Ocean Watch

Monday, January 6, 1997

Victims of jellyfish stings invited to join pain study

The Honolulu City and County lifeguards are launching a study on jellyfish stings this week.

This means that the next time you get a box jellyfish or Portuguese man-of-war sting and head for an orange tower for aid, you may hear the following:

"We're studying which substances and temperatures help relieve the pain of jellyfish stings. Wanna help?"

If you agree, the lifeguard will have you sign a consent sheet explaining the study, approved medically and sanctioned by the University of Hawaii Committee on Human Studies. Then he or she will apply one of several remedies.

You are the judge, scoring your relief (or lack of it) on a scale of 1 to 10.

At the towers where liquids and pastes are used, neither the lifeguard nor the victim knows the identity of the substance being applied. This is called a double-blind study, important because both researchers' and victims' previous beliefs and experiences greatly influence the effectiveness of pain remedies.

Fully one-third of people given a pretend treatment (a "sugar pill") have genuine relief of their symptoms. This is called the placebo effect and it doesn't just happen to nut cases. It's universal, regardless of sex, age and culture. Perhaps it's an evolved trait that helps us humans better cope with pain.

Because of this powerful placebo effect, you can't just slap a little meat tenderizer on a jellyfish sting, observe that the person feels better and declare success.

The treatment of jellyfish and Portuguese man-of-war stings has long been a puzzle worldwide.

Hawaii is the only place where people routinely use meat tenderizer on such stings. In other parts of the world, nearly every substance imaginable, including manure, mustard and figs, has been sprayed, laid and smeared on these stings with similar results: Some think the stuff is useless; others swear it's the best thing since penicillin.

Few of these substances have been tested with any scientific control. The closest anyone has come are the Australians, who have a lot more to worry about than we do. Their box jellyfish, called sea wasps, occasionally kill people with one powerful sting.

Australian researchers have recently recommended dousing all box jellyfish stings (but not those of Portuguese man-of-war) with vinegar. This dousing does not relieve pain, they say. Rather, it inactivates stinging cells still on the skin, thus preventing the sting from worsening. (Vinegar fires stinging cells in some man-of-war species.)

Pain, which can be wicked, is another issue. The Australians use ice packs to ease pain. Some people in Hawaii and on the mainland, however, swear that heat, either in the form of hot packs or hot showers, works better.

And then there's the hard core urine camp who pee on every sting, cut and puncture that comes from the ocean, believing urine relieves pain and cures wounds.

Here in Hawaii, we're lucky. Our marine stings are usually a minor annoyance, disappearing on their own in a half-hour or so. This is one reason so many remedies seem to work so well - the sting is going away on it's own anyway.

The down side of applying anything you happen to have handy is that some substances may do harm. In laboratory tests, urine, ammonia and alcohol cause active stinging cells to fire. Therefore, applying these things has the potential of making a minor sting major.

No such substances are included in the new study, designed by volunteers, myself included, and run by Oahu's lifeguards as a service to the community.

If you inaugurate the new year with a Portuguese man-of-war or box jellyfish sting, take a few minutes to participate in the study. Your contribution will help replace myth with fact and make the ocean a safer place to play.