scholarly journals An overview of the adverse effects of cannabis use for Canadian physicians

2019 ◽  
Vol 42 (3) ◽  
pp. E17-E34
Author(s):  
Heather Leduc-Pessah ◽  
Samuel K. Jensen ◽  
Christopher Newell

Purpose: Cannabis is the most widely used illicit substance and one of the most commonly used psychoactive substances in the world, preceded only by alcohol, tobacco and caffeine. Recent changes in legislation regarding cannabis use in Canada and potential upcoming changes worldwide may have a further impact on the prevalence of cannabis use. Thus, it is critical to understand the risks and potential adverse health effects of acute and long-term cannabis use. Current literature is lacking in many areas surrounding cannabis use, and for the most part is unable to provide clear associations once confounding variables are considered. Here we provide a general overview of the history of cannabis, the physical and mental health consequences, and the risks to specific groups. Source: A scoping search of published articles in PubMed from the start date (1946) until 2018. Principal finding: Current evidence supports an association between cannabis use and mild respiratory and cardiac effects, but no clear increased risk of cancer. Psychiatric disorders, including schizophrenia and anxiety, show associations with cannabis use; however, a causal effect of cannabis use is unclear. While no evidence for increased risk in pregnancy has been found, risk is still undetermined. Youth may be at a greater risk as earlier initiation of use increases the risk of adverse health effects. Conclusion: Overall, evidence for direct and long-term adverse effects of cannabis use is minimal and additional longitudinal studies will be required to better delineate unidentified effects.

Author(s):  
Martinus Løvik ◽  
Livar Frøyland ◽  
Margaretha Haugen ◽  
Sigrun Henjum ◽  
Kristin Holvik ◽  
...  

The Norwegian Scientific Committee for Food Safety (Vitenskapskomiteen for mattrygghet, VKM) has, at the request of the Norwegian Food Safety Authority (Mattilsynet; NFSA), assessed the risk of "other substances" in food supplements and energy drinks sold in Norway. VKM has assessed the risk of doses given by NFSA. These risk assessments will provide NFSA with the scientific basis while regulating "other substances" in food supplements. "Other substances" are described in the food supplement directive 2002/46/EC as substances other than vitamins or minerals that have a nutritional and/ or physiological e ffect. It is added mainly to food supplements, but also to energy drinks and other foods. In this series of risk assessments of "other substances" the VKM has not evaluated any claimed beneficial effects from these substances, only possible adverse effects. The present report is a risk assessment of specified doses of L-threonine in food supplements, and it is based on previous risk assessments and articles retrieved from literature searches. According to information from NFSA, L-threonine is an ingredient in food supplements sold in Norway. NSFA has requested a risk assessment of 1000, 1200, 1500, 2000 and 2400 mg/day of L-threonine from food supplements.  L-threonine is an essential amino acid not known to cause any adverse health effects. Previous reports do not indicate a tolerable upper intake level, apart from an approval of a dose of 1150 mg/day by the Scientific Committee of the Spanish Agency for Food Safety and Nutrition (AESAN). Long-term studies in humans were not found. The only available human studies were: a small uncontrolled one-year pilot study with doses ranging from 0.5 to 2.5 g/day, one eight-week randomised controlled trial (RCT) using a dose of 7.5 g/day, and two 2-week RCTs using doses of 6 and 4.5 g/day. No adverse effects (diary method of registration of adverse effects) were reported in the eight-week clinical trial, and the only adverse effects observed in the two-week trials were one case of indigestion and one case of diarrhoea. A four-week rodent toxicity study indicated a no observed adverse effect level (NOAEL) of 854.3 mg/kg bw per day (only dose tested, no adverse effects observed).  The value used for comparison with the estimated exposure in the risk characterisation is the NOAEL defined in an 8-week randomised placebo controlled study in humans, 7500 mg/day. For a 70-kg individual, this corresponds to 107 mg/kg bw per day. Two human two-week studies and a small one-year pilot study support the notion that this dose will be well tolerated. The overall mean threonine intake according to NHANES III (3 g/day) is slightly larger than the doses requested for evaluation in the present risk assessment. No studies in children (10 to <14 years) and adolescents (14 to <18 years) were identified. Based on the included literature there was no evidence indicating that age affects the tolerance for relevant doses of threonine. Therefore, in this risk characterisation a tolerance as for adults, based on body weight, was assumed for these age groups. VKM concludes that: In adults (≥18 years), the specified doses 1000, 1200, 1500, 2000 and 2400 mg/day L-threonine in food supplements are unlikely to cause adverse health effects. In adolescents (14 to <18 years), the specified doses 1000, 1200, 1500, 2000 and 2400 mg/day L-threonine in food supplements are unlikely to cause adverse health effects. In children (10 to <14 years), the specified doses 1000, 1200, 1500, 2000 and 2400 mg/day L-threonine in food supplements are unlikely to cause adverse health effects. Children younger than 10 years were not within the scope of the present risk assessment.


