Immunology of byssinosis: a study of the reactions between the isolated byssinosis "antigen" and human immunoglobulins.
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Antigen-Antibody Reactions↗
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Distinguishing byssinosis from chronic obstructive pulmonary disease. Results of a prospective five-year study of cotton mill workers in India.
This prospective 5-yr follow-up study of 1,241 textile workers from three mills was designed to determine the pattern and course of byssinosis in India and to distinguish this disease from chronic bronchitis. The initial prevalence of byssinosis was 14% in carding sections, 10% in spinning sections, and 11% in winding sections. In these dusty sections, the prevalences of both byssinosis and bronchitis increased with a longer service. Among workers with byssinosis; 56% had work-related and exertional dyspnea, 54% had chest tightness, 20% had wheezing, and 36% had cough. There was a history of Monday sickness in 22%. During follow-up it was confirmed that the atypical presentation of byssinosis with cough was more common in the carding department. The yearly decrease in pulmonary function was correlated with duration and degree of exposure to cotton dust. Thus, the decrease was larger in carding workers and in workers with byssinosis plus cough than in those with byssinosis or bronchitis. The yearly decrease in the one-second forced expiratory volume was different (p less than 0.05) for subjects with nonspecific chest symptoms (88 ml) and subjects with work-related chest symptoms (114 ml). The decreases in forced vital capacity and one-second forced expiratory volume were larger for increased dust loads. Fewer pulmonary infiltrates were seen in radiographs of workers with byssinosis than in those of workers with bronchitis. The immunoglobulins studied in 86 textiles workers and 17 control subjects showed higher IgG values among workers with work-related symptoms, especially cough, but not among those with bronchitic symptoms (p less than 0.01). Our results suggested that byssinosis is an entity distinct from chronic bronchitis.
Adult↗
Byssinosis in a Bombay textile mill.
BACKGROUND: Till a national campaign against dust-related lung diseases was launched by a voluntary agency in Ahmedabad in 1992, government records for the 150-year-old textile industry showed no cases of byssinosis--the disabling occupational disease caused by cotton dust. The worldwide incidence of byssinosis among workers in the dusty sections of textile mills is nearly 40%. We assessed the prevalence of byssinosis in a Bombay mill so that the Employees State Insurance Scheme would start conducting medical checks in all the 55 textile mills in Bombay and officially recognize the disease. METHODS: The study was conducted under the auspices of the Occupational Health and Safety Centre, a voluntary organization. Textile workers were called to a camp conducted over 3 nights and 3 days. We asked them to answer a questionnaire and tested their lung function using a Wright's ventilometer. The diagnosis of byssinosis was made if there was a feeling of chest tightness on exposure to cotton dust, and if the FEV1 was less than 60% of the expected result or the FEV1/FVC was less than 75%. RESULTS: Of the total 1075 workers in the mill only 273 came to the camp; 54 (30%) of the 179 individuals working in the dusty sections of the mill had byssinosis. In the non-dusty departments, 16 (17%) out of the 94 workers were affected. Among those working for less than 10 years in textile mills, 24% had byssinosis and among those working for more than 30 years, 45% had the disease. CONCLUSION: We found a prevalence of byssinosis among textile workers which is similar to that reported worldwide. The disease affected those who worked in both the dusty and non-dusty sections of the mill. There are an estimated 40,000 affected workers in Bombay and we suggest that the disease be recognized by the Employees State Insurance Scheme, and that the textile mill workers be compensated if they are affected by byssinosis.
Adult↗
Low normal alpha-1-antitrypsin serum concentrations and MZ-phenotype are associated with byssinosis and familial allergy in cotton mill workers.
