Byssinosis: Facts to Know About Brown Lung Disease

Byssinosis is a relatively rare lung disease. It is observed to affect a certain demographic of individuals that work within the textile industry, particularly with cotton.

Frequently labeled as “Monday fever,” byssinosis, is prevalent among individuals who work with unprocessed cotton, flax, and hemp. Since cotton-picking has been around for centuries, there has been a noticeable co-relation between individuals who worked with cotton and developed “chest symptoms” after a specific duration of time.

With the entry of epidemiological studies into modern medicine during the 1950s, chest tightness among cotton workers prompted further investigation into the underlying cause for byssinosis.

Byssinosis In The History Books

While byssinosis dates back to the 17th century, a lot of our understanding today is due to the studies of R.S Schilling within the cotton mills of Lancashire during the late 1950s. Among individuals who were directly exposed to handling the cotton, he documented the highest difficulties with chest tightness. Another interesting feature, also a reason byssinosis is referred to as “Monday fever,” is that symptoms had a decline over the weekend, and crept back up at the end of the workday on Monday.

Most of the chest symptoms were observed among individuals that worked with cotton for years.

Identifying Byssinosis Today

Patients with byssinosis record symptoms similar to those observed with asthma, such as chest tightness, wheezing, and general difficulty with breathing. When questioned, these patients would mention that they have been working in the textile industry for several years.

Severe and chronic cases of byssinosis might also present with muscle aches, fever, fatigue, and a chronic cough. Initial phases of exposure can have a cyclical presentation which might delay diagnosis, due to periods during which individuals might appear to seem fine. However, with time, and when left untreated, symptoms are present throughout.

Understanding Brown Lung Disease

Due to the long-term repercussions of external exposure, it is crucial to understand how to limit, manage and tackle byssinosis.

While inhalation of cotton dust has been associated with developing byssinosis, the bacteriological burden within the cotton dust has also been studied as a causative factor. A toxin produced by gram-negative bacteria has been linked with chronic respiratory distress in patients with brown lung disease. Patients who smoke, have other respiratory conditions like COPD, or are immunocompromised are at an increased risk of developing severe disease following cotton dust exposure.

Due to the inhalation of the cotton fibers, hemp, and flax, byssinosis received the name of “brown lung disease” (coal miners have a risk of black lung disease). With prolonged inhalation, these fibers get lodged within the respiratory tract and make irreversible changes, which include taking on the hue of the fibers.

Steps In Managing Byssinosis

For anyone who works within this industry and experiences the symptoms listed above, it would be crucial to check in with a healthcare provider. Most occupational inhalation conditions have similar presentations but differ in their underlying cause (think coal, silica dust, asbestos, cotton).

In addition to the irritation these fibers cause to your lungs, there is also irreversible damage to their basic function. This means if detected early, and limiting exposure, can help undo some of the damage these fibers essentially cause.

To investigate underlying byssinosis, medical professionals may start with a simple lung function test that helps to assess the extent to which the underlying disease is affecting your lung. Lung function tests might be conducted throughout the week to observe fluctuations and document periods of improvement. Imaging might involve a chest X-ray and CT scan. Lung changes observed following occupational inhalation exposure are referred to as “ground-glass opacities” on imaging scans.

Since direct exposure to the fibers is linked with underlying lung disease, treatment involves limiting exposure. Medical practitioners might also prescribe medications that help improve lung function, such as inhalers that open up airways, and steroids that lower inflammation caused by the cotton fibers. Breathing exercises also help to improve reduced lung function.

Additionally, efforts within mills to reduce the accumulation of dust and enforce proper ventilation have documented positive effects when long-term lung function of workers has been studied.

Long Term Review For Occupational Lung Diseases

Since conditions like byssinosis are relatively preventable, it is best to understand causes, and actively work towards managing them.

Occupational lung disease often affects certain demographics, and not the masses, which makes studies conducted and data collected limited. For many, a few years of exposure can cause irreversible lung damage and result in a debilitating quality of life with symptoms such as a chronic cough. Knowing that a lot of this work is here to stay for the next few centuries should facilitate prompt research into reducing the number of occupational health conditions.

True to the fact that cases are declining, but the work within these sectors is still considered essential for our city-life functioning. Keeping this in mind, technology has enabled simple ways to track symptoms which assists with reaching a conclusive diagnosis. One such method involves tracking one’s cough and its variability. In cases of byssinosis, this can be extremely useful, as symptoms decline when exposure is limited.

In our tech era, leveraging technology along with on-ground measures, such as data collection, improving work conditions and alternate job prospects can enable practical solutions and chronic disease prevention.

Dr. Michelle Frank is a healthcare consultant working in the FemTech space. Her work centers around building and fostering online women’s health communities. Read more about her latest work here.