Byssinosis, the acute and chronic airways disease among those who process flax, cotton, and hemp fibers, is reviewed with regard to causative agents, populations at risk in the cotton and flax industry, epidemiology, pathology, etiology and diagnostic criteria, methods of prevention, and research needs. Exposures causing byssinosis include cotton dust from bract, leaf, and stem, flax dust from stem, and soft hemp dust from stem. Exposure to sisal (stem) and jute (stem) fibers occasionally result in byssinosis. Workers at risk are employed in cotton ginning, classing, cottonseed oil mills, cotton compressing and warehousing, yarn manufacturing, thread mills, fabric manufacturing, and textile waste processing. The characteristic symptom of the disease is chest tightness generally occurring after a weekend away from work with onset at 2 to 3 hours after dust exposure. Prognosis is correlated with the level of impairment as measured by spirometry. Large cross sectional studies have indicated that exposure to the textile vegetable dusts and exposure to cigarette smoke are the major risk factors associated with respiratory symptoms and impaired lung function. The primary means for prevention was identified as dust control in the workplace through exhaust ventilation, cotton washing and steaming, and decreased exposure to cigarette smoke. Research needs include cross sectional studies of nontextile cotton industries to establish dose response relationships, quantitation of risk factors, impairment and reversibility studies of former workers, animal model development, interaction studies in-vitro and in-vivo, and control technology research.
Occupational Respiratory Diseases. J. A. Merchant, Editor; Division of Respiratory Disease Studies, Appalachian Laboratory for Occupational Safety and Health, NIOSH, U.S. Department of Health and Human Services, DHHS (NIOSH) Publication No. 86-102