The Green Hazards: A Meta-Analysis of Green Tobacco Sickness

Abstract

Green Tobacco Sickness (GTS) has been one of the unexplored areas of occupational health safety. The condition mainly affects the tobacco harvesters. The condition is prevalent in Asian and South American tobacco harvesters. Although transient, the condition can affect multiple organ systems. The objective of this review is to extensively discuss the background, epidemiology, clinical features and measures to counter the problem.A literature search of Medline with terms such as “green”, “tobacco” and “sickness” was done covering years 1970-2007. All studies, reviews and commentaries on health effects of farming green tobacco and preventing the disease were included.Green Tobacco Sickness is caused by the absorption of nicotine through the skin from wet tobacco plants who have direct contact with tobacco plants during cultivation and harvesting. The early symptoms often include headache and nausea followed by vomiting, weakness, pallor, dizziness, headaches, increased perspiration, chills, abdominal pain, diarrhoea, and increased salivation which may also progress to extreme conditions like prostration, shortness of breath, and occasional fluctuations in blood pressure or heart rate. The duration of the illness is usually between one and three days. The use of protective, water-resistant clothing, chemical-resistant gloves, plastic aprons and rainsuits with boots and socks has reduced the chances of contracting GTS.It is important to educate the tobacco workers and the employers about GTS in order to reduce its incidence. An international level awareness campaign has to be taken up and more stringent workers safety regulations have to be formulated.DOI: http://dx.doi.org/10.3126/ijosh.v2i1.4963 International Journal of Occupational Safety and Health, Vol. 2 No. 1 (2012) 11-14

Health Hazards and the Socioeconomic Status of Female Labour of Tobacco Processing Mills in Kushtia, Bangladesh

“…It's mainly caused by handling green and fresh wet leaves of tobacco. The symptoms of tobacco workers that are reported in the current study are also reported by several studies among green tobacco workers [44,45,46].…”

Green Tobacco Sickness among Thai Traditional Tobacco Farmers, Thailand

“…[4][5][6][7] Previous studies have shown that dermal absorption of nicotine from plant surfaces gives rise to characteristic GTS symptoms. [8][9][10] GTS morbidity concerns nearly a quarter of tobacco workers, with typical symptoms including nausea, vomiting, headache, abdominal cramps, breathing difficulty, abnormal body temperature, pallor, chills, fluctuations in blood pressure and heart a r t i c l e rate, drenching sweats, and increased salivation. [1][2][3] GTS is a result of acute nicotine poisoning caused by dermal absorption of nicotine from mature tobacco plants.…”

Socio-environmental risks associated with the green tobacco sickness in farmers: a case-control study

“…Wearing socks was a risk factor for the development of GTS, in which was confirmed in this study. However, in another study that describes the use of water-resistant protective clothing as well as chemical-resistant gloves, plastic aprons, and rainwear with boots and socks, reduce the chances of developing GTS as it would decrease exposure nicotine (9) .…”

“…Nausea and weakness may occur within 15 minutes after contact with the skin (4) , with signs and symptoms usually occurring after work for 3 and 17 hours, and may vary. Diagnosis is based on the triad: presence of compatible signs and symptoms such as those already listed, history of exposure to tobacco culture and high levels of nicotine by measuring the cotinine level (9)(10) .…”

“…During harvesting, wearing protective clothing such as waterproof clothing (gloves and waterproof clothing), gloves, boots and socks and avoiding working with tobacco and wet clothing are protective measures that would reduce the risk of disease onset (5,9) . The work carried out by tobacco workers exposes them to the risks that are produced by the conditions and the work organization (15) , being a socio-environmental condition that influences the health and illness conditions of workers (16) .…”