We entered a total of 30 indoor marijuana grow operations (IMGO) with law enforcement investigators in order to determine potential exposures to first responders. Samples for airborne fungal spores, volatile organic compounds, carbon dioxide, carbon monoxide, and delta-9-tetrahydrocannabinol (THC) were obtained as well as the identification of chemicals utilized in the IMGO. The chemicals utilized within the IMGOs were primarily pesticides and fertilizers with none showing high toxicity. Although several of the IMGOs had CO2 enrichment processes involving combustion, CO levels were not elevated. THC levels were identified on surfaces within the IMGOs and on the hands of the investigators. Surface levels ranged from <0.1 μg /100 cm(2) to 2000 μg /100 cm(2) with a geometric mean of 0.37 μg /100 cm(2). THC levels on the hands of officers ranged from <0.10 μg /wipe to 2900 μg /wipe with a geometric mean of 15 μg /wipe. These levels were not considered to be elevated to the point of causing a toxic exposure to responders. A total of 407 fungal spore samples were taken using both slit impactor plates and 400-hole impactors. Both methods identified elevated fungal spore levels, especially during the removal of plants from some of the IMGOs. After plant removal, spore counts increased to levels above 50,000 spores/m(3) with one sample over 500,000 spores/m(3). In addition, we found that there was a shift in species between indoor and outdoor samples with Cladosporium sp. the predominant outdoor species and Penicillium sp. the predominant indoor species. We concluded that the potential increase in fungal spore concentrations associated with the investigation and especially removal of the marijuana plants could potentially expose responders to levels of exposure consistent with those associated with mold remediation processes and that respiratory protection is advisable.

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Background Cannabis legalization in Colorado resulted in increased cannabis-associated health care utilization. Our objective was to examine cooccurrence of cannabis and mental health diagnostic coding in Colorado emergency department (ED) discharges and replicate the study in a subpopulation of ED visits where cannabis involvement and psychiatric diagnosis were confirmed through medical review. Methods We collected statewide ED International Classification of Diseases, 9th Revision, Clinical Modification diagnoses from the Colorado Hospital Association and a subpopulation of ED visits from a large, academic hospital from 2012 to 2014. Diagnosis codes identified visits associated with mental health and cannabis. Codes for mental health conditions and cannabis were confirmed by manual records review in the academic hospital subpopulation. Prevalence ratios (PRs) of mental health ED discharges were calculated to compare cannabis-associated visits to those without cannabis. Rates of mental health and cannabis-associated ED discharges were examined over time. Results Statewide data demonstrated a fivefold higher prevalence of mental health diagnoses in cannabis-associated ED visits (PR = 5.35, 95% confidence interval [CI], 5.27–5.43) compared to visits without cannabis. The hospital subpopulation supported this finding with a fourfold higher prevalence of psychiatric complaints in cannabis attributable ED visits (PR = 4.87, 95% CI = 4.36–5.44) compared to visits not attributable to cannabis. Statewide rates of ED visits associated with both cannabis and mental health significantly increased from 2012 to 2014 from 224.5 to 268.4 per 100,000 (p < 0.0001). Conclusions In Colorado, the prevalence of mental health conditions in ED visits with cannabis-associated diagnostic codes is higher than in those without cannabis. There is a need for further research determining if these findings are truly attributed to cannabis or merely coincident with concurrent increased use and availability.

Recently, worker exposures to diacetyl, a chemical used in the production of butter popcorn, has been linked to bronchiolitis obliterans, a severe lung disease. This chemical is also used in the flavor industry to confer a buttery flavor to many food products, with more than 228,000 pounds used in 2005. Diacetyl exposures were monitored at 16 small-to medium-sized flavor facilities to determine potential diacetyl exposures. A total of 181 diacetyl samples (both personal and area samples) were obtained, and a number of real-time samples were collected using an IR spectrometer. Samples were obtained during liquid and powder compounding operations at the facilities as well as during laboratory and QC operations. The personal and area samples ranged from non-detectable (<0.02 ppm) to as high as 60 ppm. Ninety-two (51%) of the samples were below the limit of detection, and the mean diacetyl concentration for all processes was 1.80 ppm. Mean diacetyl levels during powder operations were generally higher (4.24 ppm) than mean diacetyl levels during liquid operations (2.02 ppm). Maximum real-time diacetyl exposures during powder operations could reach as high as 525 ppm. These results are similar to exposures measured by NIOSH in popcorn facilities where lung disease was found; however, the duration of use and frequency of use may be significantly lower.