Green Tobacco Sickness: A Review
It is still an unknown fact among many that tobacco harvesters are at a potential at a risk of suffering from “Green Tobacco Sickness (GTS)”, with its prevalence seen mostly among Asian and South American tobacco harvesters. These harvesters working in hot, wet conditions are likely to develop GTS, as in such climatic conditions, the wetness and high humidity causes nicotine to reside on the surfaces of the leaves, while the high ambient temperature increases skin absorption, thereby increasing plasma nicotine concentrations by 30-45%. Patients suffering from GTS report nausea, vomiting, pallor, dizziness, headaches, increased perspiration, chills, abdominal pain, diarrhea, increased salivation, prostration, weakness, cough with or without expectoration, breathlessness and occasional reduction in blood pressure or heart rate. GTS is self-limiting and of short duration and hence treatment is not always necessary and not often sought by the harvesters. This review educates readers about GTS as well as encourages their participation in making tougher regulations in their respective countries for the control of this disease.
Fotedar S, Fotedar V. Green Tobacco Sickness: A Brief Review. Indian J Occup Environ Med. 2017;21(3):101-4. https://doi.org/10.4103/ijoem.IJOEM_160_17.
McBride JS, Altman DG, Klein M, White W. Green tobacco sickness. Tob Control. 1998;7:294–8.
Vanakoski J, Seppala T, Sievi E, Lunell E. Exposure to high ambient temperature increases absorption and plasma concentrations of transdermal nicotine. Clin Pharmacol Ther. 1996;60:308-15.
Singh JK, Rana SVS, Mishra N. Occupational Health Problems Amongst Women Beedi Rollers in Jhansi, Bundelkhand region, Uttar Pradesh. J. Ecophysiol. Occup. Hlth. 2014; 14: 17-22.
Ghosh SK, Parikh JR, Gokani VN, Rao MN, Kashyap SK, Chatterjee SK. Studies on occupational health problems in agricultural tobacco workers. J Soc Occup Med. 1980;29:113–7.
Boylan BB, Brandt V, Muehlbauer Auslander M, Spurlock C. Green tobacco sickness in tobacco harvesters—Kentucky, 1992. MMWR. 1993;42:237–40.
Gehlbach SH, Williams WA, Perry LD, Woodall JS. Green-tobacco sickness: An illness of tobacco harvesters. JAMA. 1974;229:1880–3.
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;50:384–9.
Edmonson WD, Smith BD, Morgan HJ. Green tobacco sickness (bradycardia in a young farmer) J Tenn Med Assoc. 1996;89:85–6.
McKnight RH, Koetke CA, Donnelly C. Familial clusters of green tobacco sickness. J Agromed. 1996;3:51–9.
Curwin BD, Hein MJ, Sanderson WT, Nishioka MG, Buhler W. Nicotine exposure and decontamination on tobacco harvesters' hands. Ann Occup Hyg. 2005;49:407–3.
Ghosh SK, Parikh JR, Gokani VN, Rao MN, Kashyap SK, Chatterjee SK. Studies on occupational health problems in agricultural tobacco workers. J SOC Occup Med. 1980; 29: 113-7.
Department of Agriculture (US), Foreign Agricultural Service. World’s leading unmanufactured tobacco producing, trading and consuming countries. (Online PDF). Available from: http://www.fas.usda.gov/tobacco/circular/2004/082004/TBL1.PDF. [Last Accessed on 17th July, 2021]
McKnight RH, Kryscio RJ, Mays JR, et al. Spatial and temporal clustering of an occupational poisoning: the example of green tobacco sickness. Stat Med. 1996;15:747–57.
Copyright (c) 2021 Sahil Thakar
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.