What is the name of the pneumoconiosis associated with wool?

Byssinosis: The Pneumoconiosis Associated with Wool Exposure

The pneumoconiosis associated with wool exposure is called byssinosis, a nonspecific chronic respiratory disease that affects textile workers exposed to organic dusts including wool, cotton, hemp, and flax 1.

Clinical Features and Diagnosis

Byssinosis presents with characteristic symptoms that distinguish it from other occupational lung diseases:

• Classic presentation: Chest tightness and/or breathlessness that initially occurs on the first day back to work (typically Monday) after a break, known as "Monday sickness" 2, 3
• Progression: As exposure continues, symptoms may extend to other workdays and eventually become persistent 3
• Grading system:
  • Grade 0: No symptoms of chest tightness or breathlessness on Mondays
  • Grade ½: Occasional chest tightness on Mondays or mild respiratory tract irritation
  • Grade 1: Chest tightness and/or breathlessness on Mondays only
  • Grade 2: Chest tightness and/or breathlessness on Mondays and other days 3

Pathophysiology and Risk Factors

Byssinosis develops from chronic inhalation of wool dust particles that cause:

• Inflammation of the respiratory tract
• Bronchoconstriction
• Progressive airflow limitation
• Eventual chronic obstructive changes 4

Risk factors include:

• Duration of exposure (prevalence increases with longer service) 2
• Concentration of dust exposure (higher in carding rooms) 5, 3
• Work area (higher prevalence in carding, spinning, and winding sections) 2

Pulmonary Function Changes

Characteristic functional changes include:

• Acute effects: Significant across-shift reductions in ventilatory capacity (1.4% for FEV1 to 9.1% for FEF50) 4
• Chronic effects: Progressive decline in lung function with continued exposure 2
• Pattern: Predominantly restrictive pattern with reduced lung volumes 6

Differential Diagnosis

Byssinosis must be differentiated from:

• Occupational asthma
• Chronic bronchitis
• Other pneumoconioses (silicosis, asbestosis)
• Non-occupational COPD 1, 2

Management

Management of byssinosis follows these principles:

1. Primary prevention: Workplace dust control measures and reduced exposure 6
2. Removal from exposure: Most important intervention, though it may not stop disease progression once established 6
3. Symptomatic treatment:
   • Bronchodilators for airflow limitation
   • Oxygen therapy for hypoxemia
   • Pulmonary rehabilitation
   • Vaccination against influenza and pneumococcus 6
4. Monitoring: Regular pulmonary function tests to assess disease progression 6

Prognosis

The prognosis depends on:

• Duration and intensity of exposure
• Stage at diagnosis
• Success in removing the patient from further exposure

Without removal from exposure, byssinosis can progress to irreversible airflow obstruction and respiratory disability 4, 2.

Prevention

Prevention remains the cornerstone of management:

• Implementation of dust control measures in textile mills
• Regular monitoring of dust levels (aim for <250 mg/100 m³) 3
• Use of personal protective equipment
• Medical surveillance of workers with periodic examinations 6

Byssinosis represents a significant occupational health concern in the textile industry, with wool processing workers showing higher prevalence of respiratory symptoms and impaired lung function compared to unexposed controls 4.