California Department of Public Health

Occupational Health Branch

FATALITY ASSESSMENT AND CONTROL EVALUATION 

PROGRAM (CA/FACE)

 A Date Palm Worker Dies After Being Stung by Bees

Case Report: 17CA003

SUMMARY

A date palm tree worker died after being stung by numerous bees while working in an organic

date orchard. The victim and a co-worker were spraying the dates with high-pressure water

when the incident occurred. The victim was reportedly allergic to bee stings and his employer 

was unaware of his medical condition. The victim was not carrying an epinephrine autoinjector, and the co-worker or others on the farm were not trained in emergency response for 

bee stings. The CA/FACE investigator determined that, in order to prevent similar future 

incidents, agricultural employers should ensure the following: 

• Workers who are allergic to insect stings or bites should be advised to visit a health care 

professional to obtain a prescription for an epinephrine auto-injector, carry it with them 

at all times, and inform their employer and co-workers of their allergy to insect stings or 

bites. 

• A hazard assessment, prevention steps, and incident response plan for insect stings and 

bites should be incorporated into the company’s Injury and Illness Prevention Program

(IIPP). 

INTRODUCTION

On July 3, 2017, at approximately 10:13 am, a 49-year-old Hispanic male date palm tree worker

died while spraying dates with high-pressure water in a date palm orchard. The CA/FACE 

investigator received notification of this incident on July 7, 2017, from the Cal/OSHA weekly 

update. On September 7, 2017, he made contact with the president of the business who 

employed the victim. On September 21, 2017, the CA/FACE investigator, along with an

epidemiologist, visited the organic date palm orchard where the incident occurred and 

interviewed the president of the business. Photographs were taken of the incident scene, as 

well as the tractor-towed spray rig with aerial lift the victim was in at the time of the incident. 

The County Coroner and Sheriff Department reports of the incident were reviewed. Telephone 

interviews with the victim’s next of kin and co-worker were conducted later with the help of a 

Spanish interpreter. A follow-up telephone interview with the president of the business was 

also conducted. 
EMPLOYER

The employer of the victim was a family-owned and operated business that commercially

grows, packs, and ships Medjool and Deglet Noor dates. The business started in 1931 and was 

sold in the 1980’s to the family that currently owns and operates the business. They have 

approximately 100 employees year-round that include agricultural workers and commercial 

packers. Most of the agricultural workers begin their workday at dawn to avoid the excessive 

heat in the afternoon. The business has thousands of date palm trees that vary in size and age 

in numerous orchards throughout the valley. Orchards vary in size from 5 to 40 acres.

DATE PALMS

Date palm trees vary in height according to their age and reach full fruit production in 15-20 

years. Dates are naturally pollinated by the wind; they are not typically pollinated by bees. In 

the commercialized date palm industry, dates are hand-pollinated to ensure a productive date 

crop. Male flowers are harvested for pollen and female flowers are hand-pollinated, all by date 

palm workers. Once the dates begin to grow, the workers tie up the dates in clusters to support 

the weight of the fruit and prevent breaking. Workers then place a cover over the tied dates to 

keep birds and insects away from the fruit and to minimize damage from the elements. At the 

time of this incident, the dates had not yet been tied in clusters. Each tree yields one crop per 

year, with harvest in the autumn and early winter seasons (September through December). 

Exact harvest time depends on the location and age of the orchard. The tops of the female date 

palms are accessed by agricultural workers for pollination, tie-down, covering, harvesting, and 

pruning each year. Mites feed on the dates and can encase an entire cluster of dates in their 

webbing. If not removed, they will scar the date which results in fruit and economic losses. To 

keep the mites from destroying the organic dates, workers spray the dates with water to 

disturb the mites’ webbing. 

HONEY BEES

There are two subspecies of honey bees in California. European honey bees are typically kept in 

commercial colonies. Africanized honey bees (AHBs) differ from European honey bees by their 

aggressive behavior. They swarm more often and are more likely to abandon a hive if disturbed, 

are agitated by movement and vibration more easily, and defend their hive in larger numbers. 

They nest in varying and sometimes unexpected locations, such as tree cavities, old vehicles, 

underground, and inside small containers.

Although it is not known which strain of honey bee was involved in this incident, AHBs comprise

the majority of feral honey bee colonies in Southern California. A recent study observed that 

70% of feral hives and 65% of foraging honey bees in San Diego County contained AHB genes.

