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Public Radio's Environmental News Magazine (follow us on Google News)

Green Tobacco Sickness

Air Date: Week of

While the dangers of smoking are well known, tobacco also poses a health threat to those who pick it. Leda Hartman reports from North Carolina.


CURWOOD: The dangers of smoking tobacco are well known, but farming tobacco can also be hazardous to human health. People who pick the crop can come down with a syndrome known as Green Tobacco Sickness, named for the color of the plant before it's been cured. Leda Hartman reports from Winston-Salem, North Carolina.

HARTMAN: For four summers, Eriberto Salvador has come to North Carolina from the Mexican state of Michoacan to work in tobacco. His first harvest is etched in his memory. Salvador was bent over the tobacco plants, picking the leaves, when he felt weak and nauseous and had to call for help.


VOICEOVER: At that time, I was walking in a field, when I felt it, and I said to the other guys "Which would you like better, to lose a second of work or to lose a friend?"

HARTMAN: The other farm workers came to Salvador's aid.


VOICEOVER: Yeah. They got up out of the field, the others who were carrying the tobacco, and they went and rescued me and took me from the field and then they washed me with cold water and that's how I got back to feeling normal again.

HARTMAN: Salvador's experience is not uncommon. Green Tobacco Sickness is actually acute nicotine poisoning that can occur when farm workers absorb the drug through their skin. A new study out of the Wake Forest University School of Medicine found that almost 25 percent of all tobacco workers will get Green Tobacco Sickness at least once during the growing season. Researcher Tom Arcury says that's a significant occupational hazard.

ARCURY: One quarter of your workers are sick, not because of the 'flu, not because of pneumonia, not because of measles, but because of something they do on the job. It's an incredibly high rate.

HARTMAN: Tobacco is harvested in a process called priming: workers pick the leaves by hand and then carry them under their arms. Wake Forest researcher Sara Quandt says it's at this point that the workers are exposed to the nicotine.

QUANDT: Particularly if their skin is wet from dew or perspiration and the tobacco itself is wet, the nicotine dissolves in the water and it's then absorbed through the skin.

HARTMAN: Quandt says Green Tobacco Sickness, or GTS, can last up to two days and, in rare cases, require hospitalization. Symptoms can sometimes be alleviated with anti-nausea drugs.

QUANDT: Once it gets into the bloodstream it affects a number of different systems in the body, including the nervous system, and it causes the symptoms that are characteristic of GTS, which are headache, dizziness, weakness, vomiting and nausea.

HARTMAN: Green Tobacco Sickness is not new. It was around back in the days when families farmed tobacco in small plots. Today, most farm work in North Carolina is done by foreign-born Latino workers who usually send their earnings back home. These people labor under vastly different conditions than in the old days, says Tom Arcury.

ARCURY: A woman I worked with grew up on a tobacco farm and one of her sisters got sick from Green Tobacco Sickness. She did other work; the other two sisters did the priming. Unfortunately, when migrant framers come here, they come here to work. And if they don't work, they don't get paid. So, they don't have a choice. They either work sick, if they get green tobacco sickness, or they have to move on.

HARTMAN: Yet not every worker is always able to move on. Those who are here without legal papers can try to find work in a different crop, but those who came into the U.S. on a federal guest worker contract, known as H2A, may have less flexibility.

ARCURY: It becomes an issue because if they get sick and can't work on a tobacco farm, then, because of the regulations of the H2A visa, they may have to go back to Mexico, if there's no other work on that farm for them to do.

HARTMAN: The North Carolina Growers Association says otherwise. The group brings in about 10,000 H2A workers to the state each year, and Executive Director Stan Eury says it makes a good faith effort to try to relocate workers with GTS.

EURY: Tobacco is certainly the main crop, but we have thousands of acres of other crops that our members grow and harvest. We attempt to move workers into vegetable crops or into activities where they're not exposed to tobacco when they show an extreme adverse reaction to the tobacco crop.

HARTMAN: Eury also says the Growers Association trains the guest workers in GTS and other potential health hazards upon their arrival in North Carolina. And there are ways to prevent the illness. Because nicotine is most easily absorbed when the tobacco leaves are wet, healthcare workers recommend that farm workers wear a rain suit during the early morning hours or in the rain. When the leaves dry off the workers should change to dry clothes including a long-sleeved shirt. But it's hard to disseminate this information, partly because many farm workers lack ready access to health care. Dr. Deb Norton is medical director of the North Carolina Farm Worker Health Program.

NORTON: They don't fit very well in our traditional medical system because they usually don't speak English. Most of the workers are uninsured. Most of them cannot get off work during the day. That makes it very hard to access our medical system because most doctors don't have office hours at night.

HARTMAN: It's up to farm worker health outreach workers like Eldon Rogers to spread the word about GTS prevention. He makes regular visits to more than 300 tobacco farms in the greater Winston-Salem area.

ROGERS: Most farmers who have been working several years know who I am are very helpful. There are a few, maybe, who are new or who are not that familiar with what I do, sometimes are a little bit reticent when I'm coming around, but in the main I would say 95 percent plus are very receptive.

HARTMAN: One farmer who's unusually receptive is Bruce Tilley. He says after 40 years of farming, he has figured out how to keep his five guest workers from getting sick.

TILLEY: Don't never go to a wet tobacco field without a rain suit on, and that solves all the problems, it saves the farmers having to take the men to the hospital, working with them. Tell the farmers when the men first get here, before they start topping tobacco, to get every man a rain suit.


HARTMAN: On this day, Eldon Rodgers and some of Wake Forest researchers are at Tilley's farm to create a fotonovella, that is, a flyer with photographs, explaining what Green Tobacco Sickness is and how to prevent it. The farm workers become willing actors. The protagonist, Geraldo, starts off working without a rain suit, in short sleeves. Then he gets sick. He takes a swig of soda for the camera and spits it out, to simulate vomiting.


HARTMAN: After the shoot is done, veteran farm work Augustin Figueroa says he thinks the fotonovella will go a long way toward helping workers like him understand GTS.


VOICEOVER: At the moment, we're acting it out, but, yes, a lot of people who are new to working in the United States in tobacco do get sick. They're unfamiliar with tobacco work and it can hurt some of them. And this magazine is a good idea because people can look at it and take note of what they're doing. Yes, it's very important.

HARTMAN: There is still no perfect solution to eradicating Green Tobacco Sickness. Not all workers will agree to wear a rain suit, given the heat and humidity of a North Carolina summer. And, workers will continue to hold the tobacco leaves under their arms because the leaves are too sticky to put into a sack. And, the researchers at Wake Forest are still looking into the question of why some workers get sick while others seem to have a tolerance to nicotine exposure. For Living on Earth, I'm Leda Hartman, in Winston-Salem, North Carolina.



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