Abstract
This review article concerns byssinosis, a respiratory disease that affects workers in textile mills. According to experts in the field of occupational medicine, hemp mill workers suffer worse than workers in flax, cotton, jute, and sisal mills. The causative factor in hemp dust has not been determined with certainty. However, this review assembles evidence that implicates hemp dust contaminated by bacterial endotoxins, rather than fungal toxins or constituents in hemp itself. Endotoxins are expressed by Gram negative bacteria, and Enterobacter cloacae is a prime suspect. It is proposed that endotoxin contamination occurs during the biological retting process, and not before (in living hemp plants) or after (within the textile mill). Methods of preventing and treating byssinosis are assessed, including some new proposals for management.