Byssinosis

Presentation

1. BYSSINOSIS Hemalatha sundararajan Faculty of medicine

2. Byssinosis is a rare lung disease. It’s caused by inhaling hemp, flax, and cotton particles. It commonly occurs in workers who are employed in  yarn  and  fabric manufacture industries.  Other names for byssinosis include Monday fever, brown lung disease, mill fever or cotton workers' lung.   It is a form of occupational asthma . INTRODUCTION

3. Although inhaling cotton dust was identified as a respiratory disease more than 300 years ago. Byssinosis has been recognized as an occupational hazard for textile workers for less than 50 years. In India more than100,000 workers in the cotton, flax, and rope-making industries are exposed in the workplace to airborne particles that can cause byssinosis. Only workers in mills that manufacture yarn, thread, or fabric have a significant risk of dying of this disease. EPIDEMIOLOGY

4. Inhalation of endotoxin produced by gram negative bacteria in the fibers of cotton may stimulate inflammation that damages the normal structure of the lung. It causes the release of histamine, which constricts the air passages. As a result, breathing becomes difficult. Over time the dust accumulates in the lung, producing a typical discoloration that gives the disease its name BROWN LUNG DISEASE . PATHOPHYSIOLOGY

5. Chest tightness Wheezing Upper respiratory tract irritation Dry Coughing Dyspnea Fever Muscle and joint pain Shivering Tiredness cough SYMPTOMS Byssinosis can ultimately result in narrowing of the airways,  Lung scarring  and death from infection or  respiratory failure.

6. CLASSIFICATION

7. The condition is worse at the beginning of the week.Hence the other common name for byssinosis – Monday fever

8. Textile workers(1 st stage of processing of cotton) Smoking Impaired lung function History of respiratory allergy Bronchitis Asthma Infections Exposure >20 years RISK FACTORS

9. Detailed medical history Physical examination Pulmonary function test(FEV1,FVC) Chest X-ray(opacity) CT DIAGNOSIS

10. Appearance of the Patient Weight loss is present in the chronic form of the syndrome. Vital Signs Fever and tachypnea are often present. Auscultation Diffuse fine bi basilar crackles over lower lung fields often are present. Extremities Clubbing is observed in 50% of patients with the chronic form of the syndrome PHYSICAL EXAMINATION

11. FEV1(forced expiratory volume) is decreased below 80% due to increased airway resistance. FVC (forced vital capacity) is decreased due to air trapping. Ratio of FEV1/FVC decreased. SPIROMETRY

12. In acute settings patients are encouraged to consider alternate occupations or at least reduce the exposure in the work environment. Smokers should be encouraged to stop smoking. Physical activity and breathing exercises may help in management. TREATMENT

13. Bronchodilators help to relax and dilate the airways. Bronchodilators include beta-adrenergic drugs (both those for quick relief of symptoms and those for long-term control), anticholinergics, and methylxanthines. Corticosteroids are given only in severe cases. Immunomodulators and Antihistamines can also be used.

14. Oxygen therapy is given in case of hypoxia - diminished blood oxygen levels (oxygen saturation levels of <92%). Nebulizers used in chronic byssinosis. SUPPORTIVE THERAPY

15. Enclosure of processing of cotton. Avoid smoking. Wear protective masks. Increase ventilation. Avoiding long term exposure. PREVENTION

16. Byssinosis is generally not serious. But if left untreated it can lead to chronic illnesses such as emphysema and chronic bronchitis. When exposure of fiber stop, the illness will clear up. In case of long time exposure there is irreversible damage to lungs. PROGNOSIS