Nicotine absorption by workers harvesting green tobacco.

Green-tobacco sickness is an occupational illness of tobacco harvesters. Symptoms include nausea, vomiting, dizziness, and prostration. The disease is self-limited and of short duration, but recurs frequently in susceptible workers. The aetiology is not known, but nicotine has been suspected as a causative agent. Thirty-two workers on four North Carolina tobacco farms were studied during harvesting. None of these workers smoked or chewed tobacco. Urinary cotinine (the major metabolite of nicotine) levels were monitored over a 24-hour period to evaluate nicotine absorption. There was a tenfold rise in mean excretion of cotinine among workers who had greatest contact with the tobacco. Less cotinine was found in urine of workers who had less exposure. Levels of cotinine exceeded those found in novice smokers who smoked 3 cigarettes in succession. Absorption of nicotine from tobacco leaf is the likely cause of tobacco sickness.