In 2005, Alice Arcury-Quandt got a paid summer internship at the Wake Forest University medical center where her father, Thomas Arcury, is director of the Center for Worker Health. Sixteen at the time, Alice and her father went to the North Carolina Department of Labor together so he could give his written permission for her to work, as required by law.

But to work in agriculture, an industry whose accident and injury rates are as high as in any other field except mining, Alice would not have needed her father’s permission. Federal law lets farms employ children as young as 13, even for hazardous tasks involving sharp knives and heavy equipment, without permission. Even children 12 and younger can pick crops outside of school hours with their parents’ consent.

Agriculture, which has dodged several rounds of major federal labor regulations, may be the last holdout of child labor in the United States. Human Rights Watch (HRW), an international human rights monitor, began documenting the problem in 2002. As the organization explored the issue, researchers stumbled on an especially troubling group of child workers. These workers, some as young as 7, were harvesting a poisonous crop whose toxin can enter the body through the skin. 

The crop was tobacco. 

“Nicotine is a naturally occurring alkaloid, which is a poison,” said Arcury, who has done extensive fieldwork on farmworker health, some of which is cited in a new HRW report on dangers faced by child tobacco workers. “It’s not a good idea to expose children to nicotine, and we have laws to prevent that when it comes to buying tobacco.”

The report concluded that there is no amount of training or safety gear that would make the work safe.

“We have gone to great lengths in the United States to protect kids from the dangers of nicotine. We don’t let kids under 18 walk into a store and buy a pack of cigarettes because we recognize what that means for them, but antiquated labor laws and weak protections are letting 12 year olds, and sometimes even younger kids, be exposed to nicotine while they legally work on tobacco farms here in the United States,” Margaret Wurth, one of the report's authors, told Healthline.

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How Nicotine Makes Young Workers Sick

Based on interviews with 141 child tobacco workers ages 7 to 17, HRW found that over two-thirds of the workers had experienced acute nicotine poisoning as a result of handling tobacco plants. Nicotine poisoning causes nausea, vomiting, loss of appetite, headaches, dizziness, trouble breathing, skin rashes, and irritation of the eyes and mouth. The effects generally last 12 to 36 hours.

“It happens when you’re out in the sun. You want to throw up. And you drink water because you’re so thirsty, but the water makes you feel worse. You throw up right there when you’re cutting, but you just keep cutting,” said Danielle G., a 16-year old worker quoted in the report.

North Carolina, Kentucky, Virginia, and Tennessee grow 90 percent of all tobacco produced in the United States. The heat and humidity in these states make vomiting more dangerous.

“When you vomit, you’re getting rid of even more bodily fluids. There’s a real prospect of heat strokes,” said Arcury. “Children do die, not necessarily from nicotine poisoning but from heat."

The hot climates where tobacco flourishes make protective gear impractical. Nicotine is water-soluble, so protective clothing must be waterproof. Meaningful protection would also have to cover the workers from head to toe, since tobacco plants are tall and grow close together. Such outfits would likely cause heat stroke. Many employers do not provide protective gear — the report found that the workers often brought their own black plastic garbage bags to wear as protection from wet leaves.

“We don’t let kids under 18 walk into a store and buy a pack of cigarettes because we recognize what that means for them, but antiquated labor laws and weak protections are letting 12 year olds, and sometimes even younger kids, be exposed to nicotine while they legally work on tobacco farms here in the United States.” — Margaret Wurth

The Human Rights Watch report is the first to address child tobacco workers, but Arcury has found in published research that a quarter of adult agricultural workers who handle tobacco also experience nicotine poisoning, sometimes called Green Tobacco Sickness. At the end of one harvest season, nonsmoking adult tobacco harvesters had as much nicotine in their systems as a group who smoked three cigarettes.

Because of their lower body weights, children are likely more susceptible to Green Tobacco Sickness than adults.

Most children who harvest tobacco are poor and lack health insurance. The children in the HRW report were, on average, 13 when they started picking tobacco. Nearly all were Hispanic, the ethnic group least likely to have healthcare coverage. Four out of five were U.S. citizens, according to Arcury, but many were the children of undocumented immigrants.  

Few of the young people interviewed had sought medical care after bouts of Green Tobacco Sickness. And agricultural workplaces are so lightly regulated that 77 percent of illnesses and injuries among agricultural workers are not reported, a study from the University of California, Davis, found.

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Too Many Dangers for Young People

Along with the specific dangers of nicotine poisoning, harvesting tobacco also carries all the dangers of other forms of agricultural work. Tobacco is not generally an organic crop: Most growers apply organophosphate pesticides, which are also toxic. After it’s picked, the tobacco is hung to dry in barns; workers climb high up into the rafters to lay it out.


Harvested tobacco leaves hung to dry.

All told, neither Human Rights Watch nor Arcury think there is any safe way for minors to work on tobacco farms.

"You have immature human beings — immature in terms of development and immature in terms of decision making — and we’re exposing them to neurotoxins, and nicotine and heat," Arcury said. 

Tobacco grown on farms in the U.S. is sold to some of the biggest companies in the world, including Altria Group, which makes Marlboro cigarettes, and Reynolds American, which makes Camels, Pall Malls, and Newports.

The companies exert different demands on their suppliers. Some only demand compliance with local laws, while others impose additional limits on child labor. Human Rights Watch is calling on them all to ban workers under the age of 18 from their supply chains.

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