title: Herbalists' perception of risks involving commonly sold medicinal plants in Italy.
abstract: OBJECTIVE
  Although there are several studies which have investigated pharmacists' knowledge of the safety of medicinal plants (MPs), no studies have examined herbalists' perception of risks associated with MPs.
  
  
  METHODS
  We conducted a survey of 159 herbalists (participation rate 85.9%) in the region of Tuscany (Italy). Data were collected by means of a semi-structured questionnaire using a face-to-face interview. Risk perception was rated on a 10 cm Visual Analogic Scale (VAS). Herbalists' scores were then compared with those reported by a group of 10 experts in herbal medicine.
  
  
  RESULTS
  When the overall risk was examined, herbalists had a low perception of the risks (VAS median ranged between 1.5 and 3.2) associated with the use of most MPs (Allium sativum, Aloe vera gel, Echinacea spp., Escholtzia californica, Harpagophytum procumbens, and propolis). They had an intermediate or high perception of risks associated with use of Cimicifuga racemosa, Citrus aurantium, and Panax ginseng (median ranged between 3.5 and 5.0), and for anthraquinone laxatives (median 7.2). Although the overall risk perceived by experts was generally higher than that reported by herbalists, differences were statistically significant only for Allium sativum and Escholtzia californica.
  
  
  CONCLUSIONS
  The study shows that herbalists in Tuscany are knowledgeable about the relative risks of MPs when compared with experts in herbal medicine.
authors.affiliation: Department of Neurosciences, Psychology, Drug Research and Children's Health, University of Florence, Florence, Italy; Centre for Integrative Medicine, Careggi University Hospital, Florence, Italy.
authors.forename: Eugenia
authors.initials: E
authors.lastname: Gallo
authors.affiliation: Department of Neurosciences, Psychology, Drug Research and Children's Health, University of Florence, Florence, Italy. Electronic address: ersilia.lucenteforte@unifi.it.
authors.forename: Ersilia
authors.initials: E
authors.lastname: Lucenteforte
authors.affiliation: Centre for Integrative Medicine, Careggi University Hospital, Florence, Italy.
authors.forename: Fabio
authors.initials: F
authors.lastname: Firenzuoli
authors.affiliation: National Center of Epidemiology, Surveillance and Health Promotion, National Institute of Health, Rome, Italy.
authors.forename: Francesca
authors.initials: F
authors.lastname: Menniti-Ippolito
authors.affiliation: Department of Neurosciences, Psychology, Drug Research and Children's Health, University of Florence, Florence, Italy.
authors.forename: Valentina
authors.initials: V
authors.lastname: Maggini
authors.affiliation: Department of Neurosciences, Psychology, Drug Research and Children's Health, University of Florence, Florence, Italy.
authors.forename: Alessandra
authors.initials: A
authors.lastname: Pugi
authors.affiliation: Centre for Integrative Medicine, Careggi University Hospital, Florence, Italy.
authors.forename: Vittorio
authors.initials: V
authors.lastname: Mascherini
authors.affiliation: Centre for Integrative Medicine, Careggi University Hospital, Florence, Italy.
authors.forename: Luigi
authors.initials: L
authors.lastname: Gori
authors.affiliation: Department of Neurosciences, Psychology, Drug Research and Children's Health, University of Florence, Florence, Italy.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Mugelli
authors.affiliation: Department of Neurosciences, Psychology, Drug Research and Children's Health, University of Florence, Florence, Italy; Centre for Integrative Medicine, Careggi University Hospital, Florence, Italy.
authors.forename: Alfredo
authors.initials: A
authors.lastname: Vannacci
mesh_terms: D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006282:Health Personnel / Q000523:psychology* / Q000706:statistics & numerical data; D006801:Humans; D007558:Italy; D008297:Male; D010465:Perception; D008517:Phytotherapy / Q000009:adverse effects*; D010946:Plants, Medicinal / Q000009:adverse effects*; D012306:Risk; D011795:Surveys and Questionnaires; D064232:Visual Analog Scale
keywords: Herbalists; Medicinal plants; Risk perception; Survey; VAS