Green Tobacco Sickness (GTS) is a type of nicotine poisoning caused by the transdermal absorption of nicotine from the surface of tobacco plants. [1] Tobacco plants that have yet to be cured are referred to as "green tobacco". Nicotine is a water soluble chemical, therefore the risk of GTS is elevated if this chemical from the tobacco plants mixes with any sort of moisture. [2] [3]
Green Tobacco Sickness is characterized by a wide range of symptoms, including nausea, vomiting, headache, dizziness, and severe weakness. [4] These symptoms may be accompanied by fluctuations in blood pressure or heart rate. Abdominal cramping, chills, increased sweating, salivation and difficulty breathing are also common. [5]
Symptoms of Green Tobacco Sickness may begin while at work or hours after the conclusion of the workday. They do not typically persist for more than one day. [3] The primary symptoms of GTS can be separated into two categories, neurological and respiratory. Those referred to as neurological complaints include headaches, dizziness, nausea, vomiting, chills, weakness, and increased perspiration and salivation. Symptoms that fall into the respiratory category include coughing and trouble breathing. [2]
Green Tobacco sickness is caused by the transdermal absorption of nicotine that frequently occurs when tobacco farm workers are in contact with uncured tobacco leaves. Nicotine is then able to be distributed throughout the body because it passes directly into the bloodstream upon absorption. [2]
A majority of the tobacco that is produced is grown in China, Brazil, India, and the United States. [5] [6] It is estimated that over 15 million people contribute to the process of farming tobacco worldwide. [7] Previous publications attempting to determine the prevalence of GTS typically only report the prevalence of this illness in one area during one farming season. Reported prevalence rates from these studies range from 8.2-47%, so further research is necessary to be able to definitively state the prevalence of GTS. [2] The long-term health outcomes for individuals who experience GTS are not known. [3]
Workers that are involved in directly harvesting the tobacco by hand are at the highest risk for developing GTS, especially those who harvest in the early morning in the presence of dew, those working with wet clothes, and those working with wet tobacco plants. [2] [8] Those involved in barning the tobacco, a process in which the leaves are hung up to be cured, are also at a higher risk. [2] [9] Individuals who are new to working on tobacco farms could also be at an elevated risk due to a lack of knowledge about GTS as well as having little experience with safe harvesting practices. Younger workers have been shown to have a higher risk of GTS when compared to older workers, as younger workers might be more sensitive to this kind of exposure. [6] Tobacco harvesters, whose clothing becomes saturated from tobacco wet with rain or morning dew, are at high risk of developing GTS. Workers can avoid getting this sickness by waiting to harvest until the tobacco leaves are dry, or by wearing a rain suit. Wet clothing that has come in contact with tobacco leaves should be removed immediately and the skin should be washed with warm soapy water. [2] Individuals who are working in the heat are also at a higher risk for GTS, as high temperatures can increase absorption. [2] It is also suggested that some workers may be at a lower risk than others due to activities that may increase their nicotine tolerance, such as personal tobacco use or a long history harvesting tobacco. [2] [3]
Proper workplace training and preventative efforts are important to reduce the risk of GTS. Employers should ensure any worker handling tobacco leaves has gloves that can be substituted for a new pair should they become wet. [2] [3] Long pants, long sleeve shirts, and water resistant suits are also protective against GTS as long as they are kept dry. However, those working with tobacco plants often do so in very warm weather, so it is essential that workers are given adequate breaks and opportunities for hydration in order to avoid heat exhaustion. [2] Wet clothing that has come in contact with tobacco leaves should be removed immediately and the skin should be washed with warm soapy water. Another way workers can avoid getting this sickness is by waiting to harvest until the tobacco leaves are dry. [3] Training tobacco farm workers to identify the signs and symptoms in themselves and others is helpful in early identification of GTS. [2]
There is no specific treatment for Green Tobacco Sickness, but rest and rehydration are helpful in managing symptoms. [4] In most cases, the illness will resolve on its own within one to two days, but symptoms may be so severe as to require emergency medical treatment which could include medication to treat nausea and vomiting and IV fluids. [4] The symptoms of GTS are similar to those of other conditions that are common in this profession, such as heat illness and pesticide poisoning, which can sometimes lead to misdiagnosis. [2]
Tobacco is the common name of several plants in the genus Nicotiana of the family Solanaceae, and the general term for any product prepared from the cured leaves of these plants. More than 70 species of tobacco are known, but the chief commercial crop is N. tabacum. The more potent variant N. rustica is also used in some countries.
Nicotine is a naturally produced alkaloid in the nightshade family of plants and is widely used recreationally as a stimulant and anxiolytic. As a pharmaceutical drug, it is used for smoking cessation to relieve withdrawal symptoms. Nicotine acts as a receptor agonist at most nicotinic acetylcholine receptors (nAChRs), except at two nicotinic receptor subunits where it acts as a receptor antagonist.
Altitude sickness, the mildest form being acute mountain sickness (AMS), is a harmful effect of high altitude, caused by rapid exposure to low amounts of oxygen at high elevation. People can respond to high altitude in different ways. Symptoms may include headaches, vomiting, tiredness, confusion, trouble sleeping, and dizziness. Acute mountain sickness can progress to high-altitude pulmonary edema (HAPE) with associated shortness of breath or high-altitude cerebral edema (HACE) with associated confusion. Chronic mountain sickness may occur after long-term exposure to high altitude.
