Malawi child tobacco pickers are exposed to high levels of nicotine poisoning, says a new report.
Entitled Hard Work, Long Hours and Little Pay, the report from Plan International, a nonprofit, said workers absorb up to 54 milligrams a day of dissolved nicotine, which is equivalent to 50 cigarettes.
More than 78,000 children as young as 5 work up to 12 hours a day for less than 1.7 cents an hour and without protective clothing on tobacco estates across the southern African country.
Some symptoms among the child labourers may be caused by exposure to pesticides. Children interviewed for the report described sprinkling pesticide onto plants using cups and their bare hands.
As well as physical and sexual abuse by their employers, many were unknowingly showing classic signs of Green Tobacco Sickness (GTS).
This is a common and recognised hazard of workers absorbing nicotine through their skin by contact with moist tobacco leaves. There is a lack of research into long term effects of GTS in children, but experts believe it could seriously impair their development.
The children reported symptoms including severe headaches, abdominal pain, muscle weakness, coughing and breathlessness.
"Sometimes it feels like you don't have enough breath, you don't have enough oxygen. You reach a point where you cannot breathe because of the pain in your chest. Then the blood comes when you vomit. At the end, most of this dies and then you remain with a headache," one child said.
Malawi is the world's fifth biggest tobacco producer and the crop accounts for 70% of export income but despite the profits of multinational companies, local tobacco farmers continually struggle to break even.
This leads them to look for ways to cut costs with more children being exposed to hazardous and exploitative working conditions.
Plan is now calling upon tobacco companies and plantations to vastly improve working conditions and live up to their own promised corporate responsibility guidelines by scrutinising their suppliers far more closely.
They should provide safe environments and non-exploitative wages and access to education for those children who have to work.
Plan also wants the government of Malawi to rigorously enforce existing child labour and protection laws and review land inheritance laws which restrict families' ownership of land.
The world's giant tobacco companies, including Philip Morris International and British American Tobacco, said while they buy tobacco from Malawi, they reject the use of child labour.
Many Malawian families are so poor they send their children to work in the fields out of necessity, so Plan International is not calling for a ban on child labour.
However, it wants employers to provide protective clothing and other gear for the children to reduce exposure to nicotine.