, humbled. Even the cockiest person may be just one exposure away from cleansing their curse.
References:
Burrill, L. C., Callihan, R. H. and Parker, R. (1994). Poison Oak and Poison Ivy. Pacific Northwest Extension.
Bhatia, K., Kataria, R., Singh, A., Safderi, Z. H. and Kumar, R. (2014). Allergic Contact Dermatitis by Semecarpus anacardium for Evil Eye: A Prospective Study from Central India. Indian Journal of Basic and Applied Medical Research, 3, 122-127.
Derraik, J. G. (2007). Heracleum mantegazzianum and Toxicodendron succedaneum: Plants of Human Health Significance in New Zealand and the National Pest Plant Accord. The New Zealand Medical Journal (Online), 120(1259).
Gladman, A. C. (2006). Toxicodendron Dermatitis: Poison Ivy, Oak and Sumac. Wilderness and Environmental Medicine, 17(2), 120-128.
Lee, N. P. and Arriola, E. R. (1999). Poison Ivy, Oak and Sumac Dermatitis. Western Journal of Medicine, 171(5-6), 354.
Pekovic, D. D. (2016). Vaccine Against Poison Ivy Induced Contact Dermatitis, A Lingering Scientific Challenge. International Journal of Vaccines and Vaccination, 2(1), 00023.
Your last line made me chuckle and made me think you are evil. 😉 I, too, thought I was immune, until I wasn’t. Looks like a PHD candidate ought to take this up and settle it once and for all. But I’m leaning towards believing a systematic reaction occurs from smoke inhalation of an aerosol version of poison oak simply because other substances (like nicotine) can travel (and affect us) via smoke.
Yep, when I was young camping with my family, my Dad was burning HUGE poison oak “trees” in the campfire. I walked through the smoke. The next day we walked into the emergency room with the side of my face and eye swollen shut. Poison Oak.
I had the first hand experience with poison oak smoke. Three high school friends and I were hired to clear brush on Mt Toro, just outside of Salinas California. This was in 1965 or about then. We cut and hauled making a big pile. One day the oldest guy decided to burn the pile. Fortunately for me I wasn’t there that day. I lost two friends that day when they inhaled smoke and died.
Arne, I am so sorry to hear your story. How terrible. I’ve been thinking about the lack of research on this and it makes sense that not much has been done. How could we ask anyone to participate in a research project that involves those types of risks? Sometimes anecdotal evidence is all we have, and in this case, it’s clearly something to take very seriously. I’m so sorry for your loss.
Conventional wood stove smoke can also cause skin allergies as well as respiratory diseases. In the Growing up in New Zealand study, 71% of kids received treatment for skin allergies in the heating season, mainly for atopic dermatitis treatments, including topical corticosteroids (42%) and barrier creams and emollients (29%).
Compared with the kids in the lowest 25% for exposure to domestic heater smoke (nearly all burning wood, with but small fraction using coal), kids in the next 25%, the following 25% and the top 25% had respectively 8%, 13% and 27% increased risk of needing medications for skin allergies. So it makes sense to take care when exposed to any form of wood smoke.
Journal reference: onlinelibrary.wiley.com/doi/pdf/10.1111/all.13615
Lay description: http://www.scoop.co.nz/stories/GE1810/S00095/domestic-fires-can-affect-more-than-just-kids-breathing.htm
My husband is one of those “mythical” people who has breathed poison oak smoke, and has developed extreme allergic reactions. He had extensive exposures during childhood and 15 seasons of wildland fire fighting. One memorable exposure later on while starting a fire in a woodstove (another person had cheerfully stacked some dead 3″ rounds of poison oak vine in the woodpile, and he didn’t spot it before using it to start the fire). That was a hospital trip for a full-on allergic reaction with signs of anaphylactic shock; so far it’s the only reaction of such intensity, and we’ve done our best to avoid repeating it.
His dad remembers him getting poison oak, possibly from pollen on the air, while out to sea on fishing boats – but I’d put that more in the legendary category. They don’t know of any other explanation – there was no gear or sleeping bags that would have carried the oils on that boat – but it’s not exactly a controlled data point.
We avoid mangoes, cashews, and other related plants. If he gets a little bit of cashew, for example eating some mixed nuts that used to contain cashews, he itches for several days afterwards.
I fight fire and sometimes get exposed, and I’ve seen the oils spread on clothes or fingers to other parts of the body. So I now treat my reactions with priority on protecting him from exposure, instead of the recommended dry-it-out and don’t cover it methods. I’ve noticed my reactions getting more pronounced over time, especially if I’m at home and covering the rash spots at night to sleep in my own marriage bed. I have only had a mild systemic case once; usually it’s topical, but I still avoid contact as much as I can.
