What Is Byssinosis?

Byssinosis, also known as Monday fever or brown lung disease, is a rare environmental lung disease and is considered a form of occupational asthma. It occurs almost exclusively in people who work around unprocessed cotton. The condition is caused by inhaling cotton, hemp, and flax particles while at work. Over time, inhalation of these particles causes a narrowing of the airways. Common symptoms of this condition are wheezing, coughing, and tightening of the chest. Most people experience symptoms at the beginning of the work week but feel better as the work week goes on or dust exposure decreases. Long-term exposure (more than 10 years) may cause lung damage similar to COPD.

If diagnosis is made early and exposure to cotton dust particles stops, a person should have minimal to no ongoing symptoms or permanent damage.

Signs and Symptoms

Symptoms of byssinosis tend to be worse at the beginning of the work week and gradually get better as the week goes on or exposure to dust particles decrease. People with asthma or other lung-related issues may experience worse symptoms.

The most common symptoms include:

  • Coughing
  • Wheezing
  • Chest tightness
  • Shortness of breath

In more severe cases, a person may experience flu-like symptoms, which include:

  • Fever
  • Muscle and joint aches
  • Chills and shivering
  • Fatigue
  • Dry cough


Byssinosis is caused by an inhalation of raw cotton dust, flax, or hemp particles. It is most common among textile industry workers and happens more frequently in developing countries. People who are sensitive to dust will have an asthma-like reaction to inhaling the dust particles. Sustained long-term exposure can cause permanent lung damage or chronic lung disease.

Risk Factors

There are several risk factors in developing byssinosis. Developing countries that do not have rules and regulations that protect workers against harmful working conditions put their workers at a higher risk. Additionally, people who smoke or have asthma, allergies, or other lung conditions are at a greater risk of developing byssinosis.


To diagnose byssinosis, your doctor will evaluate your symptoms, take a medical history, and perform a physical examination. Your doctor will also ask questions regarding your work and exposure to raw cotton particles. Additionally, your doctor may also recommend certain tests to assess lung health.

These tests include:

  • Chest X-ray
  • Chest CT scan
  • Lung function tests
  • Flow meter test (used at work to figure out when and where you are being exposed)


The primary form of treatment for byssinosis is to avoid exposure to cotton dust particles. Reducing dust particles in the factory through better machinery and ventilation will also help to reduce symptoms. If you’re unable to change working environments or your symptoms are persistent, your doctor may prescribe medications that can help reduce inflammation and improve your lung health.

Treatments include:

  • Bronchodilators (used to treat asthma)
  • Corticosteroids (given in more severe cases)
  • Stopping smoking
  • Breathing treatments (nebulizers)
  • Home oxygen therapy 

Other treatments may include breathing exercises, physical activity, and patient education programs to help with a chronic lung disease.


Controlling or reducing cotton dust exposure will help to prevent symptoms from developing. If you cannot change your work environment, wearing a face mask (respirator) can help protect you from dust inhalation. Quitting smoking, especially if you work near textile dust, will help reduce your risk of developing byssinosis. Risk of developing byssinosis.


Complications that may develop from byssinosis are associated with chronic lung disease. People with byssinosis, especially with long-term exposure (more than 10 years) to cotton dust particles may develop chronic bronchitis, or other chronic lung issues.

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