User:Hart2me/Green Tobacco Sickness

Lead
Tobacco plants that have yet to be cured are referred to as "green tobacco", and are associated with Green Tobacco Sickness (GTS) is, a type of nicotine poisoning caused by the transdermal absorption of nicotine from the surface uncured plants. 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.  Green Tobacco Sickness is characterized by a wide range of symptoms, Symptoms of GTS including''' nausea, vomiting, headache, dizziness, and severe weakness. 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.

Epidemiology
A majority of the tobacco that is produced is grown in China, Brazil and India, and the United States. It is estimated than over 15 million people contribute to the process of farming tobacco worldwide. '''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. The long-term health effects for individuals who experience GTS.''' exposed to nicotine transdermally for extended periods of time are not known.

Worldwide there are an estimated 33 million tobacco farm workers, with a substantial proportion living in developing countries. (No citation for number) A recent international review reported that between 8-89% of tobacco harvesters may be affected in the course of a season (No citation) (this wide variation probably being due to differences between study methodologies as well as a range of working conditions). (Plagiarism )

Risk Factors
Tobacco harvesters, whose clothing becomes saturated from tobacco wet with rain or morning dew, are at high risk of developing GTS. (Plagiarism)

'''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.  Those involved in barning the tobacco, a process in which the leaves are hung up to be cured, are also at a higher risk'''. '''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. 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.'''

Prevention and Treatment
'''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. 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.''' 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. , or by wearing a rain suit. Training tobacco farm workers to identify the signs and symptoms in themselves and others is helpful in early identification of GTS.

Nicotine from other sources, including nicotine gum, a nicotine patch or electronic cigarette, or other tobacco products like cigarettes or smokeless tobacco, appears to reduce the risk of GTS due to the body adapting to the intake of nicotine.

There is no specific treatment for Green Tobacco Sickness, but rest and rehydration are helpful in managing symptoms. 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 may include IV fluids and medication to treat nausea and vomiting. 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.