I was on the North Umpqua Fire, summer 2017, where I was exposed to large sudden volumes of smoke inhalation from a hillside that was primarily overgrown with poison oak. We were cooling a spot fire below the road and the upslope wind drove the smoke thick towards us. About half an hour later we assisted with engine water support to a controlled burnout of the adjacent hillside. The winds shifted and we had thick black smoke suddenly envelop the road. By the next day I could hardly breath. They rushed me to the hospital where they hit me with two different shots to counteract the reaction. Took a few days to recover enough to be productive but I nearly died and they said that I was one of many who had come in with severe poison oak reactions over the course of that fire. Even camp had run out of medical supplies to deal with the minor reactions and injuries from exposure.. And I too remember once being “immune” to the oak.. till I was clearing blackberries and oak for a garden and the blackberries opened me up for that oil to get in.. I had it migrating around in my bloodstream so bad it would randomly surface in different areas.. no bueno! I get the don’t even look at it or I’d break out, I feel it. Anyways thanks for sharing your experience, hope you enjoyed mine.
Very good article. I was burning manzanita today and noticed a few dead poison oak stems in the brush as I was throwing it into the fire. I try to stay upwind of any fire but I figure if I can smell it I’m breathing it. I wonder how long it would be before symptoms would appear if I have them. I think I’m fine but….
This is from the CDC: https://www.cdc.gov/niosh/docs/2010-118/pdfs/2010-118.pdf?id=10.26616/NIOSHPUB2010118
I had my own exposure to Poison Ivy smoke when I was a 11 year old growing up in Oregon in the 60s. The property down the street from where I lived, and it was overgrown and the owner used an agricultural flame thrower to burn the poison ivy and the smoke drifted to our property about 50 yards away, 8 hours later I was in the hospital with blisters all over my body, in my nose, mouth, under my eyelids, in my throat, and I had a hard time breathing. It was a very miserable 3 weeks until it was completely gone. I don’t remember what the medications were, but there was a liquid I drank some of 2x a day, drops for my eyes, and about 5 pounds of corn starch and a powder puff to apply it.
For several years after that, the airborne pollen was enough to give me a rash.
I was exposed to smoke from poison oak (toxicodendron pubescens) while in a holding role on recent controlled burn in longleaf pine/wire grass with a healthy poison oak component. I noticed my lungs and throat hurting more than normal from smoke, felt off and then mostly avoided more smoke exposure for rest of the burn. When i got home a few hours later, my face was flushed, I had been wearing a mask, and I still felt a little off. After a good ivy soap rinse, I went to bed. The next morning my face and tongue were swollen, throat sore, chest tightness. EMT and doc visits .. ended up to prednisone . As Lenya indicated, I have not found much information on poison oak smoke exposure. This seems strange since it is fairly common plant in the longleaf ecosystem maintained by frequent fire. I knew I was sensitive to Urushiol from direct skin contact but had never any trouble from smoke before. I used a neck buff, wonder if PM2.5 mask would help reduce toxin exposure? Any thoughts?
I had a similar experience to that of many of those here. I was exposed via a church bonfire at age 12. The next morning I woke with my face having doubled in size and my eyes swollen shut. I was hospitalized at Duke University for over two weeks and given IV steroids. Duke had never seen a reaction of that magnitude and they proceeded to photograph me and use me as case study. Although I experienced shortness of breath and chest pain at the time and for several years after, I am fortunate there was no permanent lung damage, but I have been diagnosed with several chronic illnesses since that time (hard to know if the bonfire incident has since made me more susceptible or if it is the other way around and an underlying illness is what caused the reaction to be so fierce). What is interesting to me is that of a group of at least 30 people at the bonfire, only three of us had reactions – two of which were your typical rashes on limbs and torso; I was the only one whose lungs and face were affected.
I came to research this subject because my area is surrounded by the California wild fire crises at this very moment. Those rolling fiery hills are also covered in Poison Oak.
Since I lead the Neighborhood Watch program for my area and neighbors are asking about smoke carrying the toxin. I had to fine out.
At this point I’m still not sure but I will read it again but my understanding at this point is that it’s possible but usually only for highly sensitive people? Our yards and vehicles are covered with soot even though we are aprox. 7-10 miles from the actual flames.
Did you all fare well with the poison oak? I know people that say to burn it downwind & you’ll be fine but I know others who are covered in it when it’s burnt. I hope you are all safe & it didn’t bother any of you!