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Occupational cannabis exposure and allergy risks
  1. Ine Ilona Decuyper1,
  2. Athina Van Gasse1,
  3. Margaretha Antje Faber1,
  4. Christel Mertens1,
  5. Jessy Elst1,
  6. Hans-Peter Rihs2,
  7. Vito Sabato1,
  8. Hilde Lapeere3,
  9. Margo Hagendorens1,
  10. Chris Bridts1,
  11. Luc De Clerck1,
  12. Didier Ebo1
  1. 1 Department of Immunology-Allergology-Rheumatology, University of Antwerp, Antwerp (Belgium) and Antwerp University Hospital, Antwerp, Belgium
  2. 2 Institute for Prevention and Occupational Medicine, German Social Accident Insurance, Ruhr-University Bochum, Bochum, Germany
  3. 3 Ghent University Hospital, University of Ghent, Gent, Belgium
  1. Correspondence to Professor Didier Ebo, Department of Immunology-Allergology-Rheumatology, Faculty of Medicine and Health Sciences, Antwerp University, Antwerp 2610, Belgium; didier.ebo{at}


Objectives Cannabis allergy has mainly been described following recreational use but some cases also point to cannabis sensitisation as a result of occupational exposure. As a consequence, little is known on the prevalence and clinical phenotype of occupational cannabis allergy. Therefore, this study aims to explore the allergy-associated health risks of occupational cannabis exposure in Belgian police force personnel.

Methods 81 participants, active in the police force, reporting regular occupational cannabis exposure during the past 12 months, were included. History was combined with a standardised questionnaire on allergies and cannabis exposure.Basophil activation tests (BATs) with a crude cannabis extract and rCan s 3 were performed. In addition, specific (s)IgE rCan s 3 as well as sIgE to house dust mite, six pollen and three mould allergens were quantified.

Results Although 42% of the participants reported respiratory and/or cutaneous symptoms on occupational cannabis exposure, all cannabis diagnostics were entirely negative, except one symptomatic case demonstrating a borderline result. Furthermore, there is no significant difference between the groups with and without symptoms on cannabis exposure in terms of allergenic sensitisations.

Conclusions The origins of the reported respiratory and cutaneous symptoms during cannabis exposure remain elusive but are probably due to non-immune reactions. It should be noted that the study was volunteer-based possibly reflecting an excessive number of symptomatic individuals. Nevertheless, as only one participant reported using fully protective gear, much improvement is needed for reducing the number of symptoms reported on duty, independent of their origin.

  • cannabis
  • occupational exposure
  • allergy
  • IgE
  • basophil
  • CD63
  • cytometric bead array
  • skin test
  • house dust mite
  • pollen
  • moulds

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  • Contributors IID:study set-up, organisation, participant inclusion, data analyses, writing themanuscript. AVG: help in participant inclusion, blood sample collection andperformance of skin prick tests. MAF: discussing results, correcting andproof-reading the manuscript. CM: performance of BAT and sIgE measurements,proof-reading manuscript. JE: correcting and proof-reading the manuscript.H-PR: production of Can s 3 protein, discussing results, correcting andproof-reading the manuscript. SV: correcting and proof-reading the manuscript.HL: help with participant inclusion, correcting and proof-reading themanuscript. MH: correcting and proof-reading the manuscript. CB: discussingflow-cytometric analyses, correcting and proof-reading the manuscript. LDC:correcting and proof-reading the manuscript. DE: help with study set-up,discussing results and analyses, writing, correcting and proof-reading themanuscript. IID and DE are guarantors of the paper.

  • Funding This work was supported by Agentschap voor Innovatie door Wetenschap en Technologie (IWT) (grant number 140185).

  • Competing interests None declared.

  • Patient consent Not required.

  • Ethics approval The local ethics committee of both the University Hospital of Antwerp and of Ghent approved and registered this study (B300201524055).

  • Provenance and peer review Not commissioned; externally peer reviewed.