Byssinosis and respiratory diseases in cotton mill workers are discussed. Occupational illness from textile dusts has been known since 1705. The relationship of dust to frequent illness in textile card room workers was described in Great Britain in the early nineteenth century. Byssinosis has been well known since the beginning of the twentieth century. Three other clinical syndromes, mill fever, weavers cough and mattress makers fever, are not distinct from byssinosis. Byssinosis is defined as a chronic respiratory disease associated with inhalation of cotton, flax and soft hemp dusts, producing chest tightness, cough, wheezing and dyspnea. It is graded on the basis of history of symptoms. With grade 3, the most severe, patients die from the disease, with chronic bronchitis and emphysema. There are three hypotheses on the mechanism of acute byssinosis: a non antigenic histamine release, endotoxin activity, and an immunologic mechanism. Attempts to control dust in cotton mills include vacuum exhaust systems on cording engines, hoods, exhaust fans, and air filtration. Improved dust control may require redesign of ventilation systems and new methods of dust removal. Until the causative material is removed from cotton before its arrival at the mill or the dust is removed from the work environment, employees with serious health impairment should be removed before they suffer irreversible insufficiency. Preemployment medical screening of workers and periodic evaluation during the work life of employees are useful. The authors conclude that the application of prudent medical knowledge can prevent or delay development of pulmonary impairment among textile workers.
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