This testimony contains information on the effects of cotton dust exposure. Recommendations for medical surveillance, environmental control, environmental monitoring, informing the worker, work practices, and respiratory protection for workers exposed to cotton dust have been transmitted to OSHA as a Draft Technical Standard under the NIOSH/OSHA Standards Completion Program. Chronic respiratory disease arising from working in textiles was first documented in 1705 in hemp workers. A new era in the investigation into respiratory disease among cotton textile workers began in 1950 with the rediscovery of byssinosis while studying increased mortality among textile workers. The definition of byssinosis is discussed and the grading scheme for the severity of the disease is delineated. The importance of environmental sampling, medical surveillance, respirators, work practices, and the posting of warning signs regarding the dangers of cotton dust are reviewed.