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Beckman S, Castañeda X, Rivas L, Schenker MB. Stress, Mental Health, and Coping Among Workers in the Northern California Cannabis Industry: A Qualitative Descriptive Analysis. New Solut 2024; 33:198-208. [PMID: 38116635 PMCID: PMC10777608 DOI: 10.1177/10482911231212936] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2023]
Abstract
California is home to a multibillion-dollar cannabis (marijuana) industry, but little is known about the occupational health and safety hazards faced by cannabis workers and even less of the stress, mental health, and coping mechanisms among these workers. Previous research has been based on long-term workers at legal businesses, but most California cannabis is produced and sold unlawfully. There are many seasonal workers whose experiences have not been studied. A qualitative study based on focus group discussions and key informant interviews was performed to understand cannabis workers' experiences, knowledge, and perceptions of occupational hazards. Participants reported sources of stress including production pressure and isolation, and mental health outcomes such as depression and mental fatigue. They described primarily maladaptive coping mechanisms. Unique characteristics of the cannabis industry, including criminalization and isolated, remote farms, make interventions challenging. However, policy approaches that involve community organizations could promote worker health.
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Affiliation(s)
- Stella Beckman
- Center for Health and the Environment, University of California Davis, Davis, CA, USA
| | - Xóchitl Castañeda
- Health Initiative of the Americas, University of California Berkeley, Berkeley, CA, USA
| | - Likhi Rivas
- Health Initiative of the Americas, University of California Berkeley, Berkeley, CA, USA
| | - Marc B. Schenker
- Department of Public Health Sciences, School of Medicine, University of California Davis, Davis, CA, USA
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Zhao C, Yu M, Wang A, Xu X, Zheng X. Construction of an evaluation system for medical staff's occupational protection ability based on knowledge, attitude, and practice theory, and a cross-sectional survey of current conditions. BMC Nurs 2023; 22:78. [PMID: 36949466 PMCID: PMC10031986 DOI: 10.1186/s12912-023-01242-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Accepted: 03/09/2023] [Indexed: 03/24/2023] Open
Abstract
INTRODUCTION Medical personnel should be in close proximity and high frequency of contact with patients, and be exposed to physical, biological and chemical risk factors for a long time. The incidence of various occupational exposures is high. however, there is still a lack of the medical staff Occupational Protection Core Competence Evaluation Index system with high reliability and validity. AIM Based on the theory of knowledge, attitude, and practice, the evaluation system of occupational protection ability of medical personnel was established, and the current situation of occupational protection ability of medical personnel at different levels was investigated, so as to take targeted training and intervention measures to improve the occupational protection ability of medical personnel and reduce the incidence of occupational exposure. METHODS Based on the knowledge, attitude, and practice theory, the index system of occupational protection core competence of medical personnel was initially constructed by literature retrieval, expert consultation, group discussion, semi-structured interview and other qualitative and quantitative methods, and the reliability and validity of the index system was tested by Delphi expert consultation method. By convenient cluster sampling method, from March to September 2021, the current status of occupational protection core competence of medical personnel was investigated among medical staff from one Class III Grade A hospital and two medical schools in Jinan City, Shandong Province, China. RESULTS The evaluation system for medical staff's occupational protection ability included 3 first-level indexes, 11 second-level indexes, and 109 third-level indexes. A total of 684 valid questionnaires were collected from Grade III, Class A hospital medical staff and two medical school students in clinical practice in Shandong, China. Kruskal Walls test showed that there were significant differences in the overall distribution of occupational protection knowledge, attitude, and practice among registered nurses, nursing students, registered physicians, and physician students (H = 70.252, P < 0.001; H = 76.507, P < 0.001; H = 80.782, P < 0.001); there were statistical significance in the knowledge/ attitude/ practice of nursing and physician students at different levels (H = 33.733, P < 0.001; H = 29.158, P < 0.001; H = 28.740, P < 0.001). CONCLUSION The results of the evaluation system for the medical staff's occupational protection ability are reliable and can provide a reference for training the medical staff's occupational protection ability. Managers should strengthen the training of theoretical knowledge of occupational protection ability of medical staff.
