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Nicotine and green tobacco sickness

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As the Stoptober anti-smoking campaign gets under way, many tobacco users(Callie Jones) will no doubt be turning to nicotine patches as a way to maintain their nicotine addiction while avoiding the major health risks of smoking.

Nicotine patches were first marketed in 1992, but the effects of transdermal nicotine had been noted in 1970, when the Journal of the Florida Medical Association published a paper about an illness experienced by farm workers who handled uncured tobacco leaves. Symptoms included headache, dizziness and vomiting. Patients normally recovered within three days with symptomatic treatment. The condition was dubbed “green tobacco sickness” (GTS).

We know now that GTS is the effect of acute nicotine poisoning, caused by skin absorption while handling green tobacco leaves wetted by dew or rain. But since the symptoms resemble those of pesticide exposure and heat exhaustion, absorption of nicotine through the skin was not initially considered as a possible cause.

The US tobacco industry plays down the significance of GTS. But claims that its incidence is low are based mainly on studies of medical records; interviews with tobacco harvesters tell a different story. A survey of North Carolina’s migrant and seasonal farm workers found that more than 40 per cent had suffered from GTS at least once during the tobacco harvest, although less than one in 10 had sought medical treatment. Many had lost work time — and therefore pay.

It has also been claimed that GTS symptoms are mild, but a review of medical records after an outbreak in Kentucky in 1992 found that of 47 people who had sought medical help 12 were admitted to hospital and two needed intensive care.

GTS is not, of course, confined to the US. Around the world more than 30 million tobacco farm workers are at risk, and many of them are in regions where emergency medical help is hard to find. And in some developing nations, much of the tobacco crop is harvested by children, who are particularly vulnerable to nicotine poisoning.      

Researchers in India — a major tobacco growing nation with a high incidence of GTS — found that wearing any type of glove can greatly reduce nicotine levels in the body. But in the US neither Big Tobacco nor legislators seem to make much effort to protect vulnerable tobacco workers.

 

General info on GTS:
http://bmj-tobacco.highwire.org/content/7/3/294.full.pdf

North Carolina:
http://onlinelibrary.wiley.com/doi/10.1002/(SICI)1097-0274(200003)37:3%3C307::AID-AJIM10%3E3.0.CO;2-Z/abstract

Kentucky:
http://www.tandfonline.com/doi/abs/10.1080/00039896.1995.9935972

India:
http://icmr.nic.in/000004/project2/project.htm

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