Byssinosis is the name given to a lung disease. It results from the long-term inhalation of hemp, sisal, cotton or flax.
What is byssinosis?
Byssinosis is a disease of the lungs, also known as weaver’s cough, Monday fever or cotton fever. The disease is caused by the inhalation of hemp, cotton or flax dusts over a long period of time. Byssinosis is one of the pneumoconioses and is a recognized occupational disease in Germany. People who are involved in the processing of textiles made from raw hemp, raw cotton, raw flax or sisal or in the production of bast fibers are particularly affected by byssinosis. This may include, but is not limited to, the panting of raw fibers. Byssinosis is most common in developing countries. In contrast, it shows up rather rarely in modern industrialized countries.
Cause
Byssinosis is caused by the inhalation of fine dusts. However, the exact triggers are largely unknown to date. People who fall ill are usually workers who come into contact with raw and unprocessed cotton. In the process, the cotton is spun or combed, for example. Both an acute and a chronic form of byssinosis are possible. After a working period of 1.5 to 2 hours, during which time raw cotton, flax or sisal is inhaled, bronchospasm occurs. However, unlike allergic bronchospasm, there is no IgE mediation. The raw material inhaled by affected individuals contains low molecular weight peptides. After prolonged exposure, these cause chronic bronchitis associated with increased secretion of mucus as well as goblet cell hyperplasia. Washed cotton, on the other hand, does not cause any symptoms. The degradation of natural fibers and dusts based on cellulose is not possible in humans. Thus, they lack the cellulases necessary for this purpose. In addition, antigens of a bacterial or plant nature often cause the body’s immune response to develop. If cellulose-based natural fibers are regularly inhaled, this results in bioaccumulation within the lungs.
Symptoms, complaints and signs
Byssinosis is initially noticeable by shortness of breath. This soon subsides. After a short break from work, the complaints then set in again. Byssinosis is also known as Monday fever because the ill person does not suffer from symptoms during their time off at the weekend. However, when they return to work on Monday, the symptoms recur. Over time, patients show the typical signs of chronic bronchitis. These include dyspnea on exertion and cough with sputum. General nonspecific symptoms often appear as well. As the disease progresses, resting dyspnea may develop. A possible complication is recurrent bacterial bronchitis. Physicians divide byssinosis into three different stages. In the third stage, secondary lung and heart changes occur, some of which are irreversible. Acute byssinosis is noticeable by wheezing (whistling rhonchus) and tachypnea (rapid breathing). In contrast, dry rales are heard in people who suffer from the chronic form.
Diagnosis and course
An important basis for the diagnosis of byssinosis is formed by the patient’s history (medical history). In addition, a clinical examination is performed. In the setting of bronchospasm, a wheeze can be detected. If chronic bronchitis is present, the physician may perceive a wheezing and humming sound when listening with a stethoscope. X-ray examinations usually do not provide greater insight into the disease in the early stages of byssinosis. In a later stage, peribronchitic drawing proliferation sometimes occurs. Another important diagnostic tool is the performance of pulmonary function tests. These often reveal a decrease in pulmonary ventilation as well as an obstructive ventilation disorder, which is considered typical of byssinosis. It is also not uncommon to see bronchial hyperreactivity to metacholine. Furthermore, a differential diagnosis to other respiratory diseases should be considered during the medical examination.These include exogenous allergic alveolitis and allergic bronchial asthma. If it is an acute bronchospasm, the patient usually does not have to fear permanent damage. However, if the affected person suffers from chronic bronchitis, cor pulmonale as well as respiratory global insufficiency are possible.
Complications
Byssinosis can cause a number of complications. Initially, the disease is manifested by shortness of breath, which occurs in episodes as it progresses. Later, bryssinosis can lead to coughing with sputum, for example, or promote the development of chronic bronchitis or asthmatic disease. A typical complication is, for example, the repeated outbreak of bacterial bronchitis, which is associated with further risks depending on the stage of the disease. Thus, in the third stage, secondary pulmonary and cardiac changes may occur, often accompanied by wheezing (whistling rhonchus) and rapid breathing. Chronic byssinosis is sometimes accompanied by severe breathing difficulties, initially manifested by dry rales and bloody sputum, and later leading to secondary infections in the lungs and pharynx. This is often compounded by chest cramping and cessation of breathing, which in severe cases can lead to death. In addition, respiratory global failure and cor pulmonale may occur, depending on the timing of treatment and the progression of byssinosis. Acute byssinosis does not usually carry severe long-term consequences if treated early.
When should you see a doctor?
