Complementary Therapies in Medicine (2014) 22, 81—86 Available online at www.sciencedirect.com ScienceDirect j ou r n a l home p a g e : w w w . e l s e v i e r h e a l t h . c o m / j o u r n a l s / c t i m Herbalists’ perception of risks involving commonly sold medicinal plants in Italy Eugenia Gallo a,b,1 , Ersilia Lucenteforte a ,∗,1 , Fabio Firenzuoli b , Francesca Menniti-Ippolito c , Valentina Maggini a , Alessandra Pugi a , Vittorio Mascherini b , Luigi Gori b , Alessandro Mugelli a , Alfredo Vannacci a,b a Department of Neurosciences, Psychology, DrugResearch andChildren’s Health, University of Florence, Florence,Italy b Centrefor Integrative Medicine,Careggi University Hospital, Florence,Italy c NationalCenterof Epidemiology, Surveillance andHealthPromotion,NationalInstitute of Health, Rome, Italy Available online11 December 2013 KEYWORDS Herbalists; Medicinal plants; Riskperception; Survey; VAS Summary Objective:Although thereare several studies whichhaveinvestigated 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 159herbalists (participation rate 85.9%) in the regionof Tuscany (Italy). Datawere collectedby means of a semi-structured questionnaire using a face- to-faceinterview. Riskperception wasratedon a 10cmVisual Analogic Scale(VAS). Herbalists’ scores were then compared with thosereportedby a groupof 10 experts in herbalmedicine. Results:Whenthe overallrisk wasexamined, herbalists had a low perception of the risks(VAS medianrangedbetween1.5 and 3.2) associated with the use of most MPs (Allium sativum, Aloe veragel, Echinacea spp., Escholtzia californica,Harpagophytum procumbens, andpropo- lis). They had an intermediate or high perceptionof risks associated with use of Cimicifuga racemosa, Citrus aurantium,and Panaxginseng (medianrangedbetween3.5 and 5.0), and for anthraquinone laxatives (median7.2). Although the overall risk perceived by expertswas generally higher thanthat reported by herbalists, differences werestatistically significant only for Allium sativumandEscholtzia californica. Conclusion: The studyshows that herbalists in Tuscany are knowledgeable about the relative risksof MPswhencompared with experts in herbalmedicine. ©2013 Elsevier Ltd. All rightsreserved. ∗ Corresponding authorat: Department of Neurosciences, Psychology, DrugResearch and Children’s Health, University of Florence,viale G. Pieraccini 6, 50139 Florence, Italy. Tel.: +39 0554271270; fax: +39 0554271280. E-mail address: ersilia.lucenteforte@unifi.it (E. Lucenteforte). 1 Theseauthors havecontributed equallyto this work. 0965-2299/$ —seefront matter©2013 Elsevier Ltd. All rightsreserved. http://dx.doi.org/10.1016/j.ctim.2013.12.002