The palm wine trade: occupational and health hazards.

The palm wine trade is an important economic activity for many tropical rural areas worldwide. In West Africa, palm wine holds high sociocultural and traditional values. Wine tappers often climb very tall trees with rudimentary equipment to harvest palm sap and risk severe injuries in the event of a fall. Furthermore, the wine quickly ferments beyond the desired taste and alcohol content, reducing the market power of these tappers. Therefore, to maximize benefits or to enhance shelf life, a variety of components are added to the palm tree sap, introducing the possibility of deadly contaminants. This paper highlights the public health implications of uncontrolled palm wine production and the relative neglect of the wine tapper. We draw from the limited published literature and use Cameroon as a case study. The palm wine trade can be more productive and safe if tappers work in cooperatives to improve their market power. Public health authorities need to monitor the quality of this cheap and common source of alcohol and enact regulations to protect wine tappers from the current level of occupational hazards. There are varying levels of progress to control quality and ensure safety in different parts of the world. Legislation and collaboration with traditional structures may offer a framework for change.