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PLANTS-SCHEFFLERA

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Classification   |    Detailed evidence-based information

Substances Included Synonyms

Therapeutic Toxic Class

    A) Schefflera plants are common houseplants and outside ornamentals in warmer climates.

Specific Substances

    A) Schefflera actinophylla
    1) Brassaia
    2) Brassaia actinophylla
    3) Australian umbrella tree
    4) Queensland umbrella tree
    5) Umbrella tree
    6) Australian ivy palm
    7) Octopus tree
    8) Schefflera plant
    9) Starleaf
    10) Schefflera actinophylla x Schefflera macrostachia

Available Forms Sources

    A) SOURCES
    1) Schefflera species are natives of the subtropics and tropics which have gained great popularity as houseplants.
    B) USES
    1) These species can be found in plant nurseries, office buildings, many private homes, and almost any floral outlet store.

Overview

Life Support

    A) This overview assumes that basic life support measures have been instituted.

Clinical Effects

    0.2.1) SUMMARY OF EXPOSURE
    A) Various Schefflera species have been shown to produce allergic contact dermatitis. Ingestion of leaves and stems does not appear to be a problem in humans. There is one case of a dog becoming ill after ingestion of plant material.
    0.2.6) RESPIRATORY
    A) Wheezing has rarely been reported in sensitized individuals.
    0.2.14) DERMATOLOGIC
    A) Allergic contact dermatitis resulting in various eczematous or bullous reactions have been reported in sensitized individuals. Sensitization to the plant may take months. Reactions have generally been in nursery workers or gardeners.

Laboratory Monitoring

    A) Patch testing may establish sensitivity to the various Schefflera species, and differentiate from other plants and garden chemicals.
    B) No routine laboratory testing is needed after ingestion unless otherwise clinically indicated.

Treatment Overview

    0.4.2) ORAL/PARENTERAL EXPOSURE
    A) No treatment is required for ingestion.

Range Of Toxicity

    A) Frequent exposure to Schefflera may result in sensitization and allergic contact dermatitis.

Clinical Effects

Summary Of Exposure

    A) Various Schefflera species have been shown to produce allergic contact dermatitis. Ingestion of leaves and stems does not appear to be a problem in humans. There is one case of a dog becoming ill after ingestion of plant material.

Respiratory

    3.6.1) SUMMARY
    A) Wheezing has rarely been reported in sensitized individuals.
    3.6.2) CLINICAL EFFECTS
    A) BRONCHOSPASM
    1) Itchy eyes, sneezing and wheezing developed in a landscape gardener exposed to multiple plants including Schefflera. Severity of symptoms increased during the work week and was worse after exposure to F. benjamina or Schefflera. Skin testing was positive to Schefflera and serum IgE against Schefflera was detected. Symptoms ceased on termination of employment (Grob & Wuthrich, 1998).

Dermatologic

    3.14.1) SUMMARY
    A) Allergic contact dermatitis resulting in various eczematous or bullous reactions have been reported in sensitized individuals. Sensitization to the plant may take months. Reactions have generally been in nursery workers or gardeners.
    3.14.2) CLINICAL EFFECTS
    A) CONTACT DERMATITIS
    1) Allergic contact dermatitis (ACD) to Brassaia actinophylla was identified in a patient who had been previously sensitized to Hedera helix (Mitchell, 1981). Reactions may include vesiculo-bullous eruptions (Calnan, 1981).
    2) Allergic contact dermatitis has also been reported with S. arboricola, S. heptapleurum (S. kwangsiensis), and Schefflera venulosa (Aplin, 1976; (Hammershoy, 1981; Calnan, 1981; Mitchell, 1981).
    3) The sensitizing agent in Schefflera appears to be falcarinol (Hansen et al, 1986).
    B) ECZEMA
    1) CASE REPORT - Eczema and pruritus of the hands and forearms developed in a 38-year-old who worked with Brassaia actinophylla for two weeks in a plant nursery (Hammershoy, 1981).

Laboratory Monitoring

Monitoring Parameters Levels

    4.1.1) SUMMARY
    A) Patch testing may establish sensitivity to the various Schefflera species, and differentiate from other plants and garden chemicals.
    B) No routine laboratory testing is needed after ingestion unless otherwise clinically indicated.

Treatment

Life Support

    A) Support respiratory and cardiovascular function.

Monitoring

    A) Patch testing may establish sensitivity to the various Schefflera species, and differentiate from other plants and garden chemicals.
    B) No routine laboratory testing is needed after ingestion unless otherwise clinically indicated.

