Beck et al suggested that the effects of dust and cigarette smoke may both have an independent role in influencing loss of lung function. 23 They compared 477 cotton textile workers with 932 non-exposed controls. Cotton workers were found to have significantly lower FEV, and FVC. The authors postulated
that smoking and dust may have differential discrete actions on the smaller and larger airways, respectively; the combination of which led to the clinical syndrome of byssinosis.