![](https://webarchive.library.unt.edu/eot2008/20090122122937im_/http://www.cdc.gov/nasd/images/line.jpg)
California Department of Health Services
A summary
of this document is available in english and spanish.
(Un resumen de este documento está disponible en inglés y español.)
SUMMARY : CASE
192-028-001
A farm
laborer was working in a vineyard, cleaning weeds away from
the base of the grape vines with a shovel. He bent under the
vines to check his work and was bitten on the left side of
the neck by a spider. The spider may have been a Brown Recluse
or some other poisonous spider. Fifteen minutes after the
bite the worker began to feel dizzy and sick to his stomach.
The employer drove the worker to a hospital emergency department,
where the worker was treated and released.
How
could this injury have been prevented?
- Check
before working under vines and other hidden areas for spiders,
yellow jackets, rattlesnakes, and other poisonous insects
or animals.
- One
person at the work site should be trained in first aid.
The worker could have had a bad reaction to the spider bite.
- Call
911 (emergency services) for poisonous insect bites and
stings.
BACKGROUND
On March
23, 1992 while reviewing the emergency department log at a
local Level 2 Trauma Center a staff nurse from the NURSE Project
noted a report of treatment for a spider bite. A farm laborer
was bitten on the left side of the neck while working in a
vineyard on March 14, 1992. The farm laborer was cleaning
weeds and trash from the base of the vines prior to irrigation.
The description of the spider was not complete (brown with
two red dots on its abdomen), yet it matches that of a Brown
Recluse spider. While not generally fatal to adults, the Brown
Recluse spider venom can cause serious illness for a week
or more. A staff nurse from the NURSE project interviewed
the employee on March 23, 1992. On March 27, 1992 the Senior
Safety Engineer of the NURSE Project contacted the farm owner/operator
by telephone and discussed the incident. NURSE staff reviewed
the emergency department medical records in detail. Cal/OSHA
was not notified by the employer and did not investigate the
incident.
The
incident occurred on a small, family owned and operated vineyard
which hires seasonal workers to work on the harvest. At the
time of the incident the injured worker was the only person
employed at the vineyard. The employee had been working as
a seasonal employee (13 to 37 weeks per year) for this farmer
the past three years and was on his second day of the new
season.
At the
time of their telephone discussion, the farm owner/operator
told the NURSE Safety Engineer that the farm did not have
a formal written safety program, as required by Title 8 California
Code of Regulations 3203 -- Injury and Illness Prevention
Program. (As of July 1, 1991 the State of California requires
all employers to have a written seven point injury prevention
program: designated safety person responsible for implementing
the program; mode for ensuring employee compliance; hazard
communication; hazard evaluation through periodic inspections;
injury investigation procedures; intervention process for
correcting hazards; and a health and safety program.)
INCIDENT
At approximately
8:15 a.m. on March 14, 1992 a 23 year old Hispanic male working
in a vineyard was bitten on the left side of his neck by a
brown spider. The seasonal farm worker was cleaning up weeds
and trash from around the base of the grape vines with a shovel.
This operation requires considerable bending and stooping
under the vines. The work was being done in a 20 acre vineyard
of Thompson grapes. This was the initial clean- up prior to
the delivery of water from the local community irrigation
district system. The farm laborer bent under the vines to
check his work and was bitten on the left side of the neck
by a brown spider. He was wearing his regular work clothing,
work trousers and a long sleeved shirt. The farm worker stated
he felt a sharp sting on his neck and reacted by swatting
his neck at which time he killed the spider. He then discovered
that he had been bitten by a brown spider. He retained the
dead spider which he later took with him to the hospital.
The
bite occurred at about 8:15 a.m. A few minutes after the spider
bite the site of the bite was warm to the touch and swollen.
About fifteen minutes later the worker began to feel dizzy
with some nausea. His employer, the owner of the vineyard,
immediately drove the farm worker in the employer's pick-up
truck ten miles to a local Level 2 Trauma Center emergency
department. The injured worker arrived at the hospital at
approximately 8:55 a.m., but was not treated until 9:50 a.m.
