Occupational and Environmental Respiratory Disease. Harber P, Schenker MB, Balmes JR, eds., St. Louis, MO: Mosby, 1995 Jul; :401-419
The utilization, health and clinical effects, dose effect risk relationships, regulation and related issues of cotton dust were presented. Cotton production and processing were discussed in detail. The number of workers exposed to cotton dust in the United States was estimated to be 500,000. Byssinosis, mill fever and ocular and nasal irritation were listed as the most common health effects of cotton dust exposure. Clinical effects of exposure in the cases of byssinosis, mill fever, asthma and weaver's cough, airway hyperresponsiveness and byssinosis syndrome. Diagnostic and therapeutic concerns, pathology, prognosis and course of illness were described for byssinosis. Studies concerning dose effect risk relationships for cotton dust, bacterial proteolytic enzymes and endotoxins present in cotton dust and biologically active plant components were reviewed. Historical perspectives on regulations of cotton dust as well as current Occupational Safety and Health Administration cotton dust regulations were given. Employee placement and training were discussed. Control methods, including exhaust systems, substitution of fibers other than cotton and proposed limits on occupational exposure to airborne cotton endotoxins were outlined.