Morning sickness, also called nausea and vomiting of pregnancy (NVP), is a symptom of pregnancy that involves nausea or vomiting. Despite the name, nausea or vomiting can occur at any time during the day. Typically the symptoms occur between the 4th and 16th week of pregnancy. About 10% of women still have symptoms after the 20th week of pregnancy. A severe form of the condition is known as hyperemesis gravidarum and results in weight loss.
Space adaptation syndrome (SAS) or space sickness is a condition experienced by as many as half of all space travelers during their adaptation to weightlessness once in orbit. It is the opposite of terrestrial motion sickness since it occurs when the environment and the person appear visually to be in motion relative to one another even though there is no corresponding sensation of bodily movement originating from the vestibular system.
Nicotine replacement therapy (NRT) is a medically approved way to treat people with tobacco use disorder by taking nicotine through means other than tobacco. It is used to help with quitting smoking or stopping chewing tobacco. It increases the chance of quitting tobacco smoking by about 55%. Often it is used along with other behavioral techniques. NRT has also been used to treat ulcerative colitis. Types of NRT include the adhesive patch, chewing gum, lozenges, nose spray, and inhaler. The use of multiple types of NRT at a time may increase effectiveness.
Nicotine gum is a chewing gum containing the active ingredient nicotine polacrilex. It is a type of nicotine replacement therapy (NRT) used alone or in combination with other pharmacotherapy for smoking cessation and for quitting smokeless tobacco.
Nicotine poisoning describes the symptoms of the toxic effects of nicotine following ingestion, inhalation, or skin contact. Nicotine poisoning can potentially be deadly, though serious or fatal overdoses are rare. Historically, most cases of nicotine poisoning have been the result of use of nicotine as an insecticide. More recent cases of poisoning typically appear to be in the form of Green Tobacco Sickness, or due to unintended ingestion of tobacco or tobacco products or consumption of nicotine-containing plants.
Nicorette is the brand name of a number of products for nicotine replacement therapy (NRT) that contain nicotine polacrilex. Developed in the late 1970s in Sweden by AB Leo in the form of a chewing gum, Nicorette was the first nicotine replacement product on the market.
Byssinosis is an occupational lung disease caused by inhalation of cotton or jute dust in inadequately ventilated working environments and can develop over time with repeated exposure. Byssinosis commonly occurs in textile workers who are employed in yarn and fabric manufacture industries. It is now thought that the cotton dust directly causes the disease and some believe that the causative agents are endotoxins that come from the cell walls of gram-negative bacteria that grow on the cotton. Although bacterial endotoxin is a likely cause, the absence of similar symptoms in workers in other industries exposed to endotoxins makes this uncertain. Current smokers are also at risk for developing byssinosis or having complications relating to byssinosis.
Dolasetron (trade name Anzemet) is a serotonin 5-HT3 receptor antagonist used to treat nausea and vomiting following chemotherapy. Its main effect is to reduce the activity of the vagus nerve, which is a nerve that activates the vomiting center in the medulla oblongata. It does not have much antiemetic effect when symptoms are due to motion sickness. This drug does not have any effect on dopamine receptors or muscarinic receptors.
Varenicline, sold under the brand names Chantix and Champix among others, is a medication used for smoking cessation and for the treatment of dry eye syndrome. It is a nicotinic acetylcholine receptor partial agonist. When activated, this receptor releases dopamine in the nucleus accumbens, the brain's reward center, thereby reducing cravings and withdrawal symptoms with smoking cessation, although less pronounced than a full agonist.
Pyridoxine/doxylamine, sold under the brand name Diclectin among others, is a combination of pyridoxine hydrochloride (vitamin B6) and doxylamine succinate. It is generally used for nausea and vomiting of pregnancy (morning sickness); even though its efficacy has not been proven and subsequent research has led to the removal of recommendations in medical journals.
A health professional, healthcare professional, or healthcare worker is a provider of health care treatment and advice based on formal training and experience. The field includes those who work as a nurse, physician, physician assistant, registered dietitian, veterinarian, veterinary technician, optometrist, pharmacist, pharmacy technician, medical assistant, physical therapist, occupational therapist, dentist, midwife, psychologist, audiologist, or healthcare scientist, or who perform services in allied health professions. Experts in public health and community health are also health professionals.
Nicotine dependence is a state of substance dependence on nicotine. It is a chronic, relapsing disease characterized by a compulsive craving to use the drug despite social consequences, loss of control over drug intake, and the emergence of withdrawal symptoms. Tolerance is another component of drug dependence. Nicotine dependence develops over time as an individual continues to use nicotine. While cigarettes are the most commonly used tobacco product, all forms of tobacco use—including smokeless tobacco and e-cigarette use—can cause dependence. Nicotine dependence is a serious public health problem because it leads to continued tobacco use and the associated negative health effects. Tobacco use is one of the leading preventable causes of death worldwide, causing more than 8 million deaths per year and killing half of its users who do not quit. Current smokers are estimated to die an average of 10 years earlier than non-smokers.
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