RESUMEN
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.
Asunto(s)
Asma Ocupacional , Cannabis , Enfermedades Profesionales , Exposición Profesional , Humanos , Asma Ocupacional/diagnóstico , Exposición Profesional/efectos adversos , Enfermedades Profesionales/diagnóstico , Massachusetts/epidemiologíaRESUMEN
OBJECTIVES: To examine barriers community health centers (CHCs) face in using workers' compensation insurance (WC). DATA SOURCES/STUDY SETTING: Leadership of CHCs in Massachusetts. STUDY DESIGN: We used purposeful snowball sampling of CHC leaders for in-depth exploration of reimbursement policies and practices, experiences with WC, and decisions about using WC. We quantified the prevalence of perceived barriers to using WC through a mail survey of all CHCs in Massachusetts. DATA COLLECTION/EXTRACTION METHODS: Emergent coding was used to elaborate themes and processes related to use of WC. Numbers and percentages of survey responses were calculated. PRINCIPAL FINDINGS: Few CHCs formally discourage use of WC, but underutilization emerged as a major issue: "We see an awful lot of work-related injury, and I would say that most of it doesn't go through workers' comp." Barriers include lack of familiarity with WC, uncertainty about work-relatedness, and reliance on patients to identify work-relatedness of their conditions. Reimbursement delays and denials lead patients and CHCs to absorb costs of services. CONCLUSION: Follow-up studies should fully characterize barriers to CHC use of WC and experiences in other states to guide system changes in CHCs and WC agencies. Education should target CHC staff and workers about WC.
Asunto(s)
Centros Comunitarios de Salud , Accesibilidad a los Servicios de Salud , Indemnización para Trabajadores , Centros Comunitarios de Salud/organización & administración , Centros Comunitarios de Salud/estadística & datos numéricos , Encuestas de Atención de la Salud , Accesibilidad a los Servicios de Salud/organización & administración , Accesibilidad a los Servicios de Salud/estadística & datos numéricos , Humanos , Reembolso de Seguro de Salud/normas , Massachusetts , Traumatismos Ocupacionales/terapia , Indemnización para Trabajadores/organización & administración , Indemnización para Trabajadores/estadística & datos numéricosRESUMEN
Three mercury (Hg) species (gaseous elemental mercury (GEM), gaseous oxidized mercury (GOM), and fine particulate-bound mercury (PBM(2.5))) were measured in the stack of a small scale wood combustion chamber at 400°C, in the stack of an advanced wood boiler, and in two areas influenced by wood combustion. The low temperature process (lab-scale) emitted mostly GEM (â¼99% when burning wood pellets and â¼95% when burning unprocessed wood). The high temperature wood boiler emitted a greater proportion of oxidized Hg (approximately 65%) than the low temperature system. In field measurements, mean PBM(2.5) concentrations at the rural and urban sites in winter were statistically significantly higher than in warmer seasons and were well correlated with Delta-C concentrations, a wood combustion indictor measured by an aethalometer (UV-absorbable carbon minus black carbon). Overall the results suggest that wood combustion may be an important source of oxidized mercury (mostly in the particulate phase) in northern climates in winter.