Surveillance of work-related asthma including the emergence of a cannabis-associated case series in Washington State

Abstract

Objective: We conducted surveillance for work-related asthma (WRA) in Washington State to identify the industry sectors and asthma exposures most commonly affecting injured workers and in need of prevention activities.

Methods: Using workers' compensation data as the primary data source, valid cases were classified as work-aggravated asthma (WAA) or new onset asthma that includes occupational asthma (OA) and reactive airways dysfunction syndrome (RADS). The source of exposure that caused the worker's asthma, their industry and occupation were determined.

Results: There were 784 valid work-related asthma cases identified for the period 2009-2016, WAA (n = 529) was most common followed by occupational asthma (n = 127) and RADS (n = 12). The Health Care and Social Assistance industry had the highest number of cases (n = 170) with 82% classified as WAA. The highest overall proportions of new onset asthma are occurring in Agriculture, Forestry, Fishing and Hunting (33% of work related asthma cases), Manufacturing (31%) and Construction (30%). The leading substances associated with new onset asthma across all industries include hop plant dust, wood and cedar dust, mineral and inorganic dust, mold, and cleaning materials. We describe ten cases of cannabis-associated asthma including seven from workers in the legalized cannabis industry, four of whom had OA.

Conclusion: State-based work-related asthma surveillance is critical in identifying the workers and exposures associated with this occupational disease, including the detection of a case-series in the cannabis industry.

Keywords: Case reports; epidemiology; prevention.