Jan

Cannabinosis, Cannabosis, Byssinosis

Published by Jan

 

CANNABINOSIS, CANNABOSIS, BYSSINOSIS,   A DISEASE BY ANY OTHER NAME . . . . .

 

All different names for the same (basic) condition.  A lung disease caused by exposure to dusts from the processing of cotton, hemp, cannabis, and flax.  The small airways become blocked, severely harming lung function.  In the United States, byssinosis is almost completely limited to workers who handle unprocessed cotton.  There is another group of people (like me), who handle marijuana seasonally.  We suffer from all the same symptoms and maybe a few more.  My concerns are, is this seasonal handling of cannabis causing irreparable,  life threatening damage?


How serious is it?
I notice a problem as soon as the trimming season is upon us.  My chest gets tight, I wheeze, my nose runs, my eyes itch, and I have developed a cough. If the resin, pollens,and dusts touch my skin I develop red blisters that are very itchy, sting, and burn if I scratch them.  My eyes get a sticky discharge.  Occasionally,  I cough up a thick, sticky, cloudy mucous (phlegm) ball.  I am miserable the entire time there is cannabis near me.  (I wear a mask, gloves, and glasses) but I suspect I have developed cannabinosis, cannabosis, or byssinosis.  I use a nebulizer nightly.  By morning, I seem to be okay, except for the cough.  The cough stays with me.  If I actually smoke a small amount of medical marijuana (expectorant), I have more success with my cough ( i.e. getting some of the phlegm to come up so I can spit it out).
This is what I have to look forward to every season at my house.  I wonder if this condition is shortening my life.  I wonder what these symptoms mean for me long term.
This condition has nothing to do with smoking, vaporizing, or any other delivery system.  I am not allergic to medical marijuana.  It is only the pollen, dusts, and resin that send me into a histamine attack.  Could it be that I am allergic to a fungus, mold, or possibly a bacteria that is present in the marijuana I come in contact with?    I am concerned that my symptoms mean I am developing a serious, possibly life threatening condition.
 

If you have Byssinosis, exposure to cotton dust can cause an asthma-like reaction at the beginning of every workweek.  The symptoms usually go away by the end of the workweek.  If you are exposed for a longer period, your symptoms may continue throughout the week without improving.
Byssinosis is a lung disease caused by inhalation of the dust produced during the processing of organic fibers such as cotton, jute, flax, hemp, or sisal.  It is characterized by a history of exposure to the dusts given off  by textile manufacture.  Repeated exposure may lead to chronic lung disease.  Interestingly, working with cleaned cotton fibers poses little threat.
 

Risk:  Byssinosis is an occupational disease.  Usually found among individuals working with crude or unprocessed materials.  Workers in mills that manufacture yarn, thread, or fabric are at significant risk of developing this disease.  Smoking also increases the risk.

The vast majority of cases reported in the United States, reportedly come from North and South Carolina and Georgia (carpet and fabric).
Incidence and Prevalence:  In the US, there are fewer than ten deaths per year due to occupational Byssinosis.  Preventive measures in the textile industry have lowered the incidence of the disease in other developed nations, but it is still common in developing countries where preventive measures are not in place.
History:  Symptoms include tightness in the chest, wheezing, coughing, and shortness of breath when exposed to the dust produced during the processing of:   cotton, flax, hemp, or sisal.  The symptoms usually lessen or go away when the worker goes home.  Symptoms, more pronounced on the first day after returning to work following a weekend or vacation.  They gradually lessen with repeated exposure throughout the week.  In chronic Byssinosis, symptoms persist even when the individual is away from work.
Physical exam:  Auscultation (listening to the chest with a stethoscope) may reveal wheezing sounds.
Tests: Pulmonary function tests using pyrometers and peak flow meters evaluate lung volume and capacity and help identify and measure any obstructions or restrictions (or combination of both) in airflow through the lungs, thus confirming the presence of lung disease.  Arterial blood gases (ABG) and oxygen saturation testing assess the efficiency of gas exchange in the lungs by showing its rate of absorption into the blood.  Chest x-rays and CT scans may be helpful in ruling out other lung disorders.
Treatment:  Aimed at reducing symptoms, the most important being to limit exposure to the offending dust.  This can be achieved by wearing protective clothing and a facemask and implementing industrial dust control measures (venting/ducting) if possible.  Those who smoke should be encouraged to quit.  Drugs to widen or expand the channels within the airways of the lungs (bronchodilators).  More severe cases may require other respiratory treatments, such as nebulizers and postural drainage, and medications to reduce inflammation in the lungs (corticosteroids).  Chronic Byssinosis may also require supplemental oxygen and breathing exercises.
Prognosis:  In most individuals, symptoms are temporary and have no long-term effects.  Most individuals fully recover after eliminating their exposure to the offending dust.  Chronic exposure over a period of years however, may permanently impair lung function.  Although rare, death due to Byssinosis is possible.


