If you have not heard of byssinosis, that could be because it’s a rare lung disease—though it appears to be more common outside of the United States. It can be called “brown lung disease,” “cotton worker’s lung,” “Monday fever” and “mill fever.” Byssinosis develops exclusively in people who have been exposed to tiny fibers in textile production plants, like cotton, hemp, flax, and jute fibers. Dust from these plants, especially cotton, is thought to block the smallest airways in the lungs—bronchioles—and cause breathing problems. These breathing problems also seem to be related to release of “endotoxin” —a toxin made within a cell of the body that is released when the cell dies or disintegrates—as all cells do.
Workers with byssinosis from particulate exposure to these plants tend to experience symptoms common to respiratory disease, including cough, chest tightness, and wheezing. In severe cases, flu-like symptoms may develop, including a fever, shivering, fatigue, muscle, and joint pain. Symptoms of byssinosis may relent when exposure to dust is avoided. However, with continued exposure, lungs can become permanently damaged and lung function permanently impaired.
While it seems odd, byssinosis symptoms often show up a just a few hours into the beginning of a work week for cotton/textile workers and often clear up by the end of the week. However, damage may still be occurring, even if symptoms are relieved. Detecting patterns in symptoms can help patients and their doctors determine where the problematic exposure may be happening. In some cases, byssinosis can be recovered from completely if the person can avoid chronic exposure to the dust fibers of the plants causing their symptoms. Medication can be given to relieve symptoms.
It is important to avoid smoking if you have or are at increased risk of byssinosis, as it increases your risk of developing the disease—non-smokers also will experience lung healing more quickly. Byssinosis is preventable with proper occupational (work) precautions. In the United States, your employer is responsible for keeping you safe at work, including by fitting you with the proper protective gear to avoid inhaling potentially harmful particles, such as textile fibers, or toxic substances.
Byssinosis: Symptoms and Diagnosis
Byssinosis can have symptoms that can range in severity. It is a disease that is unique to cotton workers who are exposed to the “dusty” fibers of cotton or other textile fibers at the beginning of processing—byssinosis is also referred to as “brown lung disease” among other names The symptoms of byssinosis can range from mild to severe and may seem like the symptoms commonly known as asthma—coughing, chest tightness, and other breathing problems.
As this disease is unique to cotton and textiles workers, many “shrug it off” as not a big deal—as co-workers may have the same symptoms, it may seem to mimic a cold or other “contagious” breathing issue. However, byssinosis is not contagious, but it does only occur in those who work in an environment with these fibers. Over time, byssinosis can become a more serious problem if not treated.
How is Byssinosis diagnosed?
If you have breathing problems, such as cough that may be dry or productive, wheezing or chest tightness, you should see your doctor, especially if you feel it may be linked to your work environment. Most often, lung function tests, a physical exam, chest x-ray and/or CT scan to visualize lung inflammation and structural changes, and detailed medical history are taken to determine if a person may have byssinosis.
The first step to treating byssinosis is to cease exposure to the cotton or other fibers that are the cause of the problem. Workers may be forced to quit their jobs to preserve their health and halt or prevent permanent lung damage. Smoking should be stopped as it can both cause—in conjunction with fiber exposure—and worsen byssinosis. Once exposure is no longer a problem, medications can be used to relieve symptoms. Typically these medications include bronchodilators like those used to treat asthma—in more serious cases where lung inflammation has developed, corticosteroids may be needed to decrease airway swelling. In rarer cases, oxygen therapy may be needed at home, and pulmonary or physical rehabilitation may be needed —exercise to help restore stamina and fitness to make breathing more efficient.
Information on this page is for reference and educational purposes only. For more information about byssinosis, talk to your doctor or primary care provider.
Page last updated: November 19, 2018
- National Institutes of Health. Byssinosis. https://www.ncbi.nlm.nih.gov/books/NBK519549/
- American Lung Association. Byssinosis Symptoms, Causes and Risk Factors. https://www.lung.org/lung-health-and-diseases/lung-disease-lookup/byssinosis/byssinosis-symptoms-causes.html
- Wint, C. Byssinosis: Brown lungs and what you need to know about them. https://www.healthline.com/health/byssinosis#symptoms
- Lara, A. Byssinosis. https://www.merckmanuals.com/en-ca/home/lung-and-airway-disorders/environmental-lung-diseases/byssinosis>