{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,25]],"date-time":"2026-10-25T08:59:04Z","timestamp":1792918744715,"version":"4.5.0"},"reference-count":62,"publisher":"Oxford University Press (OUP)","issue":"7","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,8,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>Since 2004, the National Institute for Occupational Safety and Health (NIOSH) has received 10 cannabis-related health hazard evaluation (HHE) investigation requests from law enforcement agencies (n = 5), state-approved cannabis grow operations (n = 4), and a coroner\u2019s office (n = 1). Earlier requests concerned potential illicit drug exposures (including cannabis) during law enforcement activities and criminal investigations. Most recently HHE requests have involved state-approved grow operations with potential occupational exposures during commercial cannabis production for medicinal and non-medical (recreational) use. As of 2019, the United States Drug Enforcement Administration has banned cannabis as a Schedule I substance on the federal level. However, cannabis legalization at the state level has become more common in the USA. In two completed cannabis grow operation HHE investigations (two investigations are still ongoing as of 2019), potential dermal exposures were evaluated using two distinct surface wipe sample analytical methods. The first analyzed for delta-9-tetrahydrocannabinol (\u03949-THC) using a liquid chromatography and tandem mass spectrometry (LC\u2013MS\u2013MS) method with a limit of detection (LOD) of 4 nanograms (ng) per sample. A second method utilized high performance liquid chromatography with diode-array detection to analyze for four phytocannabinoids (\u03949-THC, \u03949-THC acid, cannabidiol, and cannabinol) with a LOD (2000 ng per sample) which, when comparing \u03949-THC limits, was orders of magnitude higher than the LC\u2013MS\u2013MS method. Surface wipe sampling results for both methods illustrated widespread contamination of all phytocannabinoids throughout the tested occupational environments, highlighting the need to consider THC form (\u03949-THC or \u03949-THC acid) as well as other biologically active phytocannabinoids in exposure assessments. In addition to potential cannabis-related dermal exposures, ergonomic stressors, and psychosocial issues, the studies found employees in cultivation, harvesting, and processing facilities could potentially be exposed to allergens and respiratory hazards through inhalation of organic dusts (including fungus, bacteria, and endotoxin) and volatile organic compounds (VOCs) such as diacetyl and 2,3-pentanedione. These hazards were most evident during the decarboxylation and grinding of dried cannabis material, where elevated job-specific concentrations of VOCs and endotoxin were generated. Additionally, utilization of contemporary gene sequencing methods in NIOSH HHEs provided a more comprehensive characterization of microbial communities sourced during cannabis cultivation and processing. Internal Transcribed Spacer region sequencing revealed over 200 fungal operational taxonomic units and breathing zone air samples were predominantly composed of Botrytis cinerea, a cannabis plant pathogen. B. cinerea, commonly known as gray mold within the industry, has been previously associated with hypersensitivity pneumonitis. This work elucidates new occupational hazards related to cannabis production and the evolving occupational safety and health landscape of an emerging industry, provides a summary of cannabis-related HHEs, and discusses critical lessons learned from these previous HHEs.<\/jats:p>","DOI":"10.1093\/annweh\/wxaa013","type":"journal-article","created":{"date-parts":[[2020,1,22]],"date-time":"2020-01-22T04:28:35Z","timestamp":1579667315000},"page":"693-704","source":"Crossref","is-referenced-by-count":23,"title":["Review of NIOSH Cannabis-Related Health Hazard Evaluations and Research"],"prefix":"10.1093","volume":"64","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2577-4611","authenticated-orcid":false,"given":"James R","family":"Couch","sequence":"first","affiliation":[{"name":"NIOSH, Division of Science Integration, Cincinnati, OH, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"George Reed","family":"Grimes","sequence":"additional","affiliation":[{"name":"NIOSH, Division of Field Studies and Engineering, Cincinnati, OH, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brett J","family":"Green","sequence":"additional","affiliation":[{"name":"NIOSH, Health Effects Laboratory Division, Morgantown, WV, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Douglas M","family":"Wiegand","sequence":"additional","affiliation":[{"name":"NIOSH, Division of Field Studies and Engineering, Cincinnati, OH, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bradley","family":"King","sequence":"additional","affiliation":[{"name":"NIOSH, Western States Division, Denver, CO, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark M","family":"Methner","sequence":"additional","affiliation":[{"name":"NIOSH, Division of Field Studies and Engineering, Cincinnati, OH, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2020,2,13]]},"reference":[{"key":"2020080605404903400_CIT0001","author":"Agriculture Improvement Act of","year":"2018"},{"key":"2020080605404903400_CIT0002","doi-asserted-by":"crossref","first-page":"107","DOI":"10.1016\/j.forsciint.2014.06.008","article-title":"Simultaneous quantification of delta-9-THC, THC-acid A, CBN and CBD in seized drugs using HPLC-DAD","volume":"243","author":"Ambach","year":"2014","journal-title":"Forensic Sci Int"},{"key":"2020080605404903400_CIT0003","doi-asserted-by":"crossref","first-page":"654","DOI":"10.3109\/13693786.2012.658091","article-title":"Hypersensitivity pneumonitis induced by Shiitake mushroom spores","volume":"50","author":"Ampere","year":"2012","journal-title":"Med Mycol"},{"key":"2020080605404903400_CIT0004","doi-asserted-by":"crossref","first-page":"371","DOI":"10.1093\/toxsci\/kfs102","article-title":"Irritancy and allergic responses induced by exposure to the indoor air chemical 4-oxopentanal","volume":"127","author":"Anderson","year":"2012","journal-title":"Toxicol Sci"},{"key":"2020080605404903400_CIT0005","doi-asserted-by":"crossref","first-page":"1235","DOI":"10.1002\/ajim.22533","article-title":"Respiratory morbidity in a coffee processing workplace with sentinel obliterative bronchiolitis cases","volume":"58","author":"Bailey","year":"2015","journal-title":"Am J Ind Med"},{"key":"2020080605404903400_CIT0006","doi-asserted-by":"crossref","first-page":"AB178","DOI":"10.1016\/j.jaci.2010.12.707","article-title":"Hypersensitivity reactions to marijuana","volume":"127","author":"Basharat","year":"2011","journal-title":"J Allergy Clin Immunol"},{"key":"2020080605404903400_CIT0007","first-page":"P4023","article-title":"Oyster mushrooms (Pleurotus ostreatus) caused hypersensitivity pneumonitis: mushroom worker\u2019s lung","volume":"44","author":"Bekci","year":"2014","journal-title":"Eur Respir J"},{"key":"2020080605404903400_CIT0008","doi-asserted-by":"crossref","first-page":"398","DOI":"10.7326\/0003-4819-84-4-398","article-title":"Chronic respiratory disease in hemp workers. 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