Recent studies have shown a close association between byssinosis and airborne endotoxin concentrations. Endotoxin might induce byssinosis through the release of biochemical mediators as the broncheoalveolar surface. Alpha-1-antitrypsin (alpha-1-A) which neutralizes enzymes released by granulocytes is known to be important. This study evaluates the possible importance of alpha-1-A concentration and the heterozygosity (Pi-S and Pi-Z alleles), in the prevalence of byssinosis and familial allergy. 253 cotton workers were interviewed and clinically studied to identify persons with the cotton lung disease, byssinosis, and atopic disease. Serum was available for alpha-1-A concentration determination in 226 individuals, and for Pi phenotyping in 206. The overall prevalence of byssinosis was 30/226 (13%). In the group with alpha-1-A < or = 35 mumol l-1 the prevalence was 5/18 (28%), versus the prevalence 25/208 (12%) in the group with alpha-1-A > 35 mumol l-1 (p < 0.1, Fishers exact test). MZ phenotype was associated with an increased prevalence of byssinosis compared with the MM-group: 3/8 (38%) and 25/187 (13%), p < 0.1, Fishers exact test. An association between MZ-phenotype and familial allergy was found: 4/8 (50%) contra 23/187 (12%), p < 0.05, Fishers exact test. In a logistic regression model controlling for confounding by endotoxin, tobacco exposure, sex, and age, the odds ratio for byssinosis in the MZ-phenotype group was significantly elevated 5.8 (1.1-30.3). Odds ratio for familial allergy was also significantly elevated in the MZ-group 2.8 (1.3-5.9).(ABSTRACT TRUNCATED AT 250 WORDS)
Adult↗
The pathology of byssinosis.
In 1768, Morgagni gave the history and post=mortem findings in a man of 40 who had worked with hemp and found no abnormality in the lungs. It was the absence of gross pathology in the lungs of those who died severely disabled by byssinosis that led to our research into the disease. We see about 107 deaths a year of those with byssinosis who have been examined in life and have been given varying assessments of disablement. This article compares the pathologic findings in the lungs of a number of subjects with byssinosis with their ventilatory capacity in life and their smoking, occupational and clinical history. Emphysema is not an invariable finding. Interstitial fibrosis, which might be expected if the etiology of byssinosis was akin to farmer's lung, is not found. There is no characteristic lung lesion as is seen in the pneumoconioses. Cotton fibers are not found in the lungs and "byssinosis bodies" are not present in a majority of the cases. The pattern that emerges for byssinosis is that of asthmatic bronchitis.
Aged↗
Byssinosis among male textile workers in Pondicherry: a case-control study.
BACKGROUND: In India, 20 million workers are involved in the manufacturing of textiles. However, there are few epidemiological studies from India that have assessed the magnitude or the risk factors associated with byssinosis. In Pondicherry, textile mills have been in existence for over a century. This case-control study aimed to find the factors associated with the development of byssinosis in textile workers. METHODS: The sample consisted of 761 men above the age of 30 years who had worked for at least 10 years in a textile factory. All the respondents were interviewed by a pretested questionnaire to gather information regarding the symptoms of byssinosis, certain personal characteristics and occupational history. Byssinosis was identified using the classification proposed by the World Health Organization. Two age-matched controls were selected for each case. RESULTS: Univariate analysis of the factors for symptomatic byssinosis showed that dusty worksites, heavy smoking and duration of service > or = 30 years were significant. Logistic regression analysis showed that working in the spinning (odds ratio 6.1) and weaving sections (odds ratio 1.9), heavy smoking (odds ratio 3.9) and > or = 30 years of service (odds ratio 2.0) were independent significant risk factors. CONCLUSION: Efforts to reduce dust levels in the working environment and to discourage smoking among textile workers need to be strengthened to minimize the risk of developing byssinosis.
Byssinosis↗
Byssinosis--an historical perspective.
Based on the history of the growing awareness and recognition of ailments associated with the manufacture of cotton, it is concluded that recognition of byssinosis in the United States came late. In the American south byssinosis existed in an industry and within a social framework that helped to retard the acceptance of byssinosis as an undesirable but controllable disease. As late as the 1960s, United states medical opinion declared the disease nonexistent in American textile mills. In 1970, the scientific community showed that byssinosis existed in the United States. Mobilization of public opinion, changes in social attitudes, new scientific evidence, and the Occupational Safety and Health Act led to the setting of a standard to control and eradicate byssinosis. Controversy and debate over policy have brought the impact of scientific, sociopolitical, and economic inputs into health policy decisions, the altering perceptions of hazard, and the continually changing definition of risk into focus.
