Cannabis Workers Face Occupational Asthma Risks That May Be Fatal, CDC Warns

Individuals who work in the cannabis industry may face an increased risk of asthma, allergic reactions and severe respiratory problems, which could be fatal, according to recent warnings issued by federal health officials.

U.S. Centers for Disease Control and Prevention (CDC) researchers say microbial and plant allergens, chemicals, pesticides, and other irritants released by cannabis cultivation and production, have been linked to reports of work-related asthma and other respiratory problems.

In findings published in the Morbidity and Mortality Weekly Report on November 17, researchers indicate that at least one Massachusetts cannabis production worker has died of a fatal asthma attack after suffering work-related respiratory problems, which they have determined was occupational asthma. She reportedly experienced nausea, runny nose, cough, and shortness of breath just months after beginning employment, and died less than a year later.

Fatal Occupational Asthma Investigation

According to the CDC’s investigation, the employee began working at in an indoor cannabis cultivation and processing facility in late May 2021, where she was regularly exposed to grinding areas that generate dust and other inhalable air allergens. In late July, she began experiencing respiratory-related symptoms and was tested twice for SARS-CoV-2, however, both results were negative.

In October, the employee started working in cannabis flower production areas, where she directly handled large quantities of ground product to make rolled cannabis cigarettes, increasing her exposure to dust and other allergen particles in the air.

Just over a month later, she experienced difficulty breathing, wheezing, and was transported to the emergency room. She reported that she did not have any history of asthma, but had been experiencing lingering respiratory symptoms for over a month that she believed was work-related. An albuterol nebulizer relieved her symptoms and she was sent home with a prescription inhaler.

On January 4, 2022, the worker complained of worsening shortness of breath, and began experiencing coughing, sneezing, and labored breathing while filling cannabis cigarettes. After her prescribed albuterol inhaler failed to improve her condition, she suffered cardiac arrest.

Despite resuscitation efforts, she did not regain consciousness and was declared brain dead on January 7.

An investigation led by the Massachusetts Department of Public Health revealed that the employee had been evaluated by a pulmonologist for chronic cough in 2016, which ruled out asthma, gastroesophageal reflux disease, rhinitis, and cigarette or marijuana smoking as contributing factors.

Investigators also indicated the inhaler prescribed in November was nearly empty, suggesting she had used nearly all of the 200 inhalations available within a period of approximately two months.

Interviews with one former and nine current facility employees revealed four reports of work-related respiratory tract or allergic skin reaction symptoms, and one report of suspected occupational asthma.

Occupational Asthma and Allergic Reaction Risks

The report comes amid concerns of the increased occupational allergic disease risks individuals face while working in the country’s rapidly growing cannabis industry. At least 24 states have legalized recreational use of marijuana in recent years, and more than a dozen others have legalized medical cannabis.

The CDC indicates ground cannabis contains several airborne allergens and irritant particles that can bring on work-related asthma, worsen preexisting asthma, or trigger other allergic reactions. Industry workers in grinding and production areas are regularly exposed to large quantities of ground product, and have the most risk of developing adverse health outcomes.

Officials say further research is needed by the cannabis and healthcare industries to determine the prevalence and risk factors for cannabis-related occupational allergies, as fatal occupational asthma can occur even with mild cases of the disease.

CDC researchers recommend assessments of cannabis facilities to identify areas where potential dust exposure is highest, and to evaluate where airborne exposure control may be needed. Facility workers should also be given guidance and training on correct personal protective equipment, procedures to mitigate dust exposure, tips to identify potential hazards, and direction if occupational allergy symptoms are noticed.