Byssinosis in Hemp Workers

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Abstract
Severe byssinosis, chronic cough, and other chronic respiratory symptoms are highly prevalent among workers exposed to dust of raw, biologically retted, soft hemp (Cannabis sativa). Within this group non-reactors and reactors could be distinguished by the absence or presence of a decrease of forced expiratory volume (FEV1) during dust exposure on Mondays. The questionnaire interview underestimated the extent of the workers'' symptoms. Urinary excretion of a major histamine metabolite (1,4-methylimidazolacetic acid; MeIAA) was higher on Monday than on Wednesday in those reactors whose FEV1 decreased on Monday but not on Wednesday. Bronchoconstrictive response to hemp dust exposure on Monday is a result of the release of histamine in the lungs. A deleterious effect of long-term hemp dust exposure upon pulmonary function is highly probable: FEV1 (before dust exposure; adjusted for age and height) was significantly lower among the hemp workers than among a control group (farm workers), although the latter smoked more, and significantly lower among those with byssinosis grades 1 and 2 than among those without or with mild symptoms of disease; 9 out of 20 retired hemp workers had an FEV1 of 1/2 the expected value or less. Among the active workers, abnormally low values of FEV1 (before dust exposure) were only found in reactors and not in non-reactors. Irreversible pulmonary function changes develop primarily in those individuals who are sensitive to the acute bronchoconstrictive effect of hemp dust.

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