He was treated with antihistamines for local and systemic
reactions to the spider bite, and released. He was seen a
second time on March 16, 1992 at the request of the emergency
department physician. At this time he was noted to be on antibiotics,
and given a brief wound check.
No medical
transport unit was notified by the employer, although the
local emergency medical service was available to the employer
by calling 911. The owner/operator did not administer any
first aid treatment prior to transporting the employee to
the hospital. The farm owner had no formal first aid training.
PREVENTION STRATEGIES
- The
employer has the responsibility to have emergency medical
services available for employees at remote work sites, including
a person at the field site trained in first aid*. First
aid training may have made the employer aware of dangers
associated with insect bites. Spider bites can cause severe
reactions such as anaphylactic shock (shock brought on by
hypersensitivity to an allergen). Although in this incident
the farm laborer did not go into shock, in other incidents
workers may be more susceptible to insect bites and may
experience more severe reactions. Note: * Title 8 California
Code of Regulations 3400 (b): "In the absence of an infirmary,
clinic or hospital, in near proximity to the workplace...a
person or persons shall be adequately trained to render
first aid."
- Poisonous
insect bites are a common seasonal hazard in the agricultural
work place. A nurse from the NURSE Project noted four spider
bites and two snake bites during a two week review of records
at this same hospital. The employer should instruct employees
to be aware of the problem of insects and animals in the
vines, and warn employees to check for them before working
under the vines. Both yellow jackets and rattlesnakes can
be found in the vines. If the employee had checked for insects
and animals under the vines, he may not have been bitten
by the spider.
- Employers
should request the aid of emergency medical services when
there is the potential for a life-threatening situation
to develop. The employer should have called 911 and let
paramedics decide whether or not the employee should have
been transported in an ambulance or a private vehicle. In
this incident the employer would have been unable to provide
treatment if the worker had gone into anaphylactic shock
on the way to the hospital.
FURTHER INFORMATION
For further
information concerning this incident or other agriculture-related
injuries, please contact:
NURSE Project
California Occupational Health Program
Berkeley
office:
2151 Berkeley Way, Annex 11
Berkeley, California 94704
(510) 849-5150
Fresno office:
1111 Fulton Mall, Suite 212
Fresno, California 93721
(209) 233-1267
Salinas
office:
1000 South Main St., Suite 306
Salinas, California 93901
(408) 757-2892
![](https://webarchive.library.unt.edu/eot2008/20090122122937im_/http://www.cdc.gov/nasd/images/line.jpg)
Disclaimer
and Reproduction Information: Information in NASD does not
represent NIOSH policy. Information included in NASD appears
by permission of the author and/or copyright holder. More
NASD Review: 04/2002
This
document,
CDHS(COHP)-FI-92-005-09
,
was extracted from a series of the Nurses Using Rural Sentinal
Events (NURSE) project, conducted by the California Occupational
Health Program of the California Department of Health Services,
in conjunction with the National Institute for Occupational
Safety and Health. Publication date: May 1992.
The NURSE (Nurses Using Rural Sentinel Events) project is
conducted by the California Occupational Health Program
of the California Department of Health Services, in conjunction
with the National Institute for Occupational Safety and
Health. The program's goal is to prevent occupational injuries
associated with agriculture. Injuries are reported by hospitals,
emergency medical services, clinics, medical examiners,
and coroners. Selected cases are followed up by conducting
interviews of injured workers, co-workers, employers, and
others involved in the incident. An on-site safety investigation
is also conducted. These investigations provide detailed
information on the worker, the work environment, and the
potential risk factors resulting in the injury. Each investigation
concludes with specific recommendations designed to prevent
injuries, for the use of employers, workers, and others
concerned about health and safety in agriculture.
![](https://webarchive.library.unt.edu/eot2008/20090122122937im_/http://www.cdc.gov/nasd/images/line.jpg)
|