The pathology of byssinosis

In 1768, Morgagni gave the history and post=mortem findings in a man of 40 who had worked with hemp and found no abnormality in the lungs. It was the absence of gross pathology in the lungs of those who died severely disabled by byssinosis that led to our research into the disease. We see about 107 deaths a year of those with byssinosis who have been examined in life and have been given varying assessments of disablement. This article compares the pathologic findings in the lungs of a number of subjects with byssinosis with their ventilatory capacity in life and their smoking, occupational and clinical history. Emphysema is not an invariable finding. Interstitial fibrosis, which might be expected if the etiology of byssinosis was akin to farmer's lung, is not found. There is no characteristic lung lesion as is seen in the pneumoconioses. Cotton fibers are not found in the lungs and "byssinosis bodies" are not present in a majority of the cases. The pattern that emerges for byssinosis is that of asthmatic bronchitis.