A new study published in the Journal of Occupational and Environmental Medicine (JOEM) examines work-related asthma (WRA) among cannabis industry workers, using data from four US state-based surveillance systems (California, Massachusetts, Michigan, and Washington).
WRA cases within the cannabis industry were identified and classified as new-onset asthma or work-aggravated asthma. The findings can be used to guide preventative strategies and inform workplace safety policies to protect workers’ respiratory health.
From legalization dates (1996 in California, 2012 in Massachusetts, 2008 in Michigan, 1998 in Washington) through 2023, 30 WRA cases were identified. A majority were aged 18 to 34 years (66.7%) and were male (60%). Thirteen (52%) cases were new-onset asthma, and 12 (48%) were work-aggravated asthma, with two fatalities. Four case reports, one from each state, present detailed evidence for the association of workplace exposures and work-related asthma.
The most frequently reported exposure was plant materials (40.4%), of which 94.7% were cannabis dust and/or marijuana plant. Most cases (69%) worked in indoor cultivation/processing. 13 cases were new-onset asthma, 12 were work-aggravated asthma, and 5 cases could not be classified. Among the new-onset cases, three had worked in the industry for less than one year.
OSHA recently published an OSHA Fatal Facts report regarding q 27-year-old flower technician, who made “pre-rolls” (ground cannabis cigarettes) in an indoor cannabis cultivation and processing facility, experienced a severe asthma exacerbation at work that resulted in cardiac arrest.
To reduce the incidence of occupational allergies and asthma in this industry, a multifaceted approach is recommended by OSHA
1) Conduct medical screening and surveillance
– – – – Workers experiencing any work-related allergy and/or asthma symptoms noted above should be seen promptly by a healthcare provider with expertise in occupational allergy and asthma
– – – – Jobs with exposure to known allergens, such as cannabis, should have written surveillance programs that periodically assess employees for allergy signs and symptoms and perform medical tests as recommended by an appropriate occupational health professional with expertise in occupational allergy
– – – – Identify jobs causing symptoms in employees so that exposures can be assessed and controlled
2) Assess hazards in jobs that cause symptoms in workers to identify the causative agents involved5,7
3) Implement exposure control with engineering controls, administrative controls including work practices, and personal protective equipment (PPE) as applicable5,7
4) Provide medical management
– – For example, complete cessation of exposure with applicable benefits, rather than exposure reduction and/or respirator use, may be appropriate for workers with occupational allergies
5) Worker training and education should cover
– – Identified job hazards
– – Use of engineering controls, such as local exhaust ventilation, at point of operation
– – Work practices that minimize exposures such as HEPA vacuuming rather than dry sweeping
– – Proper use/care of PPE
– – Signs and symptoms of occupational allergy and the need for prompt employer notification and medical evaluation if symptoms occur
– – Procedures for employees to notify their employer about potential signs and symptoms of occupational allergy
Additionally, employers may also collaborate with academia on preventive efforts and risk factors for occupational allergy in this emerging industry. In particular, information that may support development of diagnostic tests for cannabis sensitization would be useful for future preventive efforts.