NIOSH warns that tobacco harvesters may be at increased risk for developing green tobacco sickness (GTS) which is a form of nicotine (54115) poisoning. A total of 47 persons with GTS were identified during 2 months in 1992 after seeking emergency treatment in a five county area of Kentucky. Nicotine can be absorbed from the wet tobacco surface through the skin of the workers. Symptoms included nausea, vomiting, dizziness, and severe weakness with changes in heart rate and blood pressure. Abdominal cramping, headaches and difficulty in breathing were frequently reported. Recommendations offered to help workers avoid this problem included not working in wet tobacco, wearing protective clothing which may reduce the amount of nicotine absorbed through the skin such as chemical resistant gloves and plastic aprons, changing to dry clothing as quickly as possible once clothes have become wet, and informing the doctor of nicotine exposure if the worker does become ill which will assist in obtaining a correct diagnosis more quickly. Since the symptoms are easily confused with those resulting from exposure to organophosphorus compounds, the correct diagnosis may be difficult to obtain.