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Shade Tobacco and Green Tobacco Sickness in Connecticut

Trapé-Cardoso, Marcia MD; Bracker, Anne MPH, CIH; Grey, Michael MD, MPH; Kaliszewski, Michael BA; Oncken, Cheryl MD, MPH; Ohannessian, Christine PhD; Barrera, Laura Victoria MPH; Gould, Bruce MD

Journal of Occupational and Environmental Medicine: June 2003 - Volume 45 - Issue 6 - p 656-661
doi: 10.1097/01.jom.0000071504.96740.ab
Original Articles

The prevalence of Green Tobacco Sickness (GTS) among shade tobacco farmworkers in Connecticut is unknown. We conducted a study to determine the prevalence of GTS in farmworkers working in shade tobacco fields who presented for clinical care at medical student-run clinics. A retrospective chart review of the tobacco workers seen at Farmworkers’ Clinics during 2001 was instituted in this study. Although GTS was not clinically diagnosed in any of the patients, we found 15% diagnoses that could be attributed to possible GTS by ICD-9 code review. Using a stricter GTS case definition, the frequency rate decreased to 4%. Nonsmokers were significantly more likely than smokers to report GTS-like symptoms (P < 0.01). Isolated symptoms of headache and dizziness were significantly more frequent among nonsmokers than smokers (P < 0.05). In conclusion, cases of possible GTS were found in Connecticut shade tobacco workers. Nonsmokers were more at risk to have possible GTS than smokers.

From the Division of Occupational and Environmental Medicine, Department of Medicine, University of Connecticut School of Medicine (Dr Trapé-Cardoso, Ms Bracker, Dr Grey); University of Connecticut School of Dental Medicine (Mr Kaliszewski); Department of Medicine, University of Connecticut School of Medicine (Dr Oncken); General Clinical Research Center (GCRC), University of Connecticut Health Center (Dr Ohannessian); and Connecticut Area Health Education program (AHEC), University of Connecticut School of Medicine (Ms Barrera, Dr Gould), Farmington, Connecticut.

Address correspondence to: Marcia Trapé-Cardoso, MD, University of Connnecticut School of Medicine, Division of Occupational and Environmental Medicine, Dowling Bldg, 263 Farmington Ave, Farmington, Connecticut, 06030-6210; e-mail:

©2003The American College of Occupational and Environmental Medicine