Specialists:  Preventive Medicine Specialist, Pulmonologist


Return to Work (Restrictions / Accommodations)
Protective clothing and/or face masks should be provided to workers exposed to cotton dust or other unprocessed organic fibers.  Particularly sensitive individuals or those with severe or advanced byssinosis may require reassignment to a position involving little or no contact with the offending dust.  If lung damage becomes extensive, prolonged or strenuous activity may become impossible.  If oxygen therapy is initiated, the individual will need to avoid certain flammable materials.


Co morbid Conditions:  Chronic obstructive pulmonary disease (COPD)
1. Lung disease
2. Lung Infection

Complications:  Byssinosis can lead to chronic bronchitis.  Lung damage can become extensive and result in respiratory failure.
Factors Influencing Duration:  Duration of disability is influenced by the severity of symptoms, the individual's overall health, or the presence of complications.  An individual who smokes may lengthen disability by aggravating the symptoms.
Length of Disability:  Disability will be longer for those with chronic disease and/or diminished lung capacity for performing moderate-to-heavy work.  If lung damage is extensive, disability may be permanent.
 

Regarding diagnosis:
 Does individual work in the textile industry?
 Is individual a smoker?
 Does individual have tightness in the chest?  Wheezing?  Coughing?  Shortness of breath?
 Are the symptoms better when the individual is away from work?  Are they more pronounced the first day backing to work after a weekend or vacation?  Do symptoms lessen as the workweek goes on?
 Were rales present on auscultation?
 Does individual have decreased breathing capacity?
 Has individual had a pulmonary function test?  Chest x-ray?  Arterial blood gases?  Oxygen saturation test?
 Have conditions with similar symptoms been ruled out?


Regarding treatment:
 Is individual being treated with corticosteroids?  Bronchodilators?  If so, are the medications being used according to the physician's instructions?
 Has exposure to the offending dust been minimized?
 Has individual quit smoking?
 Is supplemental oxygen necessary?


Regarding prognosis:
 Can individual's employer accommodate any necessary restrictions?
 Does individual have any conditions that could affect ability to recover?
 Have any complications occurred such as chronic bronchitis or respiratory failure?
 Can worker wear respiratory protective devices, if indicated?


Treatment:  The most important treatment is to stop “being exposed” to the dust.  Reducing dust levels in the factory (by improving machinery or ventilation) will help prevent Byssinosis.  Some people may have to change jobs to avoid further exposure.
Medications used for asthma, such as bronchodilators, will usually improve symptoms.  Corticosteroids are prescribed in more severe cases.
Stopping smoking is very important for people with this condition.  Breathing treatments, including nebulizers, are prescribed if the condition becomes long-term.  Home oxygen therapy may be required if (blood /oxygen) levels are low.
Physical exercise programs, breathing exercises, and patient education programs are often very helpful for people with a chronic lung disease.


Complications:  Chronic bronchitis may develop

.
Calling your health care provider:  Call your health care provider if you have symptoms of Byssinosis.


