Green tobacco sickness may be increasing as family tobacco farms are consolidated into large commercial operations and work is done by migrant or seasonal farm workers, according to a Wake Forest University School of Medicine epidemiologist.
Writing in the current American Journal of Industrial Medicine, Sara A. Quandt Ph.D., said that 41 percent of tobacco farm workers reported having green tobacco sickness at least once during the summer. Most are migrant Hispanic farm workers.
Green tobacco sickness is characterized by headaches, nausea, vomiting and dizziness.
Quandt and four colleagues reported that the illness typically occurs after exposure to wet tobacco leaves in the morning while the plants are still covered with dew, or after a rain.
The disease is attributed to acute nicotine poisoning caused by contact with nicotine on the plants, which is rapidly absorbed through the skin.
"This is the first survey research to document green tobacco sickness as an occupational health risk among seasonal and migrant farm workers," said Quandt.
While green tobacco sickness was first described in the medical literature in 1970, it rarely came to medical attention, perhaps because it was less likely to occur on small family tobacco farms, where exposure to wet tobacco leaves was limited.
"Instead of family groups with a few workers doing a relatively small amount of tobacco work, there are now hired, low-paid, usually minority workers working in tobacco almost exclusively for 8 to 12 weeks each year," said Quandt.
Other factors researchers cited as contributing to chance of exposure were height of the workers and climate conditions.
"Absorption increases with the amount of skin exposed and with skin damage or disease," said Quandt. "Because the work is done on the hot, humid days of summer, workers are more likely to work shirtless."
While symptoms of green tobacco sickness ordinarily include nausea, vomiting and dizziness, researchers said there were no established diagnostic criteria yet.
"Other frequently encountered symptoms include abdominal cramps, headache, breathing difficulty and fluctuations in blood pressure," said Quandt.
Most workers attempt to treat themselves. "Only 9 percent sought medical treatment," she said, "and 7 percent lost work time."
Quandt and other researchers are now engaged in a three-year study of green tobacco sickness among farm workers, supported by the National Institute of Occupational Health and Safety.