Introduction and Summary of the Roundtable

Byssinosis is an occupational lung disease characterized as a chronic obstructive pulmonary disease (COPD) caused by exposure to dust from processing vegetable fibers, including cotton dust. The natural history of byssinosis includes an exposure to cotton dust which results initially in some workers developing an acute reversible airways obstruction, typically seen on Mondays, and which may progress to other days of the week on continued exposure. Long term exposure may culminate in COPD. The relationship between the acute response first seen on Mondays and the development of COPD, while logical, has never been firmly demonstrated. This means that the potential exists for workers not showing the acute 'Monday' response to develop COPD. To reduce the incidence of byssinosis the Occupational Safety and Health Administration (OSHA) promulgated a Cotton Dust Standard in 1978, later revised in 1985, which limited the levels of dust exposure in cotton textile mills. In addition to placing limits on dust levels the Standard also required exposure monitoring, medical surveillance, and education and training be done on a routine basis. While the textile industry has made substantial progress in complying with the Standard and the prevalence of byssinosis has been reduced, exposures in excess of the Standard frequently occur and workers may face the risk of developing disease. Also the mills face liability associated with claims for workers compensation and the continued cost of complying with the Standard both of which impact on the competitiveness of U.S. fiber in a world market.