Abstract

Background:

The presence of contaminants in cannabis presents a potential health hazard to recreational users and susceptible patients with medical conditions. Because of the federally illegal status of cannabis, there are no unified regulatory guidelines mitigating the public health risk of cannabis contaminants.

Objective:

To inform further research and provide solutions to the public health risk of cannabis contaminants at a national level, we examined the current landscape of state-level contaminant regulations, and cannabis contaminants of concern, as well as patient populations susceptible to contaminants.

Methods:

We examined the regulatory documents for medical and recreational cannabis in all legalized U.S. jurisdictions and compiled a complete list of regulated contaminants, namely, pesticides, inorganics, solvents, microbes, and mycotoxins. We data mined the compliance testing records of 5,654 cured flower and 3,760 extract samples that accounted for $\sim 6\%$ of California’s legal cannabis production in 2020–2021. We also reviewed the publicly available medical cannabis use reports to tabulate the susceptible patient populations.

Results:

As of 18 May 2022, 36 states and the District of Columbia listed a total of 679 cannabis contaminants as regulated in medical or recreational cannabis, including 551 pesticides, 74 solvents, 12 inorganics, 21 microbes, 5 mycotoxins, and 16 other contaminants. Different jurisdictions showed significant variations in regulated contaminants and action levels ranging up to four orders of magnitude. A failure rate of 2.3% was identified for flowers and 9.2% for extracts in the California samples. Insecticides and fungicides were the most prevalent categories of detected contaminants, with boscalid and chlorpyrifos being the most common. The contaminant concentrations fell below the regulatory action levels in many legalized jurisdictions, indicating a higher risk of contaminant exposure. Cannabis use reports indicated usage in several patient populations susceptible to contamination toxicity, including cancer (44,318) and seizure (21,195) patients.

Discussion:

Although individual jurisdictions can implement their policies and regulations for legalized cannabis, this study demonstrates the urgent need to mitigate the public health risk of cannabis contamination by introducing national-level guidelines based on conventional risk assessment methodologies and knowledge of patients’ susceptibility in medical use. https://doi.org/10.1289/EHP11206

中文翻译：

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州级大麻污染物法规比较及其对公共卫生的影响

摘要

背景：

大麻中污染物的存在对娱乐使用者和患有疾病的易感患者构成潜在的健康危害。由于大麻的联邦非法地位，没有统一的监管指南来减轻大麻污染物的公共卫生风险。

客观的：

为了在国家层面为进一步研究提供信息并为大麻污染物的公共健康风险提供解决方案，我们检查了州级污染物法规的现状、关注的大麻污染物以及易受污染物影响的患者群体。

方法：

我们检查了美国所有合法司法管辖区的医用和休闲大麻监管文件，并编制了一份完整的受监管污染物清单，即杀虫剂、无机物、溶剂、微生物和霉菌毒素。我们数据挖掘了 5,654 个干花和 3,760 个提取物样品的合规性测试记录，占$～6\%$2020-2021 年加利福尼亚州合法大麻产量。我们还审查了可公开获得的医用大麻使用报告，以将易感患者群体制成表格。

结果：

截至 2022 年 5 月 18 日，36 个州和哥伦比亚特区总共列出了 679 种医用或娱乐用大麻中受管制的大麻污染物，包括 551 种农药、74 种溶剂、12 种无机物、21 种微生物、5 种霉菌毒素和 16 种其他污染物。不同的司法管辖区显示出受管制的污染物和行动水平的显着差异，最高可达四个数量级。在加州样本中，花卉的失败率为 2.3%，提取物的失败率为 9.2%。杀虫剂和杀菌剂是检测到的最普遍的污染物类别，其中最常见的是啶酰菌胺和毒死蜱。在许多合法管辖区，污染物浓度低于监管行动水平，表明污染物暴露风险较高。

讨论：

尽管个别司法管辖区可以实施其合法化大麻的政策和法规，但本研究表明，迫切需要通过引入基于传统风险评估方法和患者医疗使用敏感性知识的国家级指南来减轻大麻污染的公共卫生风险。https://doi.org/10.1289/EHP11206