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Byssinosis

By

Abigail R. Lara

, MD, University of Colorado

Last full review/revision May 2020| Content last modified May 2020
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Byssinosis is a form of reactive airways disease Reactive airways dysfunction syndrome (RADS) and irritant-induced asthma Asthma is a disease of diffuse airway inflammation caused by a variety of triggering stimuli resulting in partially or completely reversible bronchoconstriction. Symptoms and signs include dyspnea... read more characterized by bronchoconstriction that occurs in cotton, flax, and hemp workers. The etiologic agent is bacterial endotoxin in cotton dust. Symptoms are chest tightness and dyspnea that worsen on the first day of the work week and subside as the week progresses. Diagnosis is based on history and pulmonary function test findings. Treatment includes avoidance of exposure and use of asthma drugs.

Etiology of Byssinosis

Byssinosis occurs almost entirely in workers who contact unprocessed, raw cotton, especially those who are exposed to open bales or who work in cotton spinning or in the carding room. Byssinosis can occur after acute exposure but usually occurs in workers with a history of chronic exposure of a least 10 years.

Evidence suggests that the cause is bacterial endotoxin in the cotton dust. The endotoxin leads to bronchoconstriction, chronic bronchitis, and gradual decreases in pulmonary function, particularly in genetically susceptible people. Prolonged exposure to cotton dust was once thought to cause emphysema, a theory now disproved.

Symptoms and Signs of Byssinosis

Symptoms are chest tightness and dyspnea that lessen with repeated exposure. Symptoms develop on the first day of work after a weekend or vacation and diminish or disappear by the end of the week. With repeated exposure over a period of years, chest tightness tends to return and persist through midweek and occasionally to the end of the week or as long as the person continues to work. This typical temporal pattern distinguishes byssinosis from asthma Asthma Asthma is a disease of diffuse airway inflammation caused by a variety of triggering stimuli resulting in partially or completely reversible bronchoconstriction. Symptoms and signs include dyspnea... read more .

Signs of acute exposure are tachypnea and wheezing. Patients with more chronic exposure may have crackles.

Diagnosis of Byssinosis

  • History of exposure and results of pulmonary function tests

Surveillance measures, including symptom reporting and spirometry in textile workers, can aid in early detection.

Treatment of Byssinosis

  • Asthma drugs

Treatment reference

  • 1. Er M, Emri SA, Demir AU, et al: Byssinosis and COPD rates among factory workers manufacturing hemp and jute. Int J Occup Med Environ Health 29(1):55–68, 2016. doi: 10.13075/ijomeh.1896.00512

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