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Affiliation(s)
- Cunyue Zhao
- Department of Spine Surgery, Shandong Electric Power Central Hospital, Jinan, China
| | - Mingguang Yu
- Department of Spine Surgery, Shandong Electric Power Central Hospital, Jinan, China
| | - Aijun Wang
- Department of Medical Oncology, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
- Nursing Theory and Practice Innovation Research Center, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Xiaofen Xu
- Department of Medical Oncology, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Xing Zheng
- Department of Medical Oncology, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China.
- School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Jinan, China.
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Beckman S, Castañeda X, Rivas L, Schenker MB. California cannabis cultivation and processing workers: A qualitative analysis of physiological exposures and health effects. Am J Ind Med 2023; 66:75-84. [PMID: 36398400 DOI: 10.1002/ajim.23442] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Revised: 11/03/2022] [Accepted: 11/03/2022] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Cannabis is a multi-billion-dollar California industry, but little is known about the occupational hazards or health experiences of cannabis cultivation workers. Respiratory and dermal exposures, musculoskeletal hazards, and other agricultural hazards have been identified in previous research. Even in a post-legalization framework, cannabis work is stigmatized and most cannabis is still produced illegally. Qualitative research is essential for establishing rapport with cannabis workers to understand their experiences and concerns. METHODS We conducted semi-structured discussions with four focus groups including 32 cannabis workers total, and 9 key informants who were workers, industry experts, and business owners or managers. Transcribed results were analyzed to identify key themes on physiological exposures and health effects. RESULTS The majority (81.3%) of focus group participants were seasonal migrant cannabis trimmers. Themes emerged of respiratory and dermal exposures and outcomes, musculoskeletal disorders, and physical hazards including living conditions. Workers reported respiratory symptoms and rashes from exposure to cannabis, mold, and pesticides. Musculoskeletal pain was ubiquitous due to inadequate seating and long shifts performing repetitive tasks. Seasonal workers experienced chronic exposure to cold conditions and unsanitary housing. Management-level interviewees and other industry stakeholders described concerns and experiences that differed from those of workers. DISCUSSION The results were consistent with existing research on cannabis worker health, with workers reporting respiratory and dermal exposure and symptoms, musculoskeletal hazards, and physical hazards associated with agricultural work. In addition, we found that workers were affected by substandard living conditions, remote and isolated work environments, and an absence of training.
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Affiliation(s)
- Stella Beckman
- Center for Health and the Environment, University of California, Davis, Davis, California, USA
| | - Xóchitl Castañeda
- Health Initiative of the Americas, University of California, Berkeley, Berkeley, California, USA
| | - Likhi Rivas
- Health Initiative of the Americas, University of California, Berkeley, Berkeley, California, USA
| | - Marc B Schenker
- Department of Public Health Sciences, School of Medicine, University of California, Davis, Davis, California, USA
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Affiliation(s)
- Marc B Schenker
- Department of Public Health Sciences, School of Medicine, University of California, Davis, California, USA
| | - Stella Beckman
- Center for Health and the Environment, University of California Davis, Davis, California, USA
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Beckman S, Eastman Langer C, Schenker MB. A Pilot Study of Respiratory and Dermal Symptoms in California Cannabis Cultivation Workers. J Agromedicine 2023; 28:28-35. [PMID: 36305193 DOI: 10.1080/1059924x.2022.2141407] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Cannabis (Cannabis sativa, marijuana) is the largest cash crop in California. While it is difficult to characterize the size of the industry, the total production is estimated at 15 to 16 million pounds per year, with total revenues exceeding $10 billion per year. Despite the huge size and rapid growth of the industry, there has been little research on the health and safety of cannabis workers. The goal of this pilot study was to explore the feasibility of collecting cannabis worker health data with a self-administered survey and to analyze the first systematically collected data on occupational health symptoms among California cannabis cultivation workers. We performed a cross-sectional survey of demographic and job characteristics as well as eye, nasal, respiratory, and dermal symptoms among 29 workers at two cannabis farms in the Sacramento area, California. Most participants were men aged less than 30 years, with 48% of participants self-identifying as non-Hispanic white and 58% reporting at least some college education. The most frequently reported work-related symptom was nasal irritation, and 38% of the participants reported symptoms suggestive of asthma. The participants had a demographic makeup distinct from traditional California agricultural workers, and a very high prevalence of current use of cannabis (93%). The high proportion of respondents with symptoms suggestive of asthma raises concern; sensitization to the cannabis plant has been reported among cannabis workers and users and there are many well-documented agricultural exposures causing asthma and asthma-like syndrome.