Similar results are likely throughout Southern California, as AHBs have been documented in 

Riverside and Imperial Counties since the mid-1990s. Commercial bee hives, which would have 

contained European honeybees, were not present on the property. 
Typically, honey bees will swarm in the early spring and summer when they are looking for a 

new place to set up a hive, but AHBs may swarm more often throughout the year. Swarms can 

be identified when a large number of bees form a cluster or ball and are not associated with a 

hive, i.e., offspring and honey comb are not present. Honey bees are usually docile while 

swarming, but once they have something to defend, such as offspring or a hive structure, they 

can be very aggressive. Movement within 50 feet and any vibration within 100 feet of their hive

will agitate AHBs, and the bees can remain in an overstimulated state for several days. Once a

honey bee stings, it releases pheromones which incite other bees to defend the hive and sting 

as well. All honey bees can sting only once. Their barbed stinger is pulled from their body after 

a sting, killing it. The venom of an AHB sting is no more venomous than a European honey bee. 

AHBs are more dangerous because they defend their hives in greater numbers and, as a result, 

victims sustain more stings. 

Prior to this incident, there were a few reports of insect stings among this company’s 

agricultural employees, but, to the employer’s knowledge, nobody had needed or sought 

medical attention because of a sting. After this incident occurred, two feral bee hives were 

found hidden in the date palm trees that were being sprayed. They were not visible from the 

ground. In this incident, the bees may have been disturbed by either the vibration or movement 

of the operating equipment or spraying water on the dates.

WRITTEN SAFETY PROGRAMS AND TRAINING

The company had a current (2017) written Injury and Illness Prevention Program (IIPP) in both 

English and Spanish. The IIPP included prevention programs for known hazards in the date palm 

industry such as heat, working from heights, thorns on the trees, and lifting heavy objects. At 

the time of the incident, there was not a specific section in the IIPP that covered insect stings or 

bites. All supervisors were trained in first aid and cardiopulmonary resuscitation (CPR) and were 

issued first aid kits. Safety meetings were documented and held regularly throughout the year.

Safety meetings covered topics related to the current season work tasks (i.e., temperature and 

heat-related illness). 

THE VICTIM

The victim was a 49-year-old Hispanic male who had been working for this company for 27 

years in different capacities. His job title at the time of the incident was foreman. The victim 

was born in Mexico and his primary language was Spanish. According to the coroner’s report 

and victim’s next of kin, the victim had a previous allergic reaction to bee stings, but did not 

seek medical care for the previous incident. 

INCIDENT SCENE

The incident scene was a 40-acre organic date palm orchard with trees that were approximately 

50 years old. The trees were situated in straight north-to-south rows with a large lane between 
each row (Exhibit 1). The tractor and attached spray rig with an aerial bucket were found in the 

third row off the east side of the orchard.

Exhibit 1. Rows of date palms. Note: Dates were not tied in clusters 

or covered by mesh bags at the time of the incident.

WEATHER

The weather on the day of the incident was sunny with temperature at the time of the incident 

of approximately 106°F. 

INVESTIGATION

On the day of the incident, the victim and a co-worker were spraying the date palms with highpressure water to remove the webbing of the mites. They began work that day around 8 am. 

The co-worker was in an enclosed cab driving the tractor pulling the spray rig (Exhibit 2). The 

victim was in the open raised aerial bucket on the spray rig, approximately 40 feet in the air and 

20 feet from the palm dates. As the co-worker towed the spray rig down the row of date palms, 

the victim sprayed water onto the dates to wash away the mites’ webbing. During the course of 

the work, the victim sprayed a bunch of dates where a bee hive was hidden and not visible 

among the palm branches. Multiple bees began to sting the victim. The victim lowered the 

aerial bucket and exited the spray rig to escape the bees attacking him. The co-worker realized 

the victim was being stung by the bees and opened the cab door to allow the victim to enter

the enclosed cab. The victim, along with some bees, entered the cab of the tractor. The coworker drove the tractor further down the row of date palms. Both the victim and co-worker 

were stung by bees while in the enclosed cab. After driving an unknown distance down the row, 

the co-worker stopped the tractor and both men exited the cab and ran further down the row, 

away from the bees. Several calls were made to 911 by co-workers and the supervisor. While 

waiting, the victim complained of chest pain and that he was having a hard time breathing. 
While waiting, the victim collapsed and became unresponsive. The co-worker began performing 

CPR on the victim as he waited for the fire department to arrive. On their arrival, the victim was 

in cardiac arrest with an asystolic cardiac rhythm. CPR and Advanced Cardiac Life Support 

(ACLS) measures were performed, with administration of multiple doses of epinephrine and 

one dose of diphenhydramine. The victim did not respond to these measures and was 

pronounced dead at the scene. 

