Assessment of urinary cotinine as a marker of nicotine absorption from tobacco leaves: a study on tobacco farmers in Malaysia

J Occup Health. 2003 May;45(3):140-5. doi: 10.1539/joh.45.140.


To assess dermal absorption of nicotine from tobacco leaves in relation to Green Tobacco Sickness (GTS), urinary cotinine concentrations were measured in 80 male tobacco-growing farmers and in 40 healthy males (controls) who did not handle wet tobacco leaves in Kelantan, Malaysia. Among non-smokers, urinary cotinine levels in farmers were significantly higher than those of controls; farmers with urinary cotinine of 50 ng/ml/m2 or above showed eye symptoms more frequently than those below this level (p<0.05). Farmers who did not wear protective equipment had subjective symptoms more frequently than those who used the equipment (p<0.05); some of these symptoms were seen more frequently in organophosphate (Tamaron) users than in non-users. As tobacco farmers evidence a risk of nicotine poisoning from tobacco leaves, assessment including GTS together with effects of pesticides will be necessary.

MeSH terms

  • Agriculture*
  • Case-Control Studies
  • Cotinine / urine*
  • Humans
  • Malaysia
  • Male
  • Nicotine / poisoning*
  • Occupational Diseases / chemically induced*
  • Occupational Exposure*
  • Plants, Toxic*
  • Protective Clothing
  • Skin Absorption
  • Statistics, Nonparametric
  • Tobacco*


  • Nicotine
  • Cotinine