Health risks in tobacco farm workers—a review of the literature
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To systematically describe and summarize the specific occupational health impact of tobacco farm working.
Subjects and methods
Qualitative systematic review applying a standardized electronic literature search strategy (MEDLINE, TOXNET, EMBASE, AGRICOLA, Science Citation Index; until January 2007) and hand search within eligible articles. Double assessment of eligibility and study results. Inclusion of all studies on specific work-related health risks of tobacco farm workers, e.g. risk factors for and frequency of green tobacco sickness (GTS) and other specific health risks, as well as intervention studies.
We identified 31 relevant publications. Concerning GTS substantial heterogeneity was observed in terms of the case definition and frequency of disease occurrence. Seasonal prevalence ranged between 8 and 89%. Incidence was reported to be 1.9 cases per 100 person days. In the two studies included on primary prevention of GTS hand washing and the use of protective clothes were effective. Studies conducted on cancer as well as on urticaria and contact eczema in tobacco harvesters are scarce.
Health problems due to transdermal nicotine absorption are frequent among tobacco harvesters. GTS as well as chronic health effects in this population need to be further investigated. The toxicity to the cardiovascular system and carcinogenicity of chronic dermal nicotine exposure are likely to exist as non-smoking tobacco harvesters show similar cotinine and nicotine levels compared to active smokers in the general population. Effective intervention strategies addressing the specific needs of the tobacco harvesters in different regions around the world must be developed, evaluated and further improved. It is important to educate tobacco farm workers, farmers and health care providers on GTS and other health risks.
KeywordsFarm worker Green tobacco sickness Health risk Occupational disease Tobacco
The DIRERAF study was supported by partial financing from the EU Health and Consumer Protection Directorate and the Stavros Niarchos Foundation.
Conflict of interest statement
We declare that we have no conflict of interest.
- Arcury TA, Quandt SA, Simmons S (2003b) Farmer health beliefs about an occupational illness that affects farmworkers: the case of green tobacco sickness. J Agric Saf Health 9(1):33–45Google Scholar
- Centers for Disease Control and Prevention (CDC) (1993) Green tobacco sickness in tobacco harvesters—Kentucky, 1992. MMWR Morb Mortal Wkly Rep 42(13):237–240Google Scholar
- Chloros D, Sichletidis L, Kyriazis G, Vlachogianni E, Kottakis I, Kakoura M (2004) Respiratory effects in workers processing dried tobacco leaves. Allergol Immunopathol (Madr) 32(6):344–351Google Scholar
- Commission of the European Communities (Commission) (2003) Tobacco regime—extended impact assessment. Commission staff working document. Commission of the European Communities, BrusselsGoogle Scholar
- Eckholm E (1978) Cutting tobacco’s toll. British-American Tobacco Company 20Google Scholar
- Food and Agriculture Organization of the United Nations (FAO) (2006) FAOSTAT. Food and Agriculture Organization of the United Nations, Rome, Italy. Available from http://faostat.fao.org. Cited 13 Feb 2007
- Gosh SK, Parikh JR, Gokani VN, Kashyap SK, Chatterjee SK (1979) Studies on occupational health problems during agricultural operation of Indian tobacco workers. A preliminary survey report. J Occup Med 21(1):45–47Google Scholar
- Ives T (1983) Use of dimenhydrinate in the treatment of green tobacco sickness. Drug Intel Clin Pharm 17:548–549Google Scholar
- Kimura K, Yokoyama K, Sato H, Nordin RB, Naing L, Kimura S, Okabe S, Maeno T, Kobayashi Y, Kitamura F, Araki S (2005) Effects of pesticides on the peripheral and central nervous system in tobacco farmers in Malaysia: studies on peripheral nerve conduction, brain-evoked potentials and computerized posturography. Ind Health 43:285–294PubMedCrossRefGoogle Scholar
- Olade R, Lessnau KD (2006) Tobacco worker’s lung. WebMD, e-medicine, March 2006. http://www.emedicine.com/med/topic2282.htm. Cited 12 Feb 2007
- Szarmachz H, Poniecka H (1973) Contact allergy in agriculture (in Polish). Przegl Dermatol 60(4):479–484Google Scholar
- Ueda A, Ueda T, Matsushita T, Ueno T, Nomura S (1987) Prevalence rates and risk factors for allergic symptoms among inhabitants in rural districts. Jpn J Ind Health 29:3–16Google Scholar
- United States Department of Agriculture, Foreign Agricultural Service (USDA) (2004) World’s leading unmanufactured tobacco producing, trading, and consuming countries. United States Department of Agriculture, Washington, D.C. Available from http://www.fas.usda.gov/tobacco/circular/2004/082004/TBL1.PDF
- World Health Organization (WHO) (2004) Tobacco and poverty. A vicious circle. World Health Organization, GenevaGoogle Scholar