Byssinosis↗
Strategies for prevention of byssinosis.
Cotton dust is a heterogeneous mixture of plant parts and contaminants from the soil, weeds, and microorganisms. Research to control byssinosis has focused on methods to reduce the trash associated with harvested fiber and control the dust in the textile mill environment. Dust control has been effective in reducing the prevalence of byssinosis, but because cotton dust is a heterogeneous mixture of components, simple reduction in dust levels does not always assure the prevention of byssinosis. Research to identify the agents that cause byssinosis and development of methods to eliminate those agents from cotton is needed to prevent new cases of byssinosis.
Byssinosis↗
Prevalence of byssinosis in Swedish cotton mills.
The prevalence of byssinosis and of chronic bronchitis was studied in a questionnaire investigation among workers in bale opening areas, carding rooms, and spinning rooms in five Swedish cotton mills. Airborne dust and Gram-negative bacteria was measured. Nineteen per cent of the interviewed workers reported symptoms of light byssinosis (grade 1/2). The prevalence of symptoms was not related to the duration of employment, and cases of byssinosis were found among people who had worked in cotton mills for only a few years. A significantly higher proportion of male than female workers reported symptoms. No difference in the extent of byssinosis was found between smokers and non-smokers, but the prevalence was significantly higher among those workers who had ceased smoking. The prevalence of byssinosis was related to the number of airborne viable Gram-negative bacteria as well as to the dust level in the different mills.
Air Microbiology↗
Prevalence of byssinosis and respiratory symptoms among cotton mill workers.
BACKGROUND: While the prevalence of byssinosis is decreasing in industrialized countries and persists at high levels in developing countries, this prevalence is remaining constant in Turkey. OBJECTIVE: In order to determine the effects of past cotton dust exposure on the respiratory tract, a total of 223 persons working in a cotton mill were included in this study. METHODS: A questionnaire was used to inquire about respiratory symptoms. Participants underwent several spirometric measurements, which were performed on the 1st, 3rd and 5th day of the working week. Cotton dust measurements were performed in different divisions of the factory. RESULTS: The most common respiratory symptom was chest tightness (20.3%). The prevalence of byssinosis was 14.2% in cotton-processing workers. Among these cases, 28.6% had symptoms on the 1st day of the week, and 71.4% had symptoms on all days of the week. An acute effect was seen in 53.6% of the workers with byssinosis. Mean respirable dust levels were between 0.095 and 0.413 mg/m(3). CONCLUSIONS: In spite of technological improvements, respirable dust concentrations are still above the permissible limits, and thus the risk of byssinosis remains. Workers in the cotton industry where obsolete technology is used and standardized protection measures are not applied should be followed for byssinosis.
Adult↗
Prevalence of byssinosis and other respiratory problems among textile mill workers in Asaba, Nigeria.
OBJECTIVES: This study was conducted to determine the distribution and severity of byssinosis and other respiratory problems in the different operation sections in a textile mill industry in Asaba. PATIENTS AND METHODS: This is a cross-sectional and analytic study in which workers directly exposed to cotton dust are compared with those not directly exposed to cotton dust at one point in time. RESULTS: A total of 735 workers were interviewed and 437 workers had respiratory examinations carried out on them. Byssinosis was diagnosed in 8 out of 405 workers (prevalence of 1.98%) who were not directly exposed to cotton dust, and 21 out of 330 workers (prevalence of 6.36%) who were directly exposed to cotton dust. The difference was found to be statistically significant (chi2 =9.25; df=1; 0.01<p<0.001). The spinning department had the highest prevalence of 11.5%. The prevalence of respiratory abnormalities which did not necessarily meet the criteria for a diagnosis of byssinosis was 4.9% for persistent cough and persistent phlegm; 8.0% for dyspnoea grade 2+; 3.3% for dyspnoea grade 4 and 2.59% for dyspnoea grade 5. Smoking was not found to be associated with the disease as none of the byssinotics were current smokers CONCLUSION: Byssinosis and other respiratory problems were found to be more prevalent in sections of the textile mill industry that were directly exposed to cotton dust. These findings form a basis for making suitable recommendations for the prevention of byssinosis and respiratory diseases in textile mills in Nigeria.
