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To the editor: Recently, I made contact with three research papers for Green Tobacco Sickness (GTS) in Bra-zil, including yours 1. I, as a researcher studying GTS, am very happy and also feel lucky that there are many researchers taking care of the health of farmers in South America, particularly for GTS. I am delighted and grateful to meet many researchers of GTS on the other side of the earth, Brazil – a country with one of the largest productions of tobacco leaf, following China, throughout the world. With utmost gratitude to the researchers in Brazil, I would like to discuss my experience of studying GTS as well as to propose the establishment of an international network of research for GTS. GTS is acute nicotine poisoning, which occurs during tobacco leaf harvesting, in which the skin absorbs the nicotine. Moreover, GTS is one of the occupational diseases arising with tobacco harvesters. GTS occurs primarily during a condition when the tobacco leaves or clothes are wet due to sweat or rain. Major symptoms of this disease are dizziness, headache, nausea and vomiting. There are reports of cases with further syncope. Weizenecker and Deal 2 reported the first case in 1970. Since then, GTS researches were conducted in various countries around the world; first, it was mainly carried out in the United States and India, but has recently been studied in Asia, Europe and South America. Although little is known internationally, South Korea has also been steadily studying GTS for more than 10 years after my teacher and I reported the first case in Korea in 2001 3. Although our initial research had been conducted to understand the prevalence of GTS and metabolite (cotinine), I have recently been conducting research on nicotine concentration at the workplace and at the tobacco field 4. In particular, through the confirmation of nicotine in the air at the workplace or tobacco field, I knew that nicotine intoxication was possible through the respiratory tract, not only through skin contact. Air nicotine concentration in the tobacco field was 41.4 to 49.2 mg/m³, which is about 90 times higher than the level of 0.5 mg/m³ exposure limit at the workplace 5. In addition, the workplace, where the process of drying tobacco leaves was conducted, was measured with high concentrations, corresponding to 400 times the standard limit of 200 mg/m³ on average. This confirmed the fact that it was possible …

Proposal of the Global Network for the Study of Green Tobacco Sickness