Identifying Green Tobacco Sickness in Farmworkers

UConn Health Center Researchers Get Help from Medical Students

July 2002

UConn medical students are assisting in a pilot study to determine if migrant tobacco farmworkers in Connecticut are experiencing green tobacco sickness, a form of nicotine poisoning usually found in large tobacco-producing states. The illness results from the absorption of nicotine from tobacco leaves during the tobacco harvest. Although there were no reports of green tobacco sickness in Connecticut in past summers, Marcia Trapé, M.D., Occupational/Environmental Medicine at the UConn Health Center, wants to be sure cases aren't being missed. "It's difficult to diagnose green tobacco sickness, because the symptoms are vague and most migrant workers don't bother to seek medical care," said Dr. Trapé.

Symptoms include nausea or vomiting, headaches or dizziness and may also include increased blood pressure, palpitations, abdominal pains and insomnia. "Most health care providers in this area aren't familiar with the signs of this illness and could reasonably conclude that the symptoms are the result of dehydration, heat stroke or exposure to pesticides," Dr. Trapé said. In most cases, symptoms subside within a few days after stopping the exposure to green tobacco. Treatment includes the removal of nicotine-contaminated clothing, a shower, and medication to relieve vomiting and nausea if needed.

Before picking season began, saliva samples were taken from tobacco workers who volunteered to participate in the study. The samples were measured for nicotine levels and will be compared to samples that will be taken during peak harvesting time. A similar comparison will be made of carbon monoxide levels in breath samples.

Under the direction of medical faculty at the Health Center, medical students have been providing health care to migrant farm workers for the past four years. "This study will benefit the workers and further expand our students' medical knowledge," said Dr. Trapé. "If we find higher nicotine levels during the harvesting season, we can educate farmers and workers on ways to protect them against green tobacco illness."

The UConn Health Center research team includes, principal investigator Dr. Trapé; Cheryl Oncken, M.D., assistant professor, Department of Medicine, Division of Hypertension; Bruce Gould, M.D., associate dean for primary care, Department of Medicine; Anne L. Bracker, industrial hygienist, Occupational/Environmental Medicine; and Laura Victoria Barrera, health program supervisor, Area Health and Education Center at the University of Connecticut Health Center.

Funding for the initiative comes in part from the Northeast Center for Agricultural Health, one of ten regional centers in the country designated by the National Institute for Occupational Safety and Health. The Hispanic Health Council and the Connecticut Council on Occupational Safety and Health are facilitating the communication and implementation of the project.

The University of Connecticut Health Center includes the schools of medicine and dental medicine, John Dempsey Hospital, the UConn Medical Group and University Dentists. Founded in 1961, the Health Center pursues a mission of providing outstanding health care education in an environment of exemplary patient care, research and public service.