Studies on cotton dust in relation to byssinosis. I. Bacteria and fungi in cotton dust.

There is general agreement that byssinosis is associated with the inhalation of cotton dust. Good descriptions of the disease have been given by the Home Office Departmental Committee on Dust in Card Rooms in their report (1932), by Prausnitz (1936), and by Schilling (1950). An extensive and complete review of the literature on cotton dust in relation to affections of the respiratory tract has been prepared by Caminita, Baum, Neal, and Schneiter (1947). The dust affects the lungs, and the first symptoms are cough, a feeling of tightness in the chest, and breathlessness which develop gradually after working for several years in the dusty atmosphere produced by opening bales of cotton and by the carding machines which clean and comb-out the fibres. Some persons do not suffer from this disease after a life-time of exposure to the dust; those who do, find their symptoms are worse on Mondays after a week-end away from the mill. The disease is usually progressive, but some workers suffer only on Mondays during the whole of their working lives, without any progression. A change of occupation which avoids exposure to the dust gives freedom from symptoms, but a return to the dusty atmosphere of the mill after such a period of freedom results immediately in a return of symptoms. The pathological changes found in the later stages are those of emphysema. Where the disease progresses symptoms eventually persist throughout the whole week and finally there is incapacity for work, frequently with congestive heart failure. The respiratory disability has been termed ".asthma", and the disease has been known as " card-room asthma ", " strippers and grinders asthma ", or " cotton mill asthma", a terminology which has been used in a loosely descriptive sense but which nevertheless has had some influence in