Abstract

Byssinosis, also called "brown lung disease" or "Monday fever", is an occupational lung disease caused by exposure to cotton dust in inadequately ventilated working environments. Byssinosis commonly occurs in workers who are employed in yarn and fabric manufacture industries. It is now thought that the cotton dust directly causes the disease and some believe that the causative agents are endotoxins that come from the cell walls of gram-negative bacteria that grow on the cotton. Although bacterial endotoxin is a likely cause, the absence of similar symptoms in workers in other industries exposed to endotoxins makes this uncertain.

Of the 81 byssinosis-related fatalities reported in the United States between 1990 and 1999, 48% included an occupation in the yarn, thread, and fabric industry on the victim's death certificate. This disease often occurred in the times of the industrial revolution. Most commonly young girls working in mills or other textile factories would be afflicted with this disease. In the United States, from 1996 to 2005, North Carolina accounted for about 37% of all deaths caused by byssinosis, with 31, followed by South Carolina (8) and Georgia (7).

The term "brown lung" is a misnomer, as the lungs of affected individuals are not brown.

Symptoms

Brown lung can ultimately result in narrowing of the airways, lung scarring and death from infection or respiratory failure.

Diagnosis

Patient history should reveal exposure to cotton, flax, hemp, or jute dust. Diagnostic tests include a lung function test and a chest x ray or CT scan.

Measurable change in lung function before and after working shifts is key to diagnosis. Patients suffering from byssinosis show a significant drop in FEV1 over the course of work shift.

Chest radiographs show areas of opacity due to fibrosis of the pulmonary parenchyma.

Treatment

Affected workers should be offered alternative employment. Continued exposure leads to development of persistent symptoms and progressive decline in FEV1.