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. 1998 Sep;7(3):294–298. doi: 10.1136/tc.7.3.294

Green tobacco sickness

J McBride 1, D Altman 1, M Klein 1, W White 1
PMCID: PMC1763894  PMID: 9825425

Abstract

OBJECTIVE—To describe the health impact of harvesting tobacco and to suggest prevention and risk reduction strategies to avoid contracting green tobacco sickness (GTS).
DATA SOURCES—A literature search of Medline, Toxline, and Toxline65 with the terms "green", "tobacco", and "sickness" covering the years 1966-1998.
STUDY SELECTION—All studies, reviews, and commentaries that provided information on the health effects of harvesting green tobacco and disease prevention strategies.
DATA SYNTHESIS—GTS occurs when tobacco workers hand-harvest, cut, or load tobacco plants, usually in the early morning or after a rainfall when tobacco plants are covered with moisture. GTS occurs through skin exposure to dissolved nicotine from tobacco leaves. Symptoms of GTS include weakness, headache, nausea, vomiting, dizziness, abdominal cramps, breathing difficulty, abnormal temperature, pallor, diarrhoea, chills, fluctuations in blood pressure or heart rate, and increased perspiration and salivation. The onset of the illness is three to 17 hours after exposure and the duration of illness is one to three days. Initial treatment includes cessation of work, change of clothing, showering, fluid intake, and rest. In more extreme cases, intravenous rehydration, anti-emetics, and dimenhydrinate are administered. Protective, water-resistant clothing; chemical-resistant gloves, boots, and socks; working in dry conditions; and dimenhydrinate can reduce the likelihood of contracting GTS.
CONCLUSIONS—It is important to provide education to tobacco workers and employers about GTS. An international public awareness campaign about GTS timed to coincide with the tobacco harvest, along with enforced worker safety regulations, should be undertaken to protect the health of individuals working in tobacco production.



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Selected References

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  1. Ballard T., Ehlers J., Freund E., Auslander M., Brandt V., Halperin W. Green tobacco sickness: occupational nicotine poisoning in tobacco workers. Arch Environ Health. 1995 Sep-Oct;50(5):384–389. doi: 10.1080/00039896.1995.9935972. [DOI] [PubMed] [Google Scholar]
  2. Centers for Disease Control and Prevention (CDC) Green tobacco sickness in tobacco harvesters--Kentucky, 1992. MMWR Morb Mortal Wkly Rep. 1993 Apr 9;42(13):237–240. [PubMed] [Google Scholar]
  3. Edmonson W. D. Green tobacco sickness (bradycardia in a young farmer). J Tenn Med Assoc. 1996 Mar;89(3):85–86. [PubMed] [Google Scholar]
  4. Gehlbach S. H., Williams W. A., Freeman J. I. Protective clothing as a means of reducing nicotine absorption in tobacco harvesters. Arch Environ Health. 1979 Mar-Apr;34(2):111–114. doi: 10.1080/00039896.1979.10667379. [DOI] [PubMed] [Google Scholar]
  5. Gehlbach S. H., Williams W. A., Perry L. D., Woodall J. S. Green-tobacco sickness. An illness of tobacco harvesters. JAMA. 1974 Sep 30;229(14):1880–1883. [PubMed] [Google Scholar]
  6. Ghosh S. K., Gokani V. N., Doctor P. B., Parikh J. R. Intervention studies against "green symptoms" among Indian tobacco harvesters. Arch Environ Health. 1991 Sep-Oct;46(5):316–317. doi: 10.1080/00039896.1991.9934396. [DOI] [PubMed] [Google Scholar]
  7. Ghosh S. K., Gokani V. N., Parikh J. R., Doctor P. B., Kashyap S. K., Chatterjee B. B. Protection against "green symptoms" from tobacco in Indian harvesters: a preliminary intervention study. Arch Environ Health. 1987 Mar-Apr;42(2):121–124. doi: 10.1080/00039896.1987.9935807. [DOI] [PubMed] [Google Scholar]
  8. Ghosh S. K., Parikh J. R., Gokani V. N., Kashyap S. K., Chatterjee S. K. Studies on occupational health problems during agricultural operation of Indian tobacco workers: a preliminary survey report. J Occup Med. 1979 Jan;21(1):45–47. [PubMed] [Google Scholar]
  9. Ghosh S. K., Saiyed H. N., Gokani V. N., Thakker M. U. Occupational health problems among workers handling Virginia tobacco. Int Arch Occup Environ Health. 1986;58(1):47–52. doi: 10.1007/BF00378539. [DOI] [PubMed] [Google Scholar]
  10. Hipke M. E. Green tobacco sickness. South Med J. 1993 Sep;86(9):989–992. doi: 10.1097/00007611-199309000-00002. [DOI] [PubMed] [Google Scholar]
  11. Ives T. J. Use of dimenhydrinate in the treatment of green tobacco sickness. Drug Intell Clin Pharm. 1983 Jul-Aug;17(7-8):548–549. doi: 10.1177/106002808301700712. [DOI] [PubMed] [Google Scholar]
  12. McKnight R. H., Dawson S. K., Westneat S. C., Rodgers G. C., Jr, Ross M. P. Delay among the general public in telephoning a poison center. Vet Hum Toxicol. 1996 Apr;38(2):92–95. [PubMed] [Google Scholar]
  13. McKnight R. H., Kryscio R. J., Mays J. R., Rodgers G. C., Jr Spatial and temporal clustering of an occupational poisoning: the example of green tobacco sickness. 1996 Apr 15-May 15Stat Med. 15(7-9):747–757. doi: 10.1002/(sici)1097-0258(19960415)15:7/9<747::aid-sim246>3.0.co;2-p. [DOI] [PubMed] [Google Scholar]
  14. McKnight R. H., Levine E. J., Rodgers G. C., Jr Detection of green tobacco sickness by a regional poison center. Vet Hum Toxicol. 1994 Dec;36(6):505–510. [PubMed] [Google Scholar]
  15. Misumi J., Koyama W., Miura J. [2 cases of "green tobacco disease" among tobacco harvesters and percutaneous nicotine absorption in rats]. Sangyo Igaku. 1983 Jan;25(1):3–9. doi: 10.1539/joh1959.25.3. [DOI] [PubMed] [Google Scholar]
  16. Nicotine absorption by workers harvesting green tobacco. Lancet. 1975 Mar 1;1(7905):478–480. [PubMed] [Google Scholar]
  17. Svensson C. K. Clinical pharmacokinetics of nicotine. Clin Pharmacokinet. 1987 Jan;12(1):30–40. doi: 10.2165/00003088-198712010-00003. [DOI] [PubMed] [Google Scholar]
  18. Weizenecker R., Deal W. B. Tobacco cropper's sickness. J Fla Med Assoc. 1970 Dec;57(12):13–14. [PubMed] [Google Scholar]

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