Previous epidemiological surveys of flax byssinosis may have underestimated the incidence of permanent pulmonary disability by failing to reach those who have had to leave work. In the present study a representative sample of the inhabitants of a village where flax is processed both in the homes and in small plants was examined for byssinosis. The one in five random sample included a total of 190 male family heads living in the village. Dust exposure was evaluated. The study showed that 48·4% of the sample had byssinosis, and this included 92·5% of those working with flax in their homes and 75% of those working in plants. Permanent disability from byssinosis was present in 2·6% of the total sample and 12·1% of those exposed to dust for more than 20 years, whereas 75·8% of the latter group had symptoms of the earlier grades of byssinosis. It is concluded that prolonged exposure to flax dust did not result in a high incidence of permanent disability, and that is disability is not necessarily an eventual outcome in flax byssinosis. The absence of air pollution in the village may play a role in lowering the probability of workers becoming disabled by byssinosis in spite of the high prevalence of symptoms.
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