Ballard T, Ehlers J, Freund E, Auslander M, Brandt V, Halperin W
National Institute for Occupational Safety and Health, Cincinnati, Ohio, USA.
Arch Environ Health. 1995 Sep-Oct;50(5):384-9. doi: 10.1080/00039896.1995.9935972.
In this study the authors describe the investigation of a 1992 outbreak of green tobacco sickness, a form of nicotine poisoning from dermal exposure, among 47 tobacco workers in a five-county region of central and south-central Kentucky. Cases were identified through medical record searches at participating hospitals, as well as from reports submitted to the Occupational Health Nurses in Agricultural Communities program. A case-control study was undertaken to assess risk factors for green tobacco sickness. In a 20-min telephone interview, 40 cases and 83 controls responded to questions contained in a questionnaire. In 1992, 47 persons (3 were under age 16 y) in the study region sought medical treatment for green tobacco sickness. Twelve persons were hospitalized and 2 required intensive-care treatment. The crude incidence in 1992 was 10.0/1,000 tobacco workers. In 1993, 66 cases (7 were under age 16 y) of green tobacco sickness were identified in the study region (i.e., annual incidence of 14.0/1,000). A case-control study demonstrated that ill workers were younger, and were more likely to have worked in wet conditions, compared with workers who were not ill. Green tobacco sickness is a common problem among tobacco workers that may be prevented by avoiding work in wet tobacco or by use of protective clothing. Children younger than 16 y of age represented 9% of the green tobacco sickness cases in 1992 and 1993. Current occupational safety and health laws do not address protection of tobacco workers with respect to green tobacco sickness.
在本研究中，作者描述了对1992年肯塔基州中南部和中东部五县地区47名烟草工人中发生的绿烟草病疫情的调查，绿烟草病是一种因皮肤接触导致的尼古丁中毒形式。通过参与研究的医院的病历搜索以及提交给农业社区职业健康护士项目的报告来确定病例。开展了一项病例对照研究以评估绿烟草病的风险因素。在一次20分钟的电话访谈中，40例病例和83名对照回答了问卷中的问题。1992年，研究区域内有47人（3人年龄在16岁以下）因绿烟草病寻求医疗救治。12人住院治疗，2人需要重症监护治疗。1992年的粗发病率为每1000名烟草工人中有10.0例。1993年，研究区域内确诊了66例绿烟草病病例（7人年龄在16岁以下）（即年发病率为每1000人中有14.0例）。一项病例对照研究表明，与未患病的工人相比，患病工人更年轻，且更有可能在潮湿环境中工作。绿烟草病是烟草工人中常见的问题，可通过避免在潮湿烟草环境中工作或使用防护服来预防。16岁以下儿童在1992年和1993年的绿烟草病病例中占9%。现行职业安全与健康法律未涉及烟草工人在绿烟草病方面的防护问题。
