Diseases associated with exposure to plant dusts: focus on cotton dust

Research during recent years has made clear that pulmonary disease and certain general symptoms caused by organic dusts are far more common than previously suspected. To the traditional environments of cotton dust and moldy hay has been added a series of environments, such as swine confinement buildings, sewage treatment stations and industrial fermentation plants. It has been suggested that, rather than linking clinical disease with a specific environment (farmer's lung, byssinosis, etc), symptoms should be related to the relevant pulmonary cellular reactions, particularly inflammation. In so doing, a more homogenous picture of the various clinical entities has emerged. It is now understood that symptoms once considered to be unique to one particular environment, such as chest tightness in cotton mills, are also present in other organic dust environments. New models for organic dust-induced disease have been established using the criteria developed for disease among workers in cotton mills and swine confinements buildings. This has led to uniform methods for diagnosis, description of symptomatology and understanding of pathogenesis. Employing this experience on an international basis, provides an important background for dealing with new problems in this important area of occupational health and is a prerequisite for the establishment of treatment and prevention programs.