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1/4. tobacco allergy: demonstration of cross-reactivity with other members of solanaceae family and mugwort pollen.

    BACKGROUND: tobacco is a plant belonging to the solanaceae family. This plant is usually used as a contact insecticide for several infestations in some areas, such as the Canary islands. Allergy induced by inhalation of this plant is unusual. Identification of the potential allergen in growing areas is essential. OBJECTIVE: We report a patient with occupational sensitivity to an aqueous solution of cut tobacco whose clinical manifestations were rhinoconjunctivitis and urticaria. Past medical history was significant for seasonal allergic rhinoconjunctivitis to mugwort pollen and oral allergy syndrome with avocado. methods: Green tobacco and cured tobacco leaf extracts were prepared, skin prick tests were performed with green tobacco, cured tobacco leaf extracts, and certain aeroallergens. Conjunctival challenge test was carried out with green tobacco and cured tobacco leaf extract. serum-specific IgE against tobacco leaf was performed by commercial CAP. CAP inhibition experiments were carried out with tobacco and artemisia vulgaris. RESULTS: skin prick tests and conjunctival challenge tests with green tobacco and cured tobacco leaf extracts were positive, as well as serum-specific IgE by CAP, indicating an IgE-mediated sensitization. CAP inhibition experiments were carried out and it was found that tobacco, mugwort pollen, and tomato extracts inhibited the binding of the patient's serum to solid-phase tobacco leaf. No inhibition was observed when alternaria, D. pteronyssinus, and potato were used as control inhibitors. Inhibition of immunoCAP to mugwort was obtained with mugwort and tobacco extracts and no cross-reactivity to D. pteronyssinus was shown. CONCLUSION: The results suggest that tobacco can induce IgE-mediated reactions that are mediated by the existence of common antigenic epitopes between tobacco and mugwort pollen. This allergy can be a hazard of employment in the agricultural areas.
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ranking = 1
keywords = tobacco
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2/4. Green tobacco sickness in children and adolescents.

    tobacco (Nicotiana tabacum) is cultivated in more than 100 countries, and in 2004, some 5.73 million metric tons dry weight of tobacco were grown worldwide. The top five tobacco producers forecast for 2004 are china (2.01 million metric tons; 35.1%), brazil (757 thousand metric tons; 13.2%), india (598 thousand metric tons; 10.4%), united states (358 thousand metric tons; 6.2%), and malawi (138 thousand metric tons; 2.4%). Together, these five countries account for two-thirds of worldwide tobacco production. tobacco farming presents several hazards to those who cultivate and harvest the plant. Although some of these hazards, such as pesticide exposure and musculoskeletal trauma, are faced by workers in other types of agricultural production, tobacco production presents some unique hazards, most notably acute nicotine poisoning, a condition also known as green tobacco sickness (GTS). GTS is an occupational poisoning that can affect workers who cultivate and harvest tobacco. It occurs when workers absorb nicotine through the skin as they come into contact with leaves of the mature tobacco plant. GTS is characterized largely by nausea, vomiting, headache, muscle weakness, and dizziness. Historically, children have played a role in agricultural production in the united states, and they continue to do so today. This includes tobacco farming. The North American Guidelines for Children's Agricultural Tasks, a set of injury prevention guidelines prepared by the National Children's Center for Rural and Agricultural Health and safety, lists GTS as one of several hazards children face when working on tobacco farms. Children 17 years of age and younger who work on U.S. tobacco farms come from three main groups: members of farm families, migrant youth laborers (primarily Latinos), and other hired local children. All three groups are at risk for GTS. Beyond the U.S., tobacco production using child labor is an emerging topic of concern in developing nations. An international movement, advocated by the Eliminating child Labor in tobacco Foundation, is underway to restrict child labor in tobacco production. GTS is a unique occupational poisoning associated with tobacco farming. We suspect that many public health practitioners, clinicians, advocates, and researchers are unaware of GTS among children and adolescents. In this article, we provide an overview of GTS among young people who work in tobacco, summarize reports documenting pediatric GTS cases, explain GTS etiology, and present three case studies of pediatric GTS in kentucky. In addition, we discuss the need for expanded surveillance and prevention of GTS, both in the united states and globally.
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ranking = 1.125
keywords = tobacco
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3/4. Use of dimenhydrinate in the treatment of green tobacco sickness.

    A case of green tobacco sickness (GTS) in a 37-year-old male migrant worker and the use of dimenhydrinate in its treatment/prophylaxis is presented. A brief discussion of the etiology and symptomatology of GTS is included. dimenhydrinate is a useful over-the-counter product for the treatment of this occupational illness in the tobacco-growing states of the Southeast.
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ranking = 0.375
keywords = tobacco
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4/4. Green tobacco sickness.

    Green tobacco sickness (GTS) is an occupational illness that causes significant morbidity in tobacco harvesters. physicians need to be aware of GTS and its differential diagnosis, especially when patients come to emergency rooms. Dermal absorption of nicotine is reported to be the cause of GTS. No fatalities have been reported, and treatment is supportive. Prevention, by covering exposed skin, seems to be the most effective way of dealing with GTS.
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ranking = 0.375
keywords = tobacco
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