Oral Exposure

    6.5.1) PREVENTION OF ABSORPTION/PREHOSPITAL
    A) SUMMARY -
    1) Gastrointestinal decontamination is not necessary after ingestion.
    6.5.2) PREVENTION OF ABSORPTION
    A) SUMMARY
    1) Gastrointestinal decontamination is not necessary after ingestion.
    6.5.3) TREATMENT
    A) GENERAL TREATMENT
    1) Ingestion does not generally cause toxicity; treatment is usually not necessary.

Dermal Exposure

    6.9.1) DECONTAMINATION
    A) Symptoms appear to be due to a sensitivity reaction rather than a primary irritant, so decontamination is less important than discontinuing exposure of the sensitized individual to the plant.
    6.9.2) TREATMENT
    A) SUPPORT
    1) Symptomatic care may require administration of an antihistamine for pruritus or a systemic corticosteroid such as prednisone.
    B) Treatment should include recommendations listed in the ORAL EXPOSURE section when appropriate.

Range Of Toxicity

Summary

    A) Frequent exposure to Schefflera may result in sensitization and allergic contact dermatitis.

Minimum Lethal Exposure

    A) GENERAL/SUMMARY
    1) Lethal exposures have not been reported.

Maximum Tolerated Exposure

    A) GENERAL/SUMMARY
    1) Ingestions of small amounts of plant material in humans do not appear to cause symptoms. A small amount of oxalate has been found in the plant, but it is unclear what, if any, role this oxalate plays in producing symptoms.
    2) Multiple exposures to these plants may (but do not always) produce sensitization and subsequent allergic contact dermatitis.
    B) SPECIFIC SUBSTANCE
    1) OXALATE CONTENT - Samples of Schefflera leaves were tested for oxalate content. Compared to the nearly 30% found in some oxalate containing plants (Kingsbury, 1964), Schefflera had between 0.9 to 1.5% oxalate (Stowe et al, 1975). Symptomology does not always correlate well with oxalate content.
    2) SAPONINS - Various saponins (gastrointestinal irritants) have been isolated from Schefflera species (Srivastava, 1989).

Pharmacology Toxicology

Toxicologic Mechanism

    A) ALLERGIC CONTACT DERMATITIS - Falcarinol, a polyacetylene, has been identified a cause of the dermatitis produced by Schefflera (Hansen et al, 1986; Hausen et al, 1987).

Animal Toxicology

Clinical Effects

    11.1.3) CANINE/DOG
    A) Moderate ataxia and anorexia followed by vomiting were seen in a 13 kilogram poodle who ingested some leaves and a few small stems from a household Schefflera actinophylla. The vomitus contained plant material. A routine hematologic examination showed a leukopenia (2,400 white blood cells/cubic millimeter) (Stowe et al, 1975). No mention was made concerning pesiticides fertilizer, or herbicides that may have been potential contaminants.

Treatment

    11.2.2) LIFE SUPPORT
    A) GENERAL
    1) MAINTAIN VITAL FUNCTIONS: Secure airway, supply oxygen, and begin supportive fluid therapy if necessary.
    11.2.5) TREATMENT
    A) DOG
    1) CASE REPORTS
    a) One dog who became ill after ingestion was treated with antibiotics, corticosteroids, and rest (Stowe et al, 1975).

References

General Bibliography

    1) Calnan CD: Dermatitis from Schefflera. Contact Dermatitis 1981; 7:341.
    2) Grob M & Wuthrich B: Occupational allergy to the umbrella tree (Schefflera). Allergy 1998; 53:1008-1009.
    3) Hammershoy O: Allergic contact dermatitis from Schefflera. Contact Dermatitis 1981; 7:57-58.
    4) Hansen L, Hammershoy O, & Boll PM: Allergic contact dermatitis from falcarinol isolated from Schefflera arboricola. Contact Dermatitis 1986; 14:91-93.
    5) Hausen BM, Brohan J, & Konig WA: Allergic and irritant contact dermatitis from falcarinol and didehydrofalcarinol in common ivy (Hedera helix L.). Contact Dermatitis 1987; 17:1-9.
    6) Kingsbury JM: Poisonous Plants of the United States and Canada, Prentice-Hall Inc, Englewood Cliffs, NJ, 1964.
    7) Mitchell JC: Allergic contact dermatitis from Hedera helix and Brassaia actinophylla (Araliaceae). Contact Dermatitis 1981; 7:158-159.
    8) Srivastava SK: An acetylated saponin from Schefflera impressa. J Nat Prod 1989; 52:1342-1344.