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Exposure to very low levels of ambient-air malodorous sulfur compounds and their effect on eye irritation, respiratory-tract symptoms, and central nervous system symptoms in adults were assessed. A cross-sectional self-administered questionnaire (response rate = 77%) was distributed during March and April 1992 to adults (n = 336) who lived in a neighborhood that contained a pulp mill and in a nonpolluted reference community (n = 380). In the exposed community, the measured annual mean concentrations of total reduced sulfur compounds and sulfur dioxide measured in two stations were 2 to 3 micrograms/m3 and 1 micrograms/m3, respectively. In the reference community, the annual mean concentration of sulfur dioxide was 1 micrograms/m3. The residents of the community near the pulp mill reported an excess of cough, respiratory infections, and headache during the previous 4 wk, as well as during the preceding 12 mo. The relative risk for headache was increased significantly in the exposed community, compared with the reference area: the adjusted odds ratio (aOR) was 1.83 (95% confidence interval [95% CI] = 1.06-3.15] during the previous 4 wk and 1.70 (95% CI = 1.05-2.73) during the preceding 12 mo. The relative risk for cough was also increased during the preceding 12 mo (aOR = 1.64, 95% CI = 1.01-2.64). These results indicated that adverse health effects of malodorous sulfur compounds occur at lower concentrations than reported previously.

In a longitudinal study, we assessed the relation between daily exposure to ambient air malodorous sulfur compounds from pulp production and experience of symptoms in a small population living in the vicinity of a pulp mill. Special emphasis was laid on exposure-response pattern, where the intensity of the symptoms of interest was assessed in six consecutive questionnaires after three predefined levels of exposure to malodorous sulfur compounds [total reduced sulfur (TRS)] (reference: daily mean < 10 micrograms/m3, medium exposure: 10-30 micrograms/m3 high exposure: > 30 micrograms/m3). The study population included 81 adults, who responded to the baseline questionnaire (response rate 81%). The outcomes of interest were eye, respiratory, and central nervous symptoms. The mean daily intensity of the outcome symptoms, but not of control symptoms, was significantly higher on days of medium and high exposure compared with the reference days (paired t test). The probability ratios between experiencing more or fever symptoms during the medium and high exposure compared with reference days were increased for all the symptoms of interest with a consistent exposure response pattern. The probability ratios were for eye symptoms 3.17, 95% confidence intervals (CