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

Acknowledgements

The authors thank Suzanne Kelly, Elyette Martin, and Danièle Todorov for their contributions to the work-related asthma surveillance program.

Declaration of interest

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.

Additional information

Funding

This work was funded by the Safety and Health Assessment & Research for Prevention (SHARP) Program at the Washington State Department of Labor and Industries, and by Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health Cooperative Agreement under grant 5U60-OH008487.