Details Released in Asthma-Related Death of Cannabis Facility Worker
New reports released by CDC and the Massachusetts Department of Public Health (MDPH) show missed opportunities that could have prevented the January 2022 death of a 27-year-old cannabis facility worker who suffered a fatal attack of asthma at work. The fatality is believed to be the first caused by occupational asthma among cannabis workers in the United States.
CDC and MDPH investigators found that the worker did not have a history of asthma prior to beginning work at the facility in May 2021. Within three months she developed cough and shortness of breath. These symptoms worsened after her role at the facility changed from counting finished products to working in the grinding room. The employer installed plastic sheeting in an attempt to reduce her exposure, and the worker started wearing an N95 respirator that she obtained on her own. But five weeks after switching to the grinding room, the worker experienced shortness of breath, and emergency medical services were called to the facility.
On the day of the incident in January 2022, the worker repeatedly used an inhaler to control shortness of breath, but her condition worsened, and she experienced respiratory and cardiac arrest. CPR and an AED were administered on site and succeeded in restarting her heart, but she sustained a brain injury from lack of oxygen. She was transported to a trauma center and admitted to intensive care but did not recover. Care was withdrawn three days later. A severe asthma attack was identified by the medical examiner as the likely cause of death.
Research has found that cannabis dust and smoke are asthmagens and sensitizers. The MDPH report observes that the worker’s symptoms continued to worsen over time and that “[f]urther control of the hazard or removing the victim from this work environment could have prevented this fatality.” While the progression from exposure to sensitization to asthma typically takes longer than the eight months the worker was employed at the facility, CDC’s report explains that medical records from 2016 documenting the worker’s personal use of cannabis are evidence that her first exposure to cannabis predated her employment.
During its investigation of the incident, OSHA conducted personal air sampling of grinder operators at the facility and found low exposure levels. But these results were obtained after the facility upgraded its dust collection system to include a vacuum with a HEPA (high efficiency particulate air) filter that had not been in place during the worker’s time of employment.
According to MDPH, the employer’s failure to recognize ground cannabis as a potential respiratory hazard, failure to control the spread of cannabis dust, and lack of a comprehensive safety and health program contributed to the incident. The employer provided one hour of health and safety training to new hires, but the training did not discuss safety considerations for handling cannabis products or the risk of allergic reaction to cannabis dust. MDPH’s recommendations to employers include the implementation of a comprehensive safety and health program, medical surveillance, and Prevention through Design concepts.
For more information, read the reports from MDPH (PDF) and CDC’s Morbidity and Mortality Weekly Report as well as the MDPH press release.
Related: An article from the June/July 2020 issue of The Synergist discusses respiratory sensitizers and strategies to address occupational asthma.