Green Tobacco Sickness Among Tobacco Harvesters in a Korean Village

Abstract

BackgroundGreen tobacco sickness (GTS), an occupational disease in tobacco harvesters, is a form of acute nicotine intoxication by nicotine absorption through the skin from the wet green tobacco plant. We carried out a questionnaire survey and measured cotinine concentration, the metabolic product of nicotine, to determine the prevalence, incidence, and risk factors of GTS in Korean tobacco harvesters.MethodsWe measured cotinine concentrations, and administered a questionnaire survey to tobacco harvesters in Cheongsong-gun, Gyeongsangbuk-do, Korea. We repeatedly measured urine cotinine concentration five times with a questionnaire survey.ResultsCotinine concentration at dawn was significantly higher than that at other times; it was significantly lower during the nonharvesting period than during the harvesting period. However, little change in cotinine concentration was detected in the daytime during the harvesting period. Study participants included 20 men and 20 women. The prevalence of GTS was 37.5% and was significantly higher in women than in men (55.0% vs. 20.0%, p < 0.01). GTS incidence according to number of workdays was 3.4 occurrences/100 person days.ConclusionIn this study, nicotine exposure and metabolism were experimentally determined from the time of cotinine exposure, and biological monitoring was performed in each season. In the future, this information may be valuable for medical decision-making in GTS prevention.

Green tobacco sickness: mecamylamine, varenicline, and nicotine vaccine as clinical research tools and potential therapeutics

“…Farming conditions around the world vary, with some growers relying on mechanized equipment for harvesting, which eliminates much of the need for human contact with tobacco leaves. However, green tobacco sickness continues to be reported in farm operations around the world, e.g., Brazil [15] Korea [16], and Thailand [17]. Because workers are still relied upon for harvesting in many places, those workers are not consistently protected from contact with green tobacco leaves, and the sickness can be severely debilitating for several days, there is a need to disseminate knowledge about the illness to protect workers as much as possible.…”

Hubungan Pengetahuan Dan Persepsi Tentang Masalah Kesehatan Kerja Dan Perilaku Penggunaan Alat Pelindung Diri Petani Tembakau

“…Petani tembakau sangat berisiko terkena occupational disease yaitu green tobacco sickness (GTS) sebagai akibat paparan nikotin pada daun tembakau. Kadar nikotin yang ada pada daun tembakau dapat masuk ke dalam tubuh manusia jika daun tembakau dalam keadaan basah (Da Mota E Silva et al, 2018;Fotedar & Fotedar, 2017;Park, Lim, Lee, & Yoo, 2018). Nikotin akan masuk ke dalam tubuh manusia melalui kulit dan dibawa oleh aliran darah menuju otak.…”

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

“…Tobacco production setting has harmful implications for the environment and the health of the families involved (2) . Among the health problems, the risk of developing Green Tobacco Sickness (GTS) stands out (3) as an occupational disease observed among tobacco workers (4) caused by the dermal absorption of nicotine at the time of cutting tobacco leaves in the field and in the leaves (5) , as well as by the inhalation of nicotine from the air in the various environments of tobacco workers (6) .…”

“…Symptoms described in the literature (3,(7)(8) are weakness, headache, vomiting, nausea, dizziness, colicky and abdominal pain, difficulty breathing, paleness, diarrhea, fainting, chills, changes in blood pressure and heart rate during or after exposure, increased respiration and salivation, abnormal body temperature and excessive sweating. 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) .…”