The sickness, long known as a health risk among tobacco workers, is caused by the absorption of nicotine from the surface of wet tobacco leaves through the skin. Symptoms usually start several hours after exposure, and include nausea, vomiting, dizziness, and weakness. Other symptoms may include abdominal cramps, headache, breathing problems, paleness, chills, increased sweating, and changes in heart rate and blood pressure. A team of researchers led by Dr. Sara Quandt of Wake Forest University in Winston-Salem, North Carolina note that green tobacco sickness is one more risk faced by farmworkers, who are already at risk for a number of work-related health problems, including dermatitis (an inflammatory condition of the skin), cancer, and infertility. Quandt and colleagues from other North Carolina centers interviewed 144 Hispanic farm workers at 35 tobacco farms in the state about their experiences with green tobacco sickness. They report their findings in the February issue of the American Journal of Industrial Medicine. On modern farms, tobacco is planted in closely spaced rows to increase production, and workers are exposed to the leaves almost constantly. The leaves are picked from the ground up as they ripen, so workers can't help touching them as they walk through the rows, reach into the plants, and carry the picked leaves to carts. Protective clothing and gloves are hot and make picking awkward. In addition, the workers often take off their shirts because of the hot conditions, thus increasing their exposure. The researchers report that 41% of the workers interviewed said they'd had green tobacco sickness that summer, and 76% said they'd had it more than once. More than half of the workers said they took no precautions against the illness. The most frequently used precautions were wearing long sleeved shirts and taking ``some kind of medication,'' each reported by less that 20% of workers. Only 9% of those who reported having the illness said they went to a doctor, and only 7% took time off work. The most common method of self-treatment was taking anti-nausea medication. ``Many farmworkers believe they will be fired and lose their income if they get sick or work too slowly,'' Quandt said in a statement. Calling green tobacco sickness ``an environmental justice issue,'' she emphasized the growing concern that ``poor, minority, and medically underserved populations bear a disproportionate share of environmental and occupational health risks.'' SOURCE: American Journal of Industrial Medicine 2000;37:307-315.

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