Exhibit 2. Spray rig with open raised aerial bucket similar to the one

the victim was in at the time of the incident.

CAUSE OF DEATH

According to the death certificate, the cause of death was anaphylactic shock due to multiple 

bee stings.

RECOMMENDATIONS

The CA/FACE investigator determined that, in order to prevent future incidents, agricultural 

employers should ensure the following: 

Recommendation #1: Workers who are allergic to insect stings or bites should be advised to 

visit a health care professional to obtain a prescription for an epinephrine auto-injector, carry it 

with them at all times, and inform their employer and co-workers of their allergy to insect 

stings or bites.

Discussion: In this incident, the victim was allergic to bee stings, did not have an epinephrine 

auto-injector with him, and his employer was unaware of his condition. Most people who have a

known allergy to bee stings carry an epinephrine auto-injector with them and are trained on how

to administer it when needed. Workers performing work duties in areas that could or are known 

to have stinging or biting insects should be advised by their employer of the hazards and risks 

associated with their work. Additionally, employers should advise all workers that if they have a 

known allergy to stinging or biting insects, the employee should visit a health care professional 
and, if prescribed, carry an epinephrine auto-injector with them while at work to possibly prevent 

incidents such as this one. Employers should also ask their employees who could come into 

contact with stinging or biting insects to disclose any such allergies to them. Workers with known 

allergies should inform their employers and co-workers about their allergy and let them know 

where they keep their epinephrine auto-injector. Workers who know about a co-worker’s allergy 

and where to locate their epinephrine auto-injector should assist their co-worker if needed when 

they experience an allergic reaction while at work.

If the victim had carried an epinephrine auto-injector, he may have been able to administer the 

injection to himself immediately after he began to experience an allergic reaction. Alternatively, 

his co-worker could have retrieved the epinephrine auto-injector and helped administer this to 

the victim. If this had been done at the onset of his allergic symptoms, the victim may have been 

able to continue breathing until emergency personnel arrived.

Recommendation #2: A hazard assessment, prevention steps, and incident response plan for 

insect stings and bites should be incorporated into the company’s Injury and Illness 

Prevention Program (IIPP).

Discussion: In this incident, the victim and his co-worker were not aware of bee hives or swarms 

within the date palm orchard where they were spraying. Since these workers had not 

experienced prior problems with bees or other stinging insects, they may not have considered the 

potential for a life-threatening incident. When starting work in any agricultural area, a hazard 

assessment of the work area, including 100 yards around the worksite, should include surveying 

for stinging and biting insects. An AHB colony can come into an area and establish a hive in as 

short as 12 hours, so daily assessments should be conducted of the work area. It is also important 

to know what work has recently been conducted in the area because, once disturbed, AHBs can 

remain agitated for several days.

The presence of a bee hive or swarm may be first noticed by observing bees flying around. 

Buzzing can be heard from hives as well, but close proximity is needed to hear it. The best way to 

spot bees associated with a hive is to look for flight patterns. There are always insects flying 

about, but honey bees will be constantly leaving and returning to a centralized location while 

they are foraging, which typically begins in the early morning. It may be advisable to have the 

same group of workers surveying the worksite for insects each day, as they will become familiar 

with typical insect behavior in the orchards and may be able to identify flight patterns associated 

with a hive. Hives are often located in places that are protected from the elements and possible 

predators (i.e., under the eaves of a roof, under floorboards, or under tree branches); they may 

be difficult to see and are occasionally in unexpected places. AHBs swarm in smaller numbers 

than European honey bees and can colonize smaller cavities about 1-5 gallons in volume, like 

utility boxes. Two feral bee hives were later located in trees within the area that was being 

sprayed during this incident.

If a hive or nest is discovered during a hazard assessment, work in that area should not be 

conducted until the hive or nest has been removed. If a hive is found, all employees, especially 
those with known allergies, should avoid the area until the hazard is removed. A professional bee 

keeper or bee removal service should be contacted to remove the hive.

At the time of this incident, the employer did have a documented IIPP, but it did not include a 

specific plan or training on insect stings and bites. Implementing such a plan and training program 

would ensure the employees were aware of the proper prevention and incident response to 

insect stings and bites. For employees who are working in areas with possible interactions with 

stinging and biting insects, proper awareness and training is recommended for when they 

encounter bees or other insects during their work. The insect bite or sting program should 

include, but is not limited to: 1.) A description of the insect hazard and its location and 

identification in the worksite. 2.) Possible precautions (behavior and clothing) to take to avoid 

insect attacks and/or bites and stings. 3.) Training on the proper response if the insect is 

encountered or attacks an employee. 4.) What to do if someone is stung or bit by the insect, 

including first aid and epinephrine auto-injector training.

