First reported outbreak of green tobacco sickness in Brazil.

Dermal absorption of nicotine by people harvesting tobacco may cause an acute intoxication called green tobacco sickness. Although Brazil is the second largest producer of tobacco in the world, green tobacco sickness had not been reported in the country to date. We conducted a 1:1 matched case-control study among persons involved in tobacco farming to determine the occurrence of green tobacco sickness in the northeast region of Brazil and to identify the risk factors involved.