Toxic agent | Nicotiana tabacum (nicotine) |
---|---|
Exposure environment | Tobacco workers hand harvesting, cutting, or loading tobacco plants during harvest; usually (but not necessarily) in the early morning or after rainfall when tobacco plants are covered with moisture. |
Exposure attributes | Skin exposure (hands, forearms, thighs, backs, and feet) to dissolved nicotine from wet tobacco leaves. Dew from tobacco leaves often saturates workers’ clothing within minutes of beginning field work. |
Symptoms | Most common: weakness, headache, nausea, vomiting, dizziness |
Other: abdominal cramps, breathing difficulty, abnormal temperature, pallor, diarrhoea, chills, fluctuations in blood pressure or heart rate, increased perspiration and salivation | |
Illness onset | Range of onset 3–17 hours; median onset 10 hours. |
Duration of illness (untreated) | Mean duration of the illness is 2.4 days. |
Treatment | Self: change clothing, showering, work cessation, fluid intake, rest, time |
Medical facility (if needed): Intravenous rehydration, anti-emetics, dimenhydrinate, supportive care | |
Risk reduction | Protective, water-resistant clothing; chemical-resistant gloves, boots, socks; avoid harvesting during rain or in the early morning; change clothing if wet; wash clothes if soaked with tobacco sap; dimenhydrinate (treatment and prophylactic); employee awareness—inform physician about exposure to nicotine. |
Public health response | Educational outreach (timed to coincide with tobacco harvest)—informational mailings, flyers, bulletins, and news stories aimed at tobacco workers and healthcare providers. |
Economic impact | US$250 for outpatient treatment; $566 for hospital admission; $2041 for intensive care. Plus lost income and productivity. |
Adapted from McKnight.7