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Background: A decline in lung function has been associated with farming, cotton spinning, and work in the animal feed industry. The aim of the study was to reveal if loss of lung function was associated to work at a paper mill., Methods: Ninety-seven male paper workers (PW), and 55 control workers were examined. Hygiene samples included total dust, endotoxins, and microorganisms. Interview, pulmonary function testing, and skin prick test (SPT) were performed and yearly decline in lung function was calculated., Results: The exposure for endotoxin (LPS) ranged from Median (Max-Min) 69 (370-6) EU/m3, in the wet-end of the paper machines to 6 (19-16) in the pulping area. The lung function decline among the controls was comparable to the decrements among the maintenance and repair workers at the paper factory, around 51-54 and 37-38 ml/year among smokers' and non-smokers, respectively. After adjustment for baseline FEV1, the variables associated to an increased loss of FEV1 were age smoking and cough. For FVC we found an inverse relation between exposure and yearly decline., Conclusion: No increase in loss of lung function is seen among workers exposed to up to 200 EU/m3 of LPS.

Six Danish paper recycling plants were included in an assessment of exposure to chemicals. A questionnaire on processes was completed, and in-plant industrial hygiene measurement data collected 1982-1994 were examined. The assessment of chemicals did not reveal a major use of possible carcinogens, but acrylamide may have been released in the work environment in one plant. A total of 197 hygiene measurements were recorded: 126 in the largest plant. Airborne concentrations of dust, microorganisms, and endotoxins varied widely between plants. High concentrations of dust were recorded in the paper machine area in one plant and in the repulping unit in another plant. In general, endotoxin levels were low, but endotoxin levels were increased in one plant when reuse of process water was intensified. Changes in procedures should be assessed by industrial hygiene measurements.