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Background: Total paper dust exposure has been associated with respiratory problems among workers in the soft tissue paper industry. However, a comprehensive job exposure matrix (JEM) has not been developed for application to this industry. Our study was intended to address this need and to support further studies of mortality and morbidity in a cohort of Swedish workers from this industry., Methods: We evaluated four participating soft tissue paper mills in Sweden. We combined information on process and equipment status from the mills with knowledge of the mills obtained through research efforts and paper dust measurements made at all four mills to develop a semi-quantitative JEM with seven dust exposure levels. The JEM was targeted at workers enrolled into a soft tissue paper mill cohort and working any time between 1960 and 2009., Results: The JEM includes a total of 14 421 cells, with each cell corresponding to the exposure for a job title, department, or work location for a one-year period. Exposure levels in the JEM were estimated to decline at three of the four mills from 1971 to 2009, but overexposures (ie, exceedances of the relevant occupational exposure limits) remained common at the end of the period., Conclusions: The JEM results highlight the need for ongoing exposure control efforts in the soft tissue paper industry, and will inform ongoing epidemiological studies of the health effects of exposure to paper dust in Sweden. It is freely available for use by other researchers., (© 2020 Wiley Periodicals, Inc.)

Background: Malignant diseases but also cardiovascular and respiratory disorders and diabetes mellitus have been associated with work in pulp and paper production. The present cohort focuses on cardiovascular mortality in relation to various exposures in this industry., Methods: The cohort, followed-up for mortality, includes 7,107 workers, 6,350 men and 757 women, from three major old mills in the middle of Sweden., Results: Instead of a healthy-worker effect, a slightly increased risk for death in diseases of the circulatory system was found for male workers. Notably, work with sulfate digestion, steam and power generation and maintenance was associated with significantly increased risks. Cerebrovascular diseases showed non-significantly increased risks for maintenance and paper and paperboard production and manufacture., Conclusions: The differences in risk among various parts of the production are striking although it is hard to pinpoint any specific exposures. Dust and small particles along with sulfur compounds might be suspected., ((c) 2007 Wiley-Liss, Inc.)

Background: The incidence of testicular cancer has increased in recent decades. The aims of the present study were to elucidate whether Swedish paper and pulp mill workers had an increased incidence of testicular cancer, and to investigate whether certain occupational groups within the pulp and paper mill workforce were at increased risk., Methods: The study was based on the Swedish Cancer Environment Register, which links the incidence of cancer for the period 1971-1990 with 1960 and 1970 National Census data on specific industries and occupations for all employed subjects in Sweden., Results: Among maintenance workers employed both in 1960 and in 1970 in paper mills there was an increased risk for testicular cancer (standardized incidence ratio (SIR) 7.4, 95% confidence intervals (CI) 1.5-22), especially for seminomas (SIR 10.1, 95% CI 2.1-29). Maintenance workers were also at increased risk when analyzing workers employed in 1960, 1970, or both years., Conclusions: This study indicates an increased risk for testicular cancer, especially seminomas, among maintenance workers, but not among process workers, in Swedish paper mills., (Copyright 2003 Wiley-Liss, Inc.)

Process and office workers at a Swedish paper mill (n = 274) and dairy workers (n = 45) were investigated with questionnaires regarding skin symptoms. In the second part of the study, subjects reporting skin symptoms and a random sample of subjects without symptoms were examined and investigated with patch testing. Pruritus and skin irritation probably related to exposure to dust were found. The results do not indicate an increased prevalence of contact allergy. In two cases, positive patch test reactions to paper size (rosin) and a slimicide, mercaptobenzothiazole (MBT), were noted.

In an earlier case-referent study from a soft-paper mill with levels of paper dust exceeding 5 mg/m3, an increased mortality was found (OR = 3.8, p less than 0.05) from asthma and chronic obstructive pulmonary disease (COPD) among the employed. Furthermore, other studies on paper mill workers have also indicated an increased mortality from lung cancer. The main objectives of the present case-referent study were to investigate the mortality from asthma. COPD, and lung cancer in two other Swedish paper mills. In these mills, the levels of paper dust have been below 3 mg/m3. The subjects for the study were all men who died between 1961 and 1985 from asthma and COPD (n = 31), respiratory cancer (n = 27), and stomach cancer (n = 33) selected in three parishes surrounding two paper mills. As referents we randomly selected about six times as many men who had died from nonmalignant nonrespiratory diseases in these parishes (n = 550). On the basis of information found in the personnel records in the mills, the men were classified into different occupational categories or as unexposed. No increased risk of asthma or COPD was found among the workers exposed to paper dust. However, it was found that there was significantly increased mortality (OR = 5.7, p less than 0.05) for asthma and COPD among workers in a previous log sorting department. The study also showed a significantly increased risk of lung cancer (OR = 2.1, p less than 0.05) among maintenance workers. There was no increased risk of stomach cancer in the study.(ABSTRACT TRUNCATED AT 250 WORDS)

The mortality pattern among Swedish pulp and paper mill workers was evaluated in a case-referent study encompassing 4,070 men decreased during the period 1950-1987. The subjects were identified from the register of deaths and burials in six parishes. A significantly increased mortality was seen for diabetes mellitus and for secondary tumors of the lung and liver among the pulp and paper mill workers. Indications of excess risks were also found for obstructive lung disorders, pulmonary emboli, accidents, and pneumonia, as well as for malignant lymphomas, leukemias, and cancer of the pancreas and stomach. In the only parish where a sulfite process was exclusively used, cancer of the digestive tract and especially of the rectum was found to be in excess. Except for this parish, the sulfate process predominated in the plants included. The mortality pattern found in this study is in reasonable agreement with findings in various studies from this type of industry.

Analysis of data obtained by linking the 1960 Swedish Census and the Swedish Cancer Registry has demonstrated an increased risk of pleural mesothelioma among pulp and paper workers. The present study was undertaken with the aim of revealing possible environmental risk factors. The work histories of the 25 cases identified earlier were reviewed. "Certain" or "probable" exposure to asbestos was found among 70% of these workers. The study illustrates how linkage of official registers can be used to identify new risk environments and encourage the establishment of preventive measures.