Cotton bract disease

Alternative names
Cotton worker’s lung; Byssinosis

Definition
Byssinosis is an occupational disease of the lungs caused by inhalation of cotton dust or dusts from other vegetable fibers such as flax, hemp, or sisal.

Causes, incidence, and risk factors

Inhalation of the dust produced by industrial processing of textiles can cause byssinosis. An asthma-like condition results from exposure to dust in sensitive individuals.

Preventative measures in the U.S. have reduced the number of cases, but it remains common in developing countries. Smoking increases the risk for this disease. Repeated exposure to the offending substances may lead to chronic lung disease and shortness of breath or wheezing.

Symptoms

     
  • history of exposure to dusts from textile manufacture  
  • symptoms worse at the beginning of the work week  
  • symptoms improve away from the workplace  
  • chest tightness  
  • cough  
  • wheezing

Signs and tests

Your health care provider will take a detailed medical history, including many questions to try to relate your symptoms to specific exposures or times of exposure. A physical exam, with special attention to the lungs is also done. Other tests include:

     
  • chest X-ray  
  • pulmonary function tests (especially repeated throughout the work day or work week during exposure)

Treatment

The most important treatment is to remove the source of exposure to the offending agent. Reduction of dust levels within the factory by improving machinery or ventilation will help prevent byssinosis. Some people may have to change jobs to avoid further exposure.

Medications such as bronchodilators will usually improve symptoms. Corticosteroids may be prescribed in more severe cases.

Stopping smoking is very important for people with this condition. Respiratory treatments, including nebulizers and postural drainage, may be prescribed if the condition becomes chronic. Home oxygen therapy may also be needed if low blood oxygen levels are detected.

Physical exercise programs, breathing exercises, and patient education programs are often very helpful for people with a chronic lung disease.

Support Groups
Attending support groups with others who are affected by similar diseases can often help you understand your disease and adjust to the treatments and lifestyle changes required.

Expectations (prognosis)
Symptoms usually improve after stopping exposure to the offending dust. Continued exposure may lead to chronic impairment of lung function. In the U.S., worker’s compensation is available to those affected by byssinosis.

Complications
Chronic lung disease may develop.

Calling your health care provider
Call your health care provider if symptoms of byssinosis occur.

Prevention
Use of dust control measures, face masks, and other measures in industrial settings may reduce the risk. Stop smoking, especially if you work in textile manufacturing.

Johns Hopkins patient information

Last revised: December 3, 2012
by Martin A. Harms, M.D.

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