It is not thought that the cotton dust directly causes the disease and some believe that the causative agents are endotoxins that come from the cell walls of (gram- negative) bacteria that grow on the cotton.  Although bacterial endotoxin is a likely cause, the absence of similar symptoms in workers in other industries exposed to endotoxins makes this uncertain.
Of the eighty one (81) Byssinosis-related fatalities reported in the United States between 1990 and 1999, forty eight percent (48%) included an occupation in the yarn, thread, and fabric industry on the victim's death certificate.  This disease often occurred in the times of the industrial revolution.  Most commonly young girls working in mills or other textile factories would be afflicted with this disease.
The term "brown lung" is a misnomer, as the lungs of affected individuals are not brown.  Brown lung can ultimately result in narrowing of the airways, lung scarring and death from infection or respiratory failure.  Exposure (to dust), over and over again, leads to shortness of breath, wheezing, and chronic lung disease.


How is Byssinosis Treated?
• If you have byssinosis, you must stop being exposed to the dust that caused your disease.  You may need to change jobs to avoid further exposure to the dust.
• Your doctor may prescribe medications such as bronchodilators to improve your symptoms.  If you have a more severe case, your doctor may prescribe corticosteroids.
• Chronic Byssinosis may be treated with respiratory treatments, including nebulizers.
• If your blood oxygen levels are low, your doctor may prescribe home oxygen therapy.
• Quit smoking to prevent further damage to your lungs.
• You may benefit from physical exercise programs, breathing exercises, and patient education programs.

Byssinosis is a form of reactive airways disease characterized by bronchi-constriction.  Symptoms are chest tightness and dyspnea that worsen on the first day of the workweek and subside as the week progresses.  The diagnosis is based on history and pulmonary function test findings.  Treatment includes avoidance of exposure and use of asthma drugs

.
Etiology
Byssinosis occurs almost entirely in workers who contact unprocessed, raw cotton, especially those who are exposed to open bales or who work in cotton spinning or in the card room.  Byssinosis can occur after acute exposure but usually occurs in workers with a history of chronic exposure.  Evidence suggests that some agent in the cotton bract leads to bronchi-constriction.  Although bacterial endotoxin is a likely cause, the absence of similar symptoms in other settings in which workers are exposed to endotoxin leaves some uncertainty.  Prolonged exposure to cotton dust was once thought to cause emphysema, a theory now disproved.  Chronic bronchitis symptoms are common among people exposed to cotton dust.
 

Symptoms and Signs
Symptoms are chest tightness and dyspnea that lessen with repeated exposure.  Symptoms develop on the first day of work after a weekend or vacation and diminish or disappear by the end of the week.  With repeated exposure over a period of years, chest tightness tends to return and persist through midweek and occasionally to the end of the week or as long as the person continues to work.  This typical temporal pattern distinguishes byssinosis from asthma.
Signs of acute exposure are tachypnea and wheezing.  Patients with more chronic exposure may have crackles.


Diagnosis
Diagnosis is based on history and pulmonary function tests that show typical airflow obstruction and a reduction in ventilatory capacity, especially if measured at the start and end of a first work shift.  Hyper responsiveness to methacholine is also often observed.  Surveillance measures, including symptom reporting and spirometry in textile workers, can aid in early detection.
Although inhaling cotton dust was identified as a source of respiratory disease more than three hundred (300)  years ago, byssinosis has been recognized as an occupational hazard for textile workers for less than fifty (50) years.  More than 800,000 workers in the cotton, flax, and rope-making industries are exposed in the workplace to airborne particles that can cause byssinosis.  Only workers in mills that manufacture yarn, thread, or fabric have a significant risk of dying of this disease.
In the United States, byssinosis is almost completely limited to workers who handle unprocessed cotton.  More than 35,000 textile workers have been disabled by byssinosis and one hundred eighty three (183) died between 1979 and 1992.  Most of the people whose deaths were due to byssinosis lived in the textile-producing regions of North and South Carolina and Georgia.


