Occupational Exposure and adverse health effects to Dermal Nicotine for Thai TraditionalTobacco Farmers in Nan Province, Northern Thailand

摘要

Background: Thai Traditional Tobacco (Nicotiana Tabacum L.) as known as a non- Virginia type. A matured leaf contains more nicotine compare to Virginia type (3-4 times).In general process of tobacco production may lead to adverse health effect as Green Tobacco Sickness (GTS) Aims: To determine the prevalence of subjective health symptoms from occupational exposure with nicotine in Thai traditional tobacco production and to estimate potential risk factors associated with nicotine exposure from Thai traditional tobacco. Method: A cross- sectional study was conducted with 473 Thai traditional tobacco farmers in Praputtabath Sub-District and Phator Sub-District. The farmers were randomly selected and interviewed using face to face questionnaires. Results: Half of farmers were males (50.7%), the age of the famers were in the range of 20-65 years. During week period, the prevalence of subjective health symptoms from Thai traditional tobacco activities of headache and dizziness were 28.60% and 16.55%, respectively. The logistic regression analyses revealed that on the process, snapping off of tobacco leaves were associated with headache(OR6.875, 95%CI1.293-5.924) and dizziness(OR4.801, 95%CI0.077-0.867) and process of removing tobacco bud were associated with headache (OR10.775, 95%CI 1.644-7.167), dizziness (OR 8.195, 95%CI 1.505-8.890)and Nausea (OR5.497, 95%CI 1.400- 43.125). Additionally, during watering were independently associated with exposure to nicotine form wet tobacco leaves and wearing wet clothes (61%) (OR22.676, 95%CI 0.674 -0.848). During watering, the farmers exposured to wet leave and cloth about 6 hours per day and some of them reported on rash and/or irritate skin (29%). Conclusion: The study revealed that dermal pathway is a major route of exposure. Body soaking during watering may increase adverse health effects related to GTS. The health education program for increase awareness about health risk exposure of farmers is recommended.