Etiology and Prevention

The etiology is no longer believed to be cotton dust, but dust contaminated with endotoxin. The endotoxin is the outer membrane lipopolysaccharide of gram-negative bacteria, specifically lipid. The endotoxin can be liberated from several genera of gram-negative bacteria and is heat-stable (31).

Prevention measures have included decreasing dust and reducing trash in the working environment, which has reduced some of the prevalence. One study found the spraying of cotton with bactericidal water solutions of benzododecinium bromide succeeded in decreasing the amount of endotoxin, but impact on decreasing the prevalence of byssinosis has yet to be studied (33).

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