Byssinosis, other respiratory symptoms, and ventilatory capacity were investigated in 186 male spinners in two Sudanese textile mills located in Khartoum and Hassaheisa. The prevalence of byssinosis was 37% among Khartoum spinners where coarse cotton was processed, significantly higher (p less than 0.01) than the 1% found among Hassaheisa spinners, where fine cotton was used. The prevalence of chronic bronchitis was 29% in Khartoum and 2% in Hassaheisa spinners. A significant reduction in forced expiratory volumes (FEV1 after a shift) was observed in spinners of both factories. Our findings provide evidence that very low rates or absence of byssinosis, related respiratory symptoms, and significant functional abnormalities (FEV1) in the late stages of cotton yarn processing all depend on the quality of cotton used and low levels of cotton dust concentration.