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Affiliation(s)
- Stella Beckman
- Center for Health and the Environment, University of California Davis, Davis, CA, USA
| | | | - Marc B Schenker
- Department of Public Health Sciences, School of Medicine, University of California Davis, Davis, CA, USA
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Decuyper II, Green BJ, Sussman GL, Ebo DG, Silvers WS, Pacheco K, King BS, Cohn JR, Zeiger RS, Zeiger JS, Naimi DR, Beezhold DH, Nayak AP. Occupational Allergies to Cannabis. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE 2021; 8:3331-3338. [PMID: 33161961 DOI: 10.1016/j.jaip.2020.09.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Revised: 09/02/2020] [Accepted: 09/02/2020] [Indexed: 10/23/2022]
Abstract
Within the last decade there has been a significant expansion in access to cannabis for medicinal and adult nonmedical use in the United States and abroad. This has resulted in a rapidly growing and diverse workforce that is involved with the growth, cultivation, handling, and dispensing of the cannabis plant and its products. The objective of this review was to educate physicians on the complexities associated with the health effects of cannabis exposure, the nature of these exposures, and the future practical challenges of managing these in the context of allergic disease. We will detail the biological hazards related to typical modern cannabis industry operations that may potentially drive allergic sensitization in workers. We will highlight the limitations that have hindered the development of objective diagnostic measures that are essential in separating "true" cannabis allergies from nonspecific reactions/irritations that "mimic" allergy-like symptoms. Finally, we will discuss recent advances in the basic and translational scientific research that will aid the development of diagnostic tools and therapeutic standards to serve optimal management of cannabis allergies across the occupational spectrum.
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Affiliation(s)
- Ine I Decuyper
- Department of Immunology-Allergology-Rheumatology, Antwerp University Hospital, University of Antwerp, Antwerp, Belgium; Infla-Med Centre of Excellence University of Antwerp, Antwerp, Belgium
| | - Brett J Green
- Office of the Director, Health Effects Laboratory Division, Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, Morgantown, Wv
| | - Gordon L Sussman
- Division of Allergy and Clinical Immunology, Department of Medicine, University of Toronto, Toronto, ON, Canada
| | - Didier G Ebo
- Department of Immunology-Allergology-Rheumatology, Antwerp University Hospital, University of Antwerp, Antwerp, Belgium; Infla-Med Centre of Excellence University of Antwerp, Antwerp, Belgium
| | | | - Karin Pacheco
- Division of Environmental and Occupational Health Sciences, Department of Medicine, National Jewish Health, Denver, Colo
| | - Bradley S King
- Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, Western States Division, Denver, Colo
| | - John R Cohn
- Department of Medicine, Division of Pulmonary, Allergy and Critical Care Medicine, Philadelphia, Pa; Jane & Leonard Korman Respiratory Institute, Thomas Jefferson University, Philadelphia, Pa
| | | | | | | | - Donald H Beezhold
- Office of the Director, Health Effects Laboratory Division, Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, Morgantown, Wv
| | - Ajay P Nayak
- Department of Medicine, Division of Pulmonary, Allergy and Critical Care Medicine, Philadelphia, Pa; Jane & Leonard Korman Respiratory Institute, Thomas Jefferson University, Philadelphia, Pa; Center for Translational Medicine, Thomas Jefferson University, Philadelphia, Pa.
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