BYSSINOSIS

Byssinosis is a lung disease caused by occupational exposure to dust from cotton, hemp or flax.
Other names for byssinosis include Monday fever, brown lung disease, mill fever or cotton workers' lung.
New Latin, from Latin byssinus of fine linen.

1. BYSSINOSIS SHINCELY SAM SAMUEL SWATHI THIRUNARAYANAN GROUP 7

2. INTRODUCTION Byssinosis is a lung disease caused by occupational exposure to dust from cotton, hemp or flax. Other names for byssinosis include Monday fever, brown lung disease, mill fever or cotton workers' lung. New Latin, from Latin  byssinus  of fine linen.

3. EPIDEMIOLOGY Although inhaling cotton dust was identified as a source of 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.

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

5. PATHOPHYSIOLOGY Byssinosis is common among textile workers, who often inhale significant amounts of cotton dust. Cotton dust 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 .

6. SYMPTOMS Tightness in the chest Wheezing Coughing Dyspnea Fever Muscle and joint pain Shivering Tiredness Dry cough The condition is worse at the beginning of the week or upon acute exposure after a period away from the work environment. Hence the other common name for byssinosis – Monday fever.

7. CLASSIFICATION

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

9. PHYSICAL EXAMINATION 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. Muscle wasting is also observed in the chronic form of the syndrome.

10. SPIROMETRY FEV1 is decreased below 80% due to increased airway resistance. FVC is decreased due to air trapping. Ratio of FEV1/FVC decreased.

11. RADIOGRAPHIC FINDINGS

12. PROGNOSIS 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 stops,the illness will clear up. In case of long time exposure there is irreversible damage to lungs.

13. TREATMENT 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.

14. SYMPTOMATIC TREATMENT Bronchodilators help to relax and widen (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.

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

16. PREVENTION Steaming of raw cotton to reduce particle formation. Enclosure of processing of cotton. Quit smoking. Wear protective gears. Increase ventilation. Avoid long term exposure.

17. INDIAN GOVERNMENT LAWS The Factories Act(1948) objective is to protect human beings from being subjected to unduly long hours of bodily strain and manual labour . The Workmen’s Compensation Act(1967) provides that employees should work in healthy and sanitary conditions as far as the manufacturing process will allow and that precautions be taken for their safety and for the prevention of accidents.

18. REFERENCE American lung Association 〈http://www.lungusa.org〉  〈http://www.cdc.gov〉 centers for disease control and prevention. https://www.britannica.com/science/byssinosis https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1090498/ SCHILLING RS. Byssinosis in cotton and other textile workers.  Lancet.  1956 Aug 11;271(6937):261–contd. [ PubMed ]