Although inhaling cotton dust was identified as a source of respiratory disease more than 300 years ago, byssinosis has been recognized as an occupational hazard for textile workers for less than 50 years. More than 800,000 workers in the cotton, flax, and rope-making industries are exposed in the workplace to airborne particles that can cause byssinosis. Only workers in mills that manufacture yarn, thread, or fabric have a significant risk of dying of this disease.
In the United States, byssinosis is almost completely limited to workers who handle unprocessed cotton. More than 35,000 textile workers have been disabled by byssinosis and 183 died between 1979 and 1992. Most of the people whose deaths were due to byssinosis lived in the textile-producing regions of North and South Carolina.
Causes and symptoms
Wheezing, shortness of breath, and a feeling of tightness in the chest occur occasionally during the early stages of the disease. Symptoms are usually more pronounced when returning to work after a weekend, holiday, or vacation and subside as the worker becomes reaccustomed to the environment.
As many as 25% of workers with byssinosis have symptoms that continue or recur throughout the work-week. More severe breathing problems seem to result both from exposure to high levels of dust and from longer dust exposure. Workers who also smoke cigarettes suffer the most severe impairment.
Tests that detect decreasing lung capacity during the workday are used to diagnose byssinosis. Obstructive patterns are likely in patients who have had recurrent symptoms for more than 10 years.
Therapy for early-stage byssinosis focuses on reversing airway narrowing. Antihistamines may be prescribed to reduce tightness in the chest. Bronchodilators (drugs used to relax breathing passages and improve air flow) may be used with an inhaler or taken in tablet form. Reducing exposure is essential. Any worker who has symptoms of byssinosis or who has trouble breathing should transfer to a less-contaminated area.
Smoking, impaired lung function, and a history of respiratory allergy increase a textile worker's risk of developing byssinosis. Prolonged exposure makes patients wheeze more often and can cause chronic bronchitis. It does not lead to permanently disabling lung disease.
Eliminating exposure to textile dust is the surest way to prevent byssinosis. Using exhaust hoods, improving ventilation, and employing wetting procedures are very successful methods of controlling dust levels to prevent byssinosis. Protective equipment required during certain procedures also prevents exposure to levels of contamination that exceed the current United States standard for cotton dust exposure.
Harrison's Principles of Internal Medicine. Ed. Anthony S. Fauci, et al. New York: McGraw-Hill, 1997.
Current Medical Diagnosis and Treatment, 1996. 35th ed. Ed. Stephen McPhee, et al. Stamford: Appleton & Lange, 1995.
American Lung Association. 1740 Broadway, New York, NY 10019. (800) 586-4872. <http://www.lungusa.org>.
Centers for Disease Control and Prevention. 1600 Clifton Rd., NE, Atlanta, GA 30333. (800) 311-3435, (404) 639-3311. <http://www.cdc.gov>.
"Occupational Lung Disease." American Lung Association Page. 27 May 1998 <http://www.lungusa.org>.
"1996 World Surveillance Report: Selected Data Highlights." Centers for Disease Control. 27 May 1998. 27 May 1998 <http://www.cdc.gov/niosh/w7_high.html>.
Wheeze—A whistling sound made by the flow of high-velocity air through narrowed airways. Wheezing is a symptom of several respiratory diseases including byssinosis and asthma.