Abstract
GENERAL agreement exists that some persons experience an acute respiratory reaction when exposed to cotton dust. Symptoms range from coughing and wheezing to shortness of breath and chest tightness and can occur and subside intermittently. Thus, the variability of symptoms among susceptible persons appears characteristic of the condition called byssinosis. It is further recognized that a certain number of workers will experience bronchitis when continually exposed to substantial cotton dust levels over a long period. There is, however, a vast difference of opinion regarding the production of chronic obstructive lung disease to cotton dust. Many experts question whether a disabling disease develops from long-term cotton dust inhalation and do not accept a cause-and-effect relationship between cotton dust and chronic obstructive lung disease. They base their opinion on several studies, some of which will be discussed here. A group<sup>1</sup>from Duke University made two particularly striking observations that have received
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