Treatment
Therapy for early-stage byssinosis focuses on reversing airway narrowing.  Antihistamines are prescribed to reduce tightness in the chest.  Bronchodilators (drugs used to relax breathing passages and improve air- flow) may be used with an inhaler or taken in tablet form.  Reducing exposure is essential.  Any worker who has symptoms of byssinosis or who has trouble breathing should transfer to a less-contaminated area.
Wheeze — A whistling sound made by the flow of high-velocity air through narrowed airways.  Wheezing is a symptom of several respiratory diseases including byssinosis and asthma.
 

  Pneumoconiosis


Pneumoconiosis is a respiratory disease caused by inhaling various types of dust, such as coal dust, silica dust, asbestos dust, and so on.
Sugarcane,  mushrooms, and barley can produce lung disease through a severe allergic response within a few hours of exposure, even in previously non-allergic persons.  Brown lung disease (byssinosis) in textile workers is also a form of pneumoconiosis, caused by fibers of cotton, flax, or hemp that, when inhaled, stimulate histamine release.  Histamines cause the air passages to tighten and shrink down, making it very difficult to breathe.
Pneumoconiosis is a chronic lung disease caused by the inhalation of various forms of dust particles, particularly in industrial workplaces, for an extended period.  Hence it is also said to be an occupational lung disease, (which are a particular subdivision of occupational related diseases) that are related primarily to being exposed to harmful substances, whether they are gas or dusts, in the work place, and the pulmonary disorders that may result from it.  The severity and type of pneumoconiosis depends on what the dust particles consist of.   For example, small amounts of certain substances, such as asbestos and silica, (known carcinogens), can lead to serious reactions (cancer),  while others may not be as harmful. 

 

What are the Various Types of Pneumoconiosis?

Apart from the above-mentioned pneumoconiosis, there are also other kinds such as berylliosis, due to inhaling beryllium dust; bauxite fibrosis, because of inhaling bauxite dust; siderosis, due to inhaling iron dust; byssinosis, due to inhaling cotton dust.  Some of the other types of dusts that cause pneumoconiosis are:  aluminum, barium, antimony, graphite, kaolin, talc, mica, and so on.  There is also a type known as mixed-dust pneumoconiosis.
As far as public health is concerned, pneumoconiosis is (a man made disease), which can be prevented with adequate dust control and protective gear in the work place.


What are the Symptoms of Pneumoconiosis?

In its milder forms, pneumoconiosis may not have any symptoms.  However, when the symptoms do develop, they may be:
• Shortness of breath, particularly on exertion
• Wheezing
• Chronic coughing, which may or may not be accompanied by mucus


If there is severe fibrosis of the lungs, it can become extremely difficult to breathe, and when this occurs, it may lead to the fingernails and lips getting a bluish tinge.  In the advanced form of pneumoconiosis, there may also be swelling in the legs due to excessive strain on the heart.
A study was made of ninety three (93) women and thirteen (13) men employed in the spinning department of a factory in Yugoslavia.  This involved the processing soft hemp (Cannabis sativa).  There were seven occupational groups, with average concentrations of total airborne hemp dust ranging from 2•9 mg. /m.3 to more than 19•5 mg. /m.3.  Thirty-eight women (38) and eleven men (11) employed in other departments of the factory with average total dust concentrations below 1•0 mg. /m.3, were studied as controls.
In the spinning department (40•6%) of the workers had byssinosis and (15•1%) had chronic bronchitis (defined as persistent cough and phlegm on most days for as much as three months each year during the last two years).  None of the controls suffered from either disease.
After adjustment for age, sitting height, and sex, the F.E.V.0•75 and F.V.C. measured at the beginning of the shift were used to assess the long-term effects of hemp dust on the ventilator function of the lung.  The age-adjusted ratio F.E.V.0•75/F.V.C. was also used.  A comparison between the control group and the seven exposed groups showed no meaningful association between ventilatory function and present levels of dust exposure, but byssinotics with chronic bronchitis had a mean age-adjusted F.E.V.0•75/F.V.C. ratio significantly lower than that of workers with neither disease (P<0•05).
Acute effects of hemp dust, measured by the change in F.E.V.0•75 and F.V.C. during the shift, were considerable.  There were marked reductions in the mean F.E.V.0•75 and F.V.C. during the shift in all the occupational groups exposed to high concentrations of dust.  Byssinotics with chronic bronchitis had a significantly greater mean decrease in F.E.V.0•75 during the shift than the byssinotics without chronic bronchitis, and the workers with neither disease (P<0•02).
There is no doubt that the dust of Cannabis sativa (and C. indica, C. hybrids) can cause byssinosis and at least temporary impairment of ventilatory function, varying in severity according to the levels of dust exposure and the presence of respiratory disease.
Byssinosis, cannabosis, cannabinosis, lung disease caused by prolonged inhalation of fiber dust in textile factories (and in the home).  Byssinosis is a chronic, asthma-like narrowing of the airways.  Byssinosis, Cannabinosis, or Cannabosis  results from inhaling particles of cotton, flax, hemp, cannabis or jute.


