Some opinions on byssinosis in China.

On the basis of some study results in China and reports from abroad, a conclusion should be drawn that leads to the recognition of a pneumoconiosis-like lesion of interstitial fibrosis. This disease is called "cotton pneumoconiosis" and we may classify these occupational lesions into four types: 1) byssinosis; 2) chronic obstructive pulmonary disease (COPD); 3) cotton fever; and 4) cotton pneumoconiosis. Byssinosis, COPD, cotton fever and cotton pneumoconiosis may be different types of responses due to the different duration of exposure, the different parts of bronchial tree (upper respiratory tract, small airway, and respiratory part) where deposition occurs, and the different components of cotton dust (broken cotton fibers, bracts, pericarps, bacteria, and fungi). These responses, which include histaminelike reaction, allergy, and stimulation of foreign material, happen in different symptoms of the syndrome among cotton mill workers. But no matter whether responses caused by inhalation of dust are inflammation or allergic reaction, cotton dust is foreign stimulation on deposited sites, causing lung fibrosis after lung stimulation. For the health of cotton workers, we must pay attention not only to the acute effects but also to the chronic lesions. We therefore suggest that these four types of occupational lung disorders caused by inhalation of cotton dust may be called by the joint name, "Byssinosis syndrome."