2020 ◽  
Vol 94 (7) ◽  
pp. 2319-2329
Author(s):  
Thomas Schupp ◽  
Georg Damm ◽  
Heidi Foth ◽  
Alexius Freyberger ◽  
Thomas Gebel ◽  
...  

The Lancet ◽  
2009 ◽  
Vol 374 (9698) ◽  
pp. 1383-1391 ◽  
Author(s):  
Wayne Hall ◽  
Louisa Degenhardt

2016 ◽  
Vol 31 (3) ◽  
Author(s):  
Jackie Wright ◽  
John Edwards ◽  
Stewart Walker

AbstractThe clandestine manufacture of methamphetamine in residential homes may represent significant hazards and exposures not only to those involved in the manufacture of the drugs but also to others living in the home (including children), neighbours and first responders to the premises. These hazards are associated with the nature and improper storage and use of precursor chemicals, intermediate chemicals and wastes, gases and methamphetamine residues generated during manufacture and the drugs themselves. Many of these compounds are persistent and result in exposures inside a home not only during manufacture but after the laboratory has been seized or removed. Hence new occupants of buildings formerly used to manufacture methamphetamine may be unknowingly exposed to these hazards. Children are most susceptible to these hazards and evidence is available in the literature to indicate that these exposures may result in immediate and long-term adverse health effects. The assessment of exposure within the home can be undertaken by measuring contaminant levels or collecting appropriate biological data from individuals exposed. To gain a better understanding of the available data and key issues associated with these approaches to the characterisation of exposure, a review of the published literature has been undertaken.


2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Katja M. Bendtsen ◽  
Elizabeth Bengtsen ◽  
Anne T. Saber ◽  
Ulla Vogel

Abstract Background Airport personnel are at risk of occupational exposure to jet engine emissions, which similarly to diesel exhaust emissions include volatile organic compounds and particulate matter consisting of an inorganic carbon core with associated polycyclic aromatic hydrocarbons, and metals. Diesel exhaust is classified as carcinogenic and the particulate fraction has in itself been linked to several adverse health effects including cancer. Method In this review, we summarize the available scientific literature covering human health effects of exposure to airport emissions, both in occupational settings and for residents living close to airports. We also report the findings from the limited scientific mechanistic studies of jet engine emissions in animal and cell models. Results Jet engine emissions contain large amounts of nano-sized particles, which are particularly prone to reach the lower airways upon inhalation. Size of particles and emission levels depend on type of aircraft, engine conditions, and fuel type, as well as on operation modes. Exposure to jet engine emissions is reported to be associated with biomarkers of exposure as well as biomarkers of effect among airport personnel, especially in ground-support functions. Proximity to running jet engines or to the airport as such for residential areas is associated with increased exposure and with increased risk of disease, increased hospital admissions and self-reported lung symptoms. Conclusion We conclude that though the literature is scarce and with low consistency in methods and measured biomarkers, there is evidence that jet engine emissions have physicochemical properties similar to diesel exhaust particles, and that exposure to jet engine emissions is associated with similar adverse health effects as exposure to diesel exhaust particles and other traffic emissions.


Author(s):  
Sara Angione ◽  
Heather McClenaghan ◽  
Ashley LaPlante

Background: Chlorine is a commonly used agent for water disinfectant in swimming pools. Inadequate ventilation in indoor swimming pools and chlorination disinfectant by-products (DBP’s) caused by organic matter promote the increased risk of adverse health effects. Water quality and proper ventilation must be monitored to avoid health risks in youth and adolescents. Methods: Studies were researched on children and adolescents from 2-18 years old who swim indoors. Articles were limited by only including journals from the year 2000 through 2010 and contain global statistics. Peer reviewed scientific articles were reviewed and a meta-analysis of three different scientific research databases, PubMed, Web of Science and Google Scholar, was conducted. Results and Conclusions: Children under five years of age, lifeguards and elite swimmers are at an increased risk of upper and lower respiratory symptoms, such as asthma, when exposed to chlorinated swimming frequently. Recreational swimmers who swim moderately are at a lower risk for developing occupational asthma. Implications: Reducing exposure to chlorine from indoor swimming pools may limit the risk of developing upper and lower respiratory infections. 


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