Lung disease in textile workers
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Lung disease in textile workers

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      This blog is part of a series for NIOSH’s 50th anniversary highlighting research and prevention throughout the Institute’s history.

      Since the 1970s, NIOSH has worked to prevent illness from cotton dust. Byssinosis is an airways disease with features of both asthma and COPD that occurs with exposure to cotton dust. In the early 1970s, the prevalence of byssinosis among US cotton workers was estimated at 20%. In 1974, NIOSH released a Criteria Document that summarized the available evidence and recommended lowering the standard from 1 to 0.2 mg/m3. The Occupational Safety and Health Administration’s (OSHA) 1978 Cotton Dust Standard incorporated NIOSH’s recommendations, and included provisions for medical monitoring that effectively set national standards for spirometry.

      In a series of experimental field studies, NIOSH demonstrated an exposure–response relationship between airborne endotoxin-a dangerous substance released from bacterial cells- (but not dust concentration) and reduced lung function. This suggested that endotoxin was responsible for the acute response to cotton dust. Other NIOSH studies demonstrated the preventive effectiveness of washing cotton to reduce endotoxin concentration. This work contributed to the 1995 NIOSH Current Intelligence Bulletin on cotton washing methods and an amendment by OSHA to the Cotton Dust Standard. OSHA has concluded that the Cotton Dust Standard had the effect of reducing the prevalence of byssinosis from 20% to less 1% among US cotton workers. Despite this success, exposure to endotoxin remains a health concern for textile workers and others.

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