Workers who process marijuana may be at high risk of developing asthma and these cases can be serious, according to a new report that highlights a recent death in the cannabis industry.
Findings from the death investigation are published in Thursday’s Morbidity and Mortality Weekly Report, the medical journal of the US Centers for Disease Control and Prevention.
The 27-year-old woman who died worked as a cycle counter — a worker who tracks inventory — and worked in areas where cannabis flowers were ground to make joints or pre-rolls that are sold in dispensaries.
She began working at the facility, located in Massachusetts, in May of 2021, according to the report. By July of that year, she had begun to wheeze, which was noted in her medical records. She had not previously been diagnosed with asthma. Her mother told federal and state investigators that she had developed a runny nose, cough and shortness of breath after 3 to 4 months on the job.
In October, she moved to flower production, where cannabis flowers were ground and high levels of plant dust were generated.
She wore an N95 mask and long sleeves and gloves, but other employees reported that her cough increased, particularly when the grinder was on.
On November 9, 2021, she struggled to breathe and was taken by ambulance to the emergency room. On the way to the hospital, she was given albuterol through a nebulizer and was able to breathe more normally. She told the paramedics she thought she might be allergic to something at work. She was prescribed steroids and advised to follow up with her primary care physician.
On January 4, she complained to a co-worker that her cough was getting worse. Later that day, while she was filling pre-rolls, she began sneezing and her coughing increased. Despite using an inhaler, her shortness of breath worsened, and her co-workers called an ambulance. Her heart stopped before the ambulance got there. Her colleagues performed CPR and she regained circulation, but she never regained consciousness.
Doctors declared her brain dead 3 days later and life support was withdrawn.
Medical experts with the Massachusetts Department of Public Health and the Occupational Safety and Health Administration investigated her case.
They found dust levels at the facility were within permissible limits, though their report notes that a new shop vacuum with a HEPA filter had been purchased by the company since the employee’s death.
Levels of endotoxin, an inflammatory substance produced by bacteria that can contaminate cannabis flowers, were also within legal limits, leading the investigators to conclude that even exposures below those limits may be high enough to trigger asthma and other allergic symptoms.
Investigators interviewed 10 current and former co-workers of the woman who died, and four of them also reported work-related breathing problems or skin irritation. One man, who no longer worked here, also had symptoms of occupational asthma, according to the case report.
The researchers note that one study of a cannabis production facility in Washington found almost half the 31 workers had symptoms suggestive of asthma. Of 10 employees with symptoms of cannabis allergy related to their work, seven had abnormal breathing tests, and five reacted to cannabis on skin prick tests, which are used to diagnose allergies.
The researchers warn that occupational asthma can take months or years to develop after a person is first exposed to an irritant, and that fatal attacks can occur even when disease is considered mild.
They say workers at cannabis processing plants appear to be at high risk for developing the condition, and they say new strategies are needed to protect workers in this rapidly expanding industry.