Byssinosis↗
Byssinosis in South Africa. A survey of 2411 textile workers.
The first study of the prevalence of byssinosis in the South African cotton textile industry is described. Questionnaires were administered to 2411 subjects from six textile mills. Height and weight were measured and pulmonary function was tested before and after the first shift of a working week. Dust concentrations were measured using a Lumsden-Lynch vertical elutriator sampler. The prevalence of byssinosis (all grades) according to work departments was as follows: spinning 11.2%, winding 6.1%, and weaving 6.4%. Subjects with symptoms of byssinosis had a significantly reduced forced expiratory volume in 1 second (FEV1) and FEV1/forced vital capacity ratio when compared with controls matched for age, height and weight. Dust concentrations in many areas of the preparation and spinning processes exceeded the World Health Organisation's recommended permissible exposure limit for cotton dust in spinning operations. The prevalence of byssinosis in this study appears to be lower than that documented elsewhere. The mill design, machinery in use and environmental conditions in the South African cotton textile industry appear to be similar to those in Egypt and the USA before 1978. South Africa differs from these and other countries, including the UK, in having an exceptionally high labour turnover rate, which has reduced exposure periods. The subjects were found to have a high prevalence of previously treated pulmonary tuberculosis (3.4% for males and 2.2% for females), and in this population this disease appeared to cause more respiratory impairment than byssinosis.(ABSTRACT TRUNCATED AT 250 WORDS)
Adult↗
Byssinosis and other respiratory ailments: a survey of 6,631 cotton textile employees.
A Pulmonary Function Survey involving a questionnaire and pulmonary function testing was carried out in 14 plants of a large cotton textile manufacturing corporation. The edited records of 6,631 employees were analyzed to help identify the prevalence and location of byssinosis and other respiratory ailments and to explore the environmental conditions associated with them. A majority of the complaints of byssinosis were found among the relatively small subset of employees located in the high dust work areas of opening, picking, and carding. Byssinosis was significantly associated with bronchitis. Smoking was significantly associated with byssinosis for employees in opening, picking, and carding. While 3% of the population had subjective symptoms (history) of byssinosis, 0.8% indicated both symptoms and objective sign by a 10% or greater drop during the working day of the one-second forced expiratory volume (FEV1). The techniques commonly used to predict FEV1 should employ race as a predictive factor.
Black People↗
Discrepancies in the study of byssinosis in China.
The existence of byssinosis in China was first reported in 1964. Detailed studies only started in the late 1970s and early 1980s. The work of the WHO study group as edited by the Technical Report Series no. 684, "Recommended health-based occupational exposure limits for selected vegetable dusts," promotes the further study of occupational disease in China; a few points need further discussion. The word byssinosis translated in Chinese is misleading as to the real pathogenesis of the disease. Some still believe cotton dust causes interstitial fibrosis, while the majority of researchers agree with the WHO study group. A poorly designed animal model may have led to the (incorrect) conclusion that dust from carding room is toxic if it is injected intratracheally. The reasons for the controversy in the prevalence of byssinosis in different reports in earlier years are the different diagnosis criteria and the fact that dust sampling methods were not standardized; pulmonary function tests were not used as a routine index; chronic bronchitis and smoking are now recognized as confounders and should have been considered. This Institute initiated the hygiene standards study on cotton dust and recommended 1 mg/m3 for respirable dust and 3 mg/m3 for total dust. If a reduction in dust levels could prevent byssinosis, it would likely also control the risk factor for developing bronchitis.
Byssinosis↗
Byssinosis: environmental and respiratory symptoms among textile workers in Sudan.
