Fatal Occupational Asthma in Cannabis Production - Massachusetts, 2022

Abstract

Multiple respiratory hazards have been identified in the cannabis cultivation and production industry, in which occupational asthma and work-related exacerbation of preexisting asthma have been reported. An employee working in a Massachusetts cannabis cultivation and processing facility experienced progressively worsening work-associated respiratory symptoms, which culminated in a fatal asthma attack in January 2022. This report represents findings of an Occupational Safety and Health Administration inspection, which included a worksite exposure assessment, coworker and next-of-kin interviews, medical record reviews, and collaboration with the Massachusetts Department of Public Health. Respiratory tract or skin symptoms were reported by four of 10 coworkers with similar job duties. Prevention is best achieved through a multifaceted approach, including controlling asthmagen exposures, such as cannabis dust, providing worker training, and conducting medical monitoring for occupational allergy. Evaluation of workers with new-onset or worsening asthma is essential, along with prompt diagnosis and medical management, which might include cessation of work and workers' compensation when relation to work exposures is identified. It is important to recognize that work in cannabis production is potentially causative.

FIGURE

Timeline of work assignments, onset of signs and symptoms, and events associated with fatal occupational asthma in a cannabis facility worker — Massachusetts, 2021–2022 Abbreviations: CXR = chest radiograph; ED = emergency department; ICU = intensive care unit; PCR = polymerase chain reaction. * Cycle counter’s responsibilities are counting packaged cannabis products throughout the facility, including in ground product areas; flower technician’s responsibilities are grinding cannabis flowers and making prerolls.