Byssinosis is a narrowing of the airways caused by inhaling cotton, flax, or hemp particles.
In the United States and Great Britain, byssinosis 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, something in the raw cotton causes the airways of susceptible people to narrow. Variations of this condition may occur in people exposed to grain dusts in agricultural environments (grain worker's lung).
Symptoms and Diagnosis
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.
The diagnosis is made by using pulmonary function tests that show decreasing lung capacity over the course of a workday. Usually, the decrease in lung capacity is greatest on the first day of the workweek.
Prevention and Treatment
Controlling dust is the best way to prevent byssinosis. 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. Drugs that open the airways (bronchodilators) may be given.
Last full review/revision April 2008 by Lee S. Newman, MD, MA