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Bissinosis
Last reviewed: 05.07.2025
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Byssinosis is a form of reactive airway disease characterized by bronchospasm in workers exposed to cotton, flax, and hemp. The etiologic cause is unknown.
Symptoms of byssinosis include chest tightness and shortness of breath that worsen on the first day of the workweek and improve by the end of the week. Diagnosis is based on history and pulmonary function tests. Treatment of byssinosis includes discontinuation of exposure and use of asthma medications.
[ What causes byssinosis?
Byssinosis occurs almost exclusively in workers who handle unprocessed, raw cotton, especially those exposed to open-air manufacturing or who work in cotton-spinning rooms. Byssinosis may occur after acute exposure, but usually develops in workers with a history of chronic exposure. Evidence suggests that certain components of the cotton inflorescence cause bronchospasm. Although bacterial endotoxin is the probable cause, the absence of similar symptoms in other circumstances where workers are exposed to endotoxin leaves some doubt. Long-term exposure to cotton dust was once thought to cause emphysema, a theory that has not been disproved. Symptoms of chronic bronchitis are common in those exposed to cotton dust.
Symptoms of Byssinosis
Symptoms of byssinosis consist of chest tightness and shortness of breath that improve with repeated exposure. Symptoms develop on the first day of work after a weekend or vacation and decrease or disappear by the end of the week. With repeated exposure over several years, the sensation of chest tightness tends to recur and persist beyond midweek and sometimes until the end of the week or as long as the person continues to work. This typical periodic pattern distinguishes byssinosis from bronchial asthma. Symptoms of byssinosis with acute exposure are tachypnea and wheezing. Patients with extensive chronic exposure may have crackling wheezing.
Diagnosis of byssinosis
Diagnosis of byssinosis is based on history and pulmonary function tests that show typical obstructive changes and reduced ventilatory capacity, especially when performed at the beginning and end of the first work period. Hyperreactivity to methacholine is also frequently observed. Medical surveillance, including symptomatic assessment and spirometry in textile workers, may aid in early detection.
Treatment of byssinosis
Treatment of byssinosis involves avoiding or reducing exposure to the irritant and using anti-asthma medications.