If a swarm of bees or a bee hive is encountered in the workplace, the employee should get to a 

safe place or a safe distance away from the insects and report it to their supervisor for removal 

and communication to all other employees to avoid the area. Avoid movement or making loud 

noises, generating vibrations, and using power equipment near the hive as it could agitate the 

colony. If bees attack an employee, the employee should leave the area as quickly as possible, 

run if possible, or get to an enclosed space that the bees cannot enter (i.e., a sealed building or

vehicle with closable doors). If on foot, AHBs will chase for long distances, sometimes up to a 

quarter of a mile. Do not jump into a body of water. The bees will stay in the area and sting the 

person when they surface to breathe. Once in a safe location, gently brush bees away from the 

body; do not swat or squish bees. If stung, remove stingers as soon as possible by scraping the 

stinger out sideways with a fingernail or a credit card. Workers should seek medical attention if 

they feel ill after being stung. In this incident, the co-worker who was with the victim promptly 

got the two of them away from the hazard (the bees), called 911 for help, and performed CPR. 

Employers should ensure their employees are aware of the symptoms and first aid response to 

insect stings and bites. This is especially important since employees may be unaware of an 

allergy. Training on the proper first aid response to insect stings or bites should be given by the 

employer.

In this incident, if a hazard assessment had been performed and the hive of bees had been 

identified and removed, the victim may not have disturbed the bees and been stung. The victim 

did appropriately remove himself from the immediate area, seek shelter in the enclosed cab, and 

run away from the bees. Unfortunately, that was likely not enough to avoid the subsequent lifethreatening allergic response. 

GLOSSERY OF TERMS

Epinephrine auto-injector – a medical device for injecting a measured dose or doses of 

epinephrine (adrenaline) by means of auto-injector technology. It is most often used for the 

treatment of anaphylaxis (a severe, potentially life-threatening allergic reaction).
Feral – existing in a natural state, as animals or plants; not domesticated or cultivated; wild.

Foraging – characterized by or dependent upon the acquisition of food by such means; foodgathering.

REFERENCES

Division of Occupational Safety and Health - Title 8 regulations - Subchapter 7 - General 

Industry Safety Orders, Group 3. Tree Work, Maintenance or Removal §3421. General. §3427. 

Safe Work Procedures. §3428. Operating Rules.

https://www.cdph.ca.gov/Programs/CID/DCDC/Pages/AfricanizedHoneybees.aspx

https://www.ars.usda.gov/pacific-west-area/tucson-az/honey-bee-research/docs/bee-stingssafety/

https://www.cdfa.ca.gov/plant/pdep/target_pest_disease_profiles/ahb_profile.html

http://bees.ucr.edu/ahb-update.html

Chao, T., and R. R. Krueger. 2007. The date palm (Phoenix dactylifera L.): Overview of biology, 

uses, and cultivation. HortScience 42:1077 –1082. 

Negm M.W., De Moraes G.J., Perring T.M. (2015) Mite Pests of Date Palms. In: Wakil W., Romeno 

Faleiro J., Miller T. (eds) Sustainable Pest Management in Date Palm: Current Status and Emerging 

Challenges. Sustainability in Plant and Crop Protection. Springer, Cham

Special thanks to Elizabeth Andrews, Ph.D., California Department of Public Health.

_____________________________ ______________________________

Hank Cierpich Robert Harrison, MD, MPH

FACE Investigator FACE Project Officer

______________________________ March 20, 2018 

Laura Styles, MPH

Research Scientist
 

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FATALITY ASSESSMENT AND CONTROL EVALUATION PROGRAM

The California Department of Public Health, in cooperation with the Public Health Institute 

and the National Institute for Occupational Safety and Health (NIOSH), conducts 

investigations of work-related fatalities. The goal of the CA/FACE program is to prevent fatal 

work injuries. CA/FACE aims to achieve this goal by studying the work environment, the 

worker, the task the worker was performing, the tools the worker was using, the energy 

exchange resulting in fatal injury, and the role of management in controlling how these 

factors interact. NIOSH-funded, state-based FACE programs include: California, Iowa, 

Kentucky, Massachusetts, Michigan, New Jersey, New York, Oregon, and Washington.

 

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Additional information regarding the CA/FACE program is available from:

California FACE Program

California Department of Public Health

Occupational Health Branch

850 Marina Bay Parkway, Building P, Third Floor

Richmond, CA 94804

www.cdph.ca.gov/face