This study has been carried out to investigate the prevalence of byssinosis and other respiratory symptoms among 311 Sudanese workers in different sections of the Khartoum Weaving and Spinning Company. The prevalence of byssinosis was 67% among blowers, 40% in carders and draw-frame workers, 42% in simplex workers and 37% in ring-frame workers. The prevalence of chronic bronchitis ranged between 29 to 47% in all groups. A significant fall in FEV1 was recorded in carders and draw- and ring-frame workers. There was also a statistically significant decrease in FVC after shift in all groups except in the ring-frame group. The result of the present study revealed that the prevalence of byssinosis was very high in mills processing coarse cotton. Application of control measures and the early detection of exposure effects will reduce the prevalence of byssinosis and other respiratory impairments.
Adolescent↗
Occupational-type exposure tests and bronchoalveolar lavage analyses in two patients with byssinosis and two asymptomatic cotton workers.
Two workers suffering from stage III byssinosis and claiming for compensation were examined. Bronchial obstruction was present in one case. MEF25-75 values were significantly reduced and bronchial hyperreactivity was present in both subjects. Occupational-type exposure tests with cotton dust resulted in significant decreases in arterial oxygen pressure for more than 2 h and were associated with an obstructive ventilation pattern in one of the patients. Prolonged hypoxemia which is not paralleled by lung function changes is probably typical for byssinosis patients since we have never seen this in inhalative challenge tests with various environmental antigens and other occupational substances including flour dust. No specific IgE or IgG antibodies could be detected. In the two patients a hitherto unknown significant increase in CD23+ lymphocytes and granulocytosis were detected by bronchoalveolar lavage (BAL). Corresponding investigations in two cotton workers without any evidence of byssinosis revealed neither lung function changes after the exposure test nor striking BAL findings. Our results demonstrate the diagnostic value of specific challenge tests and BAL investigations in patients suffering from byssinosis, which is often difficult to diagnose.
Adult↗
Bactericidal treatment of raw cotton as the method of byssinosis prevention.
In early studies, research to control byssinosis focused on methods to reduce the trash in the textile mill environment. Dust control has been effective in reducing the prevalence of byssinosis, but simple reduction in dust levels does not always assure its prevention. Also, bacteria and fungi present in cotton do not in themselves cause byssinosis, but the endotoxins-heat-stable lipopolysaccharide-protein complexes contained in the cell wall of Gram-negative bacteria-are responsible for the development of this respiratory disease of workers on cotton, flax, and some other fibers. Experimental work was carried out in cotton fields in different cotton growing countries. Opened cotton capsules were treated by spraying them with bactericidal water solutions of benzododecinium bromide to avoid the growth of bacteria by bacteriostatic effect during transportation and storage and thus to prevent the formation of endotoxins. To simulate transport conditions, treated and nontreated cotton samples were incubated under high air humidity. The endotoxin contents were determined by Limulus amebocyte lysate assay depending on the duration of incubation. In nontreated samples the endotoxin content grew to over 5,000 ng/mg. In comparison, in treated samples the endotoxin content grew extremely slowly. Thus, the bactericidal treating of raw cotton showed high efficiency as a potential method of byssinosis prevention. The irradiation by gamma-rays is also efficient, but it is not realistic in cotton growing areas of developing countries at the present time.
Benzalkonium Compounds↗
Mill effect and dose-response relationships in byssinosis.
Four hundred and eighty-six textile workers in three cotton mills and one wool/synthetic mill were studied for symptoms and functional effects of workroom exposure to dust. Byssinosis was found in 5.7% of 386 cotton workers, with an apparent threshold level of 0.5 mg cotton dust/m3 of air. Mean post-shift functional declines were greater in workers exposed to greater than or equal to 0.2 mg/m3. Workers with byssinosis were unequally distributed, however, with respect to job category and mill; and these variables, rather than current dust exposure levels, accounted for the observed distribution of byssinosis prevalence rates. Variation in biological potency of different samples of cotton dust could be responsible for 'mill effect', the residual variation in response rates by mill after controlling for variation due to dust exposure. A number of other potential influencing variables that are likely to be distributed unequally by mill should also be considered. Mill effect should be assessed in large-scale studies of byssinosis, most of which have analysed biological response rates by combining mill and other variables to examine first-order effects of dust dosage. In such analyses, much of the observed variability may be due to factors other than dust dosage.
Air Pollutants, Occupational↗