Bees & Other Insect Stings
US residents died as a result of bee, hornet and wasp stings. According to the Bureau of Labor Statistics, 83 workers died from injuries due to insects, arachnids, and mites from 2003 to 2010. The majority of fatalities involved bee stings. Fatalities are often due to anaphylactic shock, a serious allergic reaction to insect venom. Insect-related deaths are most common in farming, construction, and landscaping. Annual nonfatal work-related injuries and illnesses that led to days away from work ranged from 4,930 to 6,870 between 2008 and 2010.
The following are important for prevention of insect stings:
• Wear light-colored, smooth-finished clothing covering as much of the body as possible.
– Clothing that seals at the wrists and ankles prevents insects from entering under clothing.
• Avoid colognes, perfumes, and scented soaps, shampoos, and deodorants.
• Wear clean clothing and bathe daily since sweat may anger bees.
• Avoid flowering plants and discarded food.
• Remain calm and still if a single stinging insect is flying around.
– Swatting at an insect may cause it to sting or release a chemical (pheromone) that attracts more insects. Crushing a bee may also result in pheromone release.
• If you are attacked by several stinging insects at once, run to get away from them. (They may release pheromones while attacking).
– Go indoors.
– A shaded area is better than an open area to get away from the insects.
– If you are able to physically move out of the area, do not to attempt to jump into water. Some insects (particularly
Africanized Honey Bees) are known to hover above the water, continuing to sting once you surface for air.
• If a bee comes inside your vehicle, stop the car slowly, and open all the windows.
• Those with a history of severe allergic reactions to insect bites or stings should consider carrying an epinephrine auto injector (e.g. Epi-PenTM) and should wear a medical identification bracelet or necklace stating their allergy.
Training on exposure risk and prevention, insect identification and first aid is also important.
First aid for insect stings includes:
• Remove the stinger using gauze wiped over the area or by scraping with a fingernail or other straight-edged object such as a credit card. Do not squeeze the stinger or use tweezers as this may release more venom.
• Wash the site with soap and water or antiseptic towelettes.
• Remove rings and other tight fitting jewelry.
• Elevate the affected body area and apply ice or a cold compress to reduce swelling.
• Do not scratch the sting as this may increase swelling, itching, and risk of infection.
• Have someone stay with the worker to assist if they have an allergic reaction.
• Treatment for localized swelling and itching may include over-the-counter pain relievers, steroid creams, anesthetic
sprays and/or oral antihistamines, if the individual is not allergic to these. However, antihistamines may cause drowsiness, which could create a safety concern for employees returning to work that day.
The website of the American Academy of Allergy, Asthma and Immunology (a professional organization for physicians and other healthcare providers who treat patients with allergies including from stinging insects) notes that most people develop pain, redness and swelling at the site of an insect sting. Much less commonly, some people experience anaphylaxis, which is a severe allergic reaction. According to the Mayo Clinic, people who have a severe allergic reaction to a bee sting have a 25% to 65% chance of anaphylaxis the next time they are stung.
Symptoms and signs of anaphylaxis can include:
• Swelling of the face, throat or tongue
• Difficulty breathing
• Dizziness or fainting
• Stomach cramps
• Nausea or diarrhea
• Itchiness and hives over large areas of the body
Treatment for anaphylaxis involves properly administered epinephrine. Patients with a known history of this type of allergy carry auto-injectors with them for use if needed before they can get to an emergency room. Several states have passed laws allowing entities rather than individuals to have auto-injectable epinephrine in their first aid kits.