Cotton worker's lung; Cotton bract disease; Mill fever; Brown lung
Causes, incidence, and risk factors
Breathing in the dust produced by raw cotton can cause byssinosis. It is most common in people who work in the textile industry.
Those who are sensitive to the dust can have an asthma-like condition after being exposed.
Methods of prevention in the U.S. have reduced the number of cases, but byssinosis is still common in developing countries. Smoking increases the risk for this disease. Being exposed to the dust many times can lead to chronic lung disease and shortness of breath or wheezing.
Symptoms will get worse at the beginning of the work week, and then improve while you are away from the workplace, or later in the work week.
Signs and tests
Your health care provider will take a detailed medical history, and will ask many questions to try to find out whether your symptoms relate to certain exposures or times of exposure. The health care provider will also do a physical exam, paying special attention to the lungs.
The most important treatment is to stop being exposed to the dust. Reducing dust levels in the factory (by improving machinery or ventilation) will help prevent byssinosis. Some people may have to change jobs to avoid further exposure.
Medications used for asthma, 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. Breathing treatments, including nebulizers, may be prescribed if the condition becomes long-term. Home oxygen therapy may be needed if blood oxygen levels are low.
Physical exercise programs, breathing exercises, and patient education programs are often very helpful for people with a chronic lung disease.
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.
Symptoms usually improve after stopping exposure to the dust. Continued exposure can lead to reduced lung function. In the U.S., worker's compensation may be available to people with byssinosis.
Chronic bronchitis may develop.
Calling your health care provider
Call your health care provider if you have symptoms of byssinosis.
Controlling dust, using face masks, and other measures can reduce the risk. Stop smoking, especially if you work in textile manufacturing.
Chan-Yeung M, Malo J-L. Asthma in the workplace and occupational asthma. In: Mason RJ, Broaddus VC, Martin Tr, et al, eds. Murray and Nadel's Textbook of Respiratory Medicine. 5th ed. Philadelphia, Pa: Saunders Elsevier; 2010:chap 64.
Rose CS, Lara AR. Hypersensitivity pneumonitis. In: Mason RJ, Broaddus VC, Martin Tr, et al, eds. Murray and Nadel's Textbook of Respiratory Medicine. 5th ed. Philadelphia, Pa: Saunders Elsevier; 2010:chap 66.
David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine; and Denis Hadjiliadis, MD, Assistant Professor of Medicine, Division of Pulmonary, Allergy and Critical Care, University of Pennsylvania, Philadelphia, PA. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.