First reported outbreak of green tobacco sickness in Brazil.
Dermal absorption of nicotine by people harvesting tobacco may cause an acute intoxication called green tobacco sickness. Although Brazil is the second largest producer of tobacco in the world, green tobacco sickness had not been reported in the country to date. We conducted a 1:1 matched case-control study among persons involved in tobacco farming to determine the occurrence of green tobacco sickness in the northeast region of Brazil and to identify the risk factors involved. A case-patient was a person who received a diagnosis by health professional of acute intoxication during the study period and had a cotinine level over 10 ng/mL detected by High Performance Liquid Chromatography. We identified 107 case-patients. The main signs and symptoms observed were dizziness, weakness, vomit, nausea and headache. Independent risk factors identified were being male, a non smoker and having worked in the harvest of tobacco leaves. Case-patients had higher median urinary cotinine levels than controls (p < 0.05). Epidemiological and laboratory data indicate for the first time the occurrence of green tobacco sickness in Brazil.
Ministério da Saúde, Brasília, Brasil. ppvoenf@gmail.com
Patricia Pereira Vasconcelos de
PP
Oliveira
Camila Brederode
CB
Sihler
Lenildo de
Ld
Moura
Deborah Carvalho
DC
Malta
Maria Célia de Albuquerque
MC
Torres
Sandra Márcia da Costa Pereira
SM
Lima
Ana Lucia Alves de
AL
Lima
Carlos Eduardo
CE
Leite
Vera Luiza da
VL
Costa-e-Silva
Jeremy
J
Sobel
Tatiana Miranda
TM
Lanzieri
D000293:Adolescent; D000328:Adult; D000382:Agricultural Workers' Diseases / Q000139:chemically induced / Q000175:diagnosis / Q000453:epidemiology*; D015415:Biomarkers / Q000652:urine; D001938:Brazil / Q000453:epidemiology; D016022:Case-Control Studies; D002648:Child; D003367:Cotinine / Q000652:urine*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009538:Nicotine / Q000506:poisoning*; D016273:Occupational Exposure / Q000009:adverse effects*; D012307:Risk Factors; D012869:Skin Absorption; D012907:Smoking / Q000453:epidemiology; D018709:Statistics, Nonparametric; D014026:Nicotiana / Q000737:chemistry / Q000506:poisoning*; D055815:Young Adult
D015415:Biomarkers; D009538:Nicotine; D003367:Cotinine