Byssinosis: scheduled asthma in the textile industry.

Abstract

Byssinosis, an occupational lung disease of textile workers, can be distinguished from asthma and other forms of reversible airway obstruction by its characteristic history of chest tightness, cough, and wheezing on first working days after absence from work. Lung function tests before and after exposure to dust on first working days confirm the occurrence of airway obstruction as an acute effect of dust exposure during work in carding, spinning and other dusty operations in cotton, flax and soft-hemp factories. The dust in these factories contains a water-soluble, heat-stable agent which releases histamine from human lung tissue. In the case of cotton dust, this agent originates in the bracts of the cotton plant. Recent epidemiological studies in U.S. cotton textile workers and in Spanish hemp workers have shown that prolonged exposure to textile dusts often leads to disabling chronic lung disease and to loss of lung function which is irreversible with β-adrenergic drugs. At this stage, the disease may progress even after exposure to dust ceases. This recent work further strengthens the need for adequate control of exposure to respirable dust among textile workers. Implementation of this goal remains elusive because of its economic consequences, in spite of adequate medical documentation of the health risks of textile dust exposure during the past 20 years.