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Byssinosis +bi-su-!nO-sus

by Lee S. Newman, MD, MA

Byssinosis is a narrowing of the airways caused by inhaling cotton, flax, or hemp particles.

  • Byssinosis may cause wheezing and tightness in the chest, usually on the first day of work after a break.

  • The diagnosis is made by using a test that shows decreasing lung function over the course of a workday.

  • Exposure should be stopped, then wheezing and chest tightness can be treated with drugs used for asthma.

Byssinosis is an environmental lung disease (see Overview of Environmental Lung Diseases) that, in the United States and Great Britain, occurs almost exclusively in people who work with unprocessed cotton. People who work with flax and hemp may also develop the condition. People who open bales of raw cotton or who work in the first stages of cotton processing seem to be most affected. Apparently, a toxin produced by bacteria in the raw cotton becomes mixed with the cotton dust and causes the airways of susceptible people to narrow.

Symptoms

Byssinosis may cause wheezing and tightness in the chest, usually on the first day of work after a break. Unlike with asthma, the symptoms tend to diminish after repeated exposure, and the chest tightness may disappear by the end of the workweek. However, after a person has worked with cotton for many years, the chest tightness may last for 2 or 3 workdays or even the whole week. Prolonged exposure to cotton dust increases the frequency of symptoms (wheezing, chest tightness) and leads to permanent lung disease, which can sometimes be disabling.

Diagnosis

  • Lung function testing

The diagnosis is made by using pulmonary function tests that show decreasing lung function over the course of a workday. Usually, the decrease in lung function is greatest on the first day of the workweek.

Prevention

Controlling dust is the best way to prevent byssinosis.

Treatment

  • Removal from exposure

  • Drugs to open airways

Workers with symptoms who also experience sudden drops in lung function on the first day of the workweek should be removed from exposure. Wheezing and chest tightness can be treated with the drugs used for asthma (see Asthma : Treatment). Drugs that open the airways (bronchodilators) may be given.