If there are episodes of shortness of breath and symptoms of chronic bronchitis, a doctor should be consulted immediately. Byssinosis is manifested primarily by breathing difficulties, especially cough with sputum and irritated airways. Groups at risk of byssinosis (hemp workers, cotton field workers, etc.) should stop work immediately if they experience these symptoms and then consult a doctor. Until byssinosis has been diagnosed and treated with medication, the triggering activity must not be resumed under any circumstances. If contact is made with the triggering substances despite byssinosis, the disease causes further complaints that increase in intensity and frequency as it progresses. Often, bacterial bronchitis, chronic respiratory diseases and life-threatening breathing cessations occur. For this reason, a doctor should be consulted at the latest when shortness of breath and repeated coughing attacks occur. If cramps in the chest and breathing stops occur, an emergency doctor must be called immediately. Accompanying first aid measures may have to be taken. If unconsciousness occurs, further treatment in hospital is necessary in any case.
Treatment and therapy
In order to successfully treat byssinosis, it is important to consistently avoid contact with the triggering substances. When working with cotton, it must be cleaned before human contact. Thus, it is crucial for the patient’s health to reduce the amount of harmful fiber dust. Taking special medications such as inhaled corticosteroids or sympathomimetics rarely improves acute bronchospasm. In contrast, the administration of corticosteroids and sympathomimetics is useful for the treatment of chronic bronchitis. The same applies to treatment with inhaled agents such as theophylline and anticholinergics. Bronchodilators usually improve the symptoms. If it is not possible to reduce the patient’s exposure to particulate matter, treatment takes considerably longer, especially since there is also a risk of lung damage.
Outlook and prognosis
The further course of byssinosis depends relatively much on how long the triggering substance has been inhaled and what exactly the substance is. As a rule, the function of the lungs cannot be fully restored if they have been damaged for many years, so only symptomatic treatment is given. First and foremost, the symptoms of byssinosis are alleviated by avoiding contact with the triggering substance. In some cases, the symptoms disappear completely and can be relieved by taking medication, although a complete cure does not occur. Treatment is delayed if contact with fine dust or with other substances is not interrupted.As a rule, the presence of byssinosis significantly increases the risk of lung damage. Therefore, if the disease is ignored, in the worst case it can lead to pulmonary insufficiency, which can lead to death. There are also some home remedies available to the sufferer to combat this disease. However, among the most effective remedies is usually the abandonment of the professional activity, if it has led to byssinosis.
Prevention
Prevention of byssinosis is possible only if there is no prolonged contact with the causative agents. Occupational health surveillance and screening of textile workers can be done as part of early detection.
Aftercare
Byssinosis resolves rapidly with appropriate treatment. Follow-up care includes regular check-ups with a family doctor or ear, nose, and throat specialist, as well as taking prescribed medications. In addition, those affected must determine the cause of the lung disease and eliminate it through a targeted change in lifestyle. If the symptoms are due to exposure to pollutants at work, a change of career is recommended. In severe cases, however, this is not sufficient for recovery. Those affected then require regular examinations throughout their lives so that the necessary measures can be initiated quickly in the event of any complications. In addition, attention should generally be paid to a healthy lifestyle. Sufficient exercise is just as important as a balanced diet. No food or drink should be consumed that could put additional strain on the lungs. A light diet with plenty of vitamins and minerals is recommended. Byssinosis will weaken in the long term, provided that the trigger is avoided and the patient follows the doctor’s instructions regarding diet and hygiene. At home, any allergens should be avoided. This can be achieved by a regular change of clothing and bed linen and the use of gentle soaps and shampoos. If, despite all measures, breathing problems recur, medical advice is required.
What you can do yourself
If byssinosis is not treated professionally, there is a risk of chronic bronchitis and severe lung damage. Affected persons should therefore under no circumstances treat themselves, but should definitely see a doctor promptly. What patients can do themselves, however, is to avoid the cause of the disease. Contact with the fibrous substances that trigger the disorder must be prevented immediately or at least largely restricted. This may require a change of workplace, employer or profession. Since byssinosis is a recognized occupational disease in Germany, those affected are quite well protected against the financial consequences of this condition. Sick employees should definitely seek advice from their trade union, the works council or a specialist lawyer for labor law. The symptoms of the disease can, in addition to the medically prescribed therapy, also be combated with mild home remedies and natural healing methods. The most common symptoms of pneumoconiosis are a tough cough and bronchitis. Inhaler pens with menthol or capsules containing menthol for oral use, which are available in pharmacies, help against acute respiratory problems. For tough coughs, steam baths with salt water or chamomile tea provide relief. In naturopathy, ribwort plantain is used as a juice or tea in the fight against tough cough.
