Prevention of Green Tobacco Sickness among Tobacco Harvesters

India ranks third among the most important tobacco producing countries next only to mainland China and U.S.A. and accounts for about 7.9% of the total tobacco production. It is estimated that about seven lakh growers and five lakh curers are engaged in tobacco cultivation. The chief tobacco growing states in India are – Andhra Pradesh, Gujarat, Karnataka, West Bengal, Maharashtra, Tamil Nadu, Orissa, and Bihar. Of these, Andhra Pradesh ranks first; Gujarat second and Karnataka third. India produces several types of tobacco which fall under two botanical species namely Nicotiana tabacum and Nicotiana rustica.

Occupational health problems associated with tobacco cultivation are known as “Green Tobacco Sickness” (GTS). It is a mild and acute form of nicotine toxicity that affects tobacco workers who have direct dermal contact with tobacco plants during cultivation and harvesting. Headache, nausea, vomiting, giddiness, and loss of appetite, fatigue, weakness and sometimes fluctuations in blood pressure or heart rate characterize it. The GTS was first reported from USA in 1970. Later on it was also reported by NIOH in Indian Tobacco Harvesters in 1979 & 1986. The Prevalence of GTS among Indian tobacco harvesters in these studies was found fairly high among the harvesters of both the varieties i.e. non-Virginia (86.20%) and Virginia (53.29%) respectively. It was also observed in these studies that the excretion rate of nicotine and its major metabolite cotinine in urine were increased and about 3 to 4 times higher among exposed workers.

In tobacco harvesters, nicotine gets absorbed mainly through the skin of the hands. Gloves would, therefore, be the most logical solution. Two types of gloves were provided to non-Virginia tobacco harvesters who suffered from green tobacco sickness (GTS). Use of both the types of gloves showed significant reduction in prevalence of GTS and in nicotine absorption as reflected by nicotine and cotinine excretion rate in urine. It was found that with respect to GTS, the use of rubber gloves afforded protection to 93% of the subjects, while with cotton gloves the proportion was 78.5%. Both the types of gloves were found saturated and encrusted with thick plant sap during harvesting and they were difficult to wash and clean after short term use. Different types of gloves are now being tried for testing their acceptability and efficacy