Of course,   I am not working in a textile factory.  Nevertheless, as long as the actual physical handling of medical marijuana stays part of my life, I will continue to have all of my symptoms. 


My Symptoms:
1. Runny nose
2. Itchy eyes, with discharge
3. Bronchial Constricture/Impaired ventilatory function
4. Cough with mucous that does not go away
5. Impaired breathing/Shortness of breath
6. Red pustules on skin (where skin is exposed)
7. Where skin is exposed-histamine reaction (swelling, itchy, burning, stinging)
8. Asthma
9. Blocked bronchial passageway


The dust, pollen, and resins that get into my airways cause all of these symptoms.  I am not encountering the stems of the plants at all.  These symptoms have nothing to do with smoking, vaporizing, or eating medical marijuana.  Once into my system, marijuana is very beneficial for the other conditions I use it for:  TBI, arthritis, and chronic pain!

 

Summary

There is no doubt that the dust of Cannabis sativa hemp can cause byssinosis and at least temporary
impairment of ventilatory function, varying in severity according to the level of dust exposure and the
presence of respiratory disease.  Although increasing attention has been paid in recent years to the effects of vegetable dust on the respiratory system, comparatively little is known about the effects of hemp dust.
There are two distinct types of hemp--hard fibers, which are derived from the leaf of the plant, and soft fibers, derived from the stem.  Results from studies of hemp workers are often reported without mention of the type of hemp used.  While it appears to be unlikely that exposure to the dust of hard hemp causes byssinosis, there is evidence that exposure to soft hemp may cause the disease.  Of course, I am in complete disagreement with these findings because I only encounter the hard fiber kind (buds and leaves).

Barbero Carnicero and Flores and Jimenez Diaz and Lahoz (1944) were the first to describe a condition they called cannabosis in workers exposed to the dust of soft hemp.  In a more recent study of soft hemp workers in Spain, it has been shown quite clearly that cannabosis is identical to the disease byssinosis which occurs in cotton and flax workers.  Bouhuys, Barbero Carnicero, Lindell, Roach, and Schilling, (1967). 


It is clear that exposure to the dust of Cannabis sativa and Cannabis indica and Cannabis hybrids cause temporary impairment of ventilatory function, varying in severity according to the level of dust concentration and the presence of respiratory disease.1

 

 

1.  Chaboya-Hembree, Jan:  personal experience from 1991-2011.

 

 

 

 


