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As part of a large human biomonitoring study, we conducted occupational monitoring in a glass fibre factory inSlovakia. Shopfloor workers (n = 80), with a matched group of administrators in the same factory (n = 36), weremonitored for exposure to glass fibres and to polycyclic aromatic hydrocarbons (PAHs). The impact of occupationalexposure on chromosomal aberrations, DNA damage and DNA repair, immunomodulatory markers, andthe role of nutritional and lifestyle factors, as well as the effect of polymorphisms in metabolic and DNA repairgenes on genetic stability, were investigated. The (enzyme-modified) comet assay was employed to measure DNA strand breaks (SBs) and apurinic sites,oxidised and alkylated bases. Antioxidant status was estimated by resistance to H2O2-induced DNA damage. Baseexcision repair capacity was measured with an in vitro assay (based on the comet assay). Exposure of workers to fibres was low, but still was associated with higher levels of SBs, and SBs plus oxidisedbases, and higher sensitivity to H2O2. Multivariate analysis showed that exposure increased the risk of high levelsof SBs by 20%. DNA damage was influenced by antioxidant enzymes catalase and glutathione S-transferase(measured in blood). DNA repair capacity was inversely correlated with DNA damage and positively withantioxidant status. An inverse correlation was found between DNA base oxidation and the percentage ofeosinophils (involved in the inflammatory response) in peripheral blood of both exposed and reference groups.Genotypes of XRCC1 variants rs3213245 and rs25487 significantly decreased the risk of high levels of baseoxidation, to 0.50 (p = 0.001) and 0.59 (p = 0.001), respectively. Increases in DNA damage owing to glass fibre exposure were significant but modest, and no increases wereseen in chromosome aberrations or micronuclei. However, it is of concern that even low levels of exposure tothese fibres can cause significant genetic damage.