Journal of The Korean Society of Clinical Toxicology (대한임상독성학회지)

Korean society of Clincal Toxicology (대한임상독성학회)
권호 표지
DOI QR코드

DOI QR Code

A Case of Green Tobacco Sickness (GTS) in Elderly Patient

담뱃잎농부병으로 진단된 고령 환자 1례

  • Jeong, Dong Kil (Department of Emergency Medicine, Taean-Gun Health Center) ;
  • Kim, Doh-Eui (Department of Emergency Medicine, Soonchunhyang University College of Medicine, Cheonan Hospital)
  • 정동길 (태안군보건의료원 응급의학과) ;
  • 김도의 (순천향대학교 천안병원 응급의학과)
  • Received : 2019.11.29
  • Accepted : 2019.12.10
  • Published : 2019.12.31
Download PDF
⟨ Previous Next ⟩

Abstract

Green tobacco sickness is an illness caused by dermal exposure to nicotine. The common symptoms of the disease include dizziness, headache, nausea, vomiting, severe general weakness, fluctuations of blood pressure or heartbeat, abdominal cramping, chills, increased sweating, salivation, and difficulty breathing. A 79-year-old female arrived at the emergency room for an evaluation of sudden onset dizziness. Magnetic resonance imaging and angiography of the brain did not show any relevant abnormal findings. Four days later, with supportive care, she said that she had harvested green tobacco for six hours on the day of admission and the tobacco harvest was the first time in her life. She sweated excessively during the hot and humid weather and the tobacco leaves were wet from rain the night before. The serum cotinine tested at five days of admission was 16ng/ml. She was diagnosed with acute nicotine poisoning by her clinical symptoms and the half-life of cotinine in the blood.

Keywords

References

  1. Hipke ME. Green tobacco sickness. South Med J 1993;86:989-92. https://doi.org/10.1097/00007611-199309000-00002
  2. Ballard T, Ehlers J, Freund E, et al. Green tobacco sickness: occupational nicotine poisoning in tobacco workers. Arch Environ Health 1995;50:384-9. https://doi.org/10.1080/00039896.1995.9935972
  3. Ghosh SK, Parikh JR, Gokani VN, et al. Studies on occupational health problems during agricultural operation of Indian tobacco workers: a preliminary survey report. J Occup Med 1979;21:45-7.
  4. Lee K, Lim HS. Cases of Green Tobacco Sickness: Occupational Nicotine Poisoning in Tobacco Harvesters in Korea. Korean J of Rural Med 2001;26:7-14.
  5. Lee K, Nam SH, Lim HS. Prevalence and Risk Factors of Green Tobacco Sickness among Korean Tobacco Harvesters. Korean J Prev Med 2004;37:37-43.
  6. Park SJ, Lim HS, Lee K, et al. Green Tobacco Sickness Among Tobacco Harvesters in a Korean Village. Saf Health Work 2018;9:71-4. https://doi.org/10.1016/j.shaw.2017.06.007
  7. Weizenecker R, Deal WB. Tobacco cropper's sickness. J Fla Med Assoc 1970;57:13-4.
  8. Fassa AG, Faria NM, Meucci RD, et al. Green tobacco sickness among tobacco farmers in southern Brazil. Am J Ind Med 2014;57:726-35. https://doi.org/10.1002/ajim.22307
  9. McBride JS, Altman DG, Klein M, et al. Green tobacco sickness. Tob Control 1998;7:294-8. https://doi.org/10.1136/tc.7.3.294
  10. Onuki M, Yokoyama K, Kimura K, et al. Assessment of Urinary Cotinine as a Marker of Nicotine Absorption from Tobacco Leaves: A Study on Tobacco Farmers in Malaysia. J Occup Health 2003;45:140-5. https://doi.org/10.1539/joh.45.140
  11. Benowitz NL, Bernert JT, Caraballo RS, et al. Optimal serum cotinine levels for distinguishing cigarette smokers and nonsmokers within different racial/ethnic groups in the United States between 1999 and 2004. Am J Epidemiol 2009;169:236-48. https://doi.org/10.1093/aje/kwn301
  12. Park SJ, Kim JS, Kim JS, et al. Airborne Nicotine Concentrations in Harvesting and the Processing of Tobacco Leaves. J Korean Soc Occup Environ Hyg 2010;20:47-52.