References………………………………………………………………………………………………………………………………………………….
Byssinosis in hemp workers.
A Bouhuys, A Barbero, S E Lindell, S A Roach, R S Schillingin Archives of Environmental Health (1967)
1. Byssinosis and chronic bronchitis among cotton textile workers.
J A Merchant, K H Kilburn, W M O'Fallon, J D Hamilton, J C Lumsdenin Annals of Internal Medicine(1972)
2. Byssinosis among hemp and sisal workers in Greece
X G Kondakis, N Pournaras, J Moraitisin Archives Des Maladies Professionnelles De Medecine Du Travail Et De Securite Sociale(1967)
3. The prevalence of chronic bronchitis among workers in the dust-exposed occupations of machinery building
A I Kleĭner, V M Makotchenko, V A Efremova, L M Kashin, L S Smol'nikovain Vrachebnoe Delo (1991)
4. Dust disease in hemp workers.
A Barbero, R Floresin Archives of Environmental Health (1967)
1. American Lung Association.  1740 Broadway, New York, NY 10019.  (800) 586-4872.  http://www.lungusa.org.
2. Centers for Disease Control and Prevention.  1600 Clifton Rd., NE, Atlanta, GA 30333.  (800) 311-3435, (404) 639-3311.  http://www.cdc.gov
3. Gale Encyclopedia of Medicine.  Copyright 2008 The Gale Group, Inc.  All rights reserved.
4. Chan-Yeung M, Malo J-L.  Asthma in the workplace and occupational asthma.  In: Mason RJ, Broaddus VC, Martin Tr, et al, eds. Murray and Nadel's Textbook of Respiratory Medicine .  5th ed. Philadelphia, Pa: Saunders Elsevier; 2010:  chap 64.
5. Rose CS, Lara AR. Hypersensitivity pneumonitis.  In: Mason RJ, Broaddus VC, Martin Tr, et al, eds. Murray and Nadel's Textbook of Respiratory Medicine .  5th ed. Philadelphia, Pa: Saunders Elsevier; 2010:  chap 66.
6. Samet JM.  Occupational pulmonary disorders.  In: Goldman L, Ausiello D, eds. Cecil Medicine.  23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007:  chap 93.
7. ^ Hollander, AG (December 1953).  "Byssinosis".  Chest (American College of Chest Physicians) 24 (6): 674–678.  doi:  10.1378/chest.24.6.674 (inactive 2010-06-23).  PMID 13107566.  Retrieved 2008-01-31.
8. ^ Newman, Lee S. (June 2008).  "Byssinosis".  Merck Manuals: online medical dictionary.  Merck & Co. Retrieved 2009-06-15.
9. ^ The Work-Related Lung Disease Surveillance Report, 2002.  Section 4.  Byssinosis and Related Exposures.  National Institute for Occupational Safety and Health.  Accessed March 17, 2009.
10. Snyder, Rachel Louise (2007).  Fugitive Denim: A Moving Story of People and Pants in the Borderless World of Global Trade.  W. W. Norton.
11. Rose CS, Lara AR. Hypersensitivity pneumonitis.  In: Mason RJ, Broaddus VC, Martin Tr, et al, eds. Murray and Nadel's Textbook of Respiratory Medicine.  5th ed. Philadelphia, Pa: Saunders Elsevier; 2010:  chap 66.
12. Samet JM.  Occupational pulmonary disorders.  In: Goldman L, Ausiello D, eds. Cecil Medicine.  23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007:  chap 93.
13. .  Chan-Yeung M, Malo J-L.  Asthma in the workplace and occupational asthma.  In: Mason RJ, Broaddus VC, Martin Tr, et al, eds. Murray and Nadel's Textbook of Respiratory Medicine.  5th ed. Philadelphia, Pa: Saunders Elsevier; 2010:  chap 64.
14. Jan Chaboya-Hembree, personal experience.  1991-2011 (twenty years of exposure).

Like This Article  

 
hawgdawg  (81 posts)
Wednesday, Mar 20 2013 at 2:21p
 
Ugh. I like this article because of the information provided, but I dislike it because I must hold myself accountable to an even greater extent than I do. I already have COPD (Emphysema) but, since my first exposure to asbestos in all it's forms was while serving in the United States Navy then, years later, working in the environmental abatement and demolition industry, I'm being closely monitored for the onset of an asbestos related lung disorder which would technically subordinate my diagnosis of COPD.
 
Sam
Monday, Apr 14 at 9:29a
 
Do you really think that is the problem without the hemp dust? I know some people are alergic to Cannabis, its resin and terpenes, or the male pollen. But I think all the diseases you mention are for hemp workers in a fiber or pulp that breath the dust all day long for years. Not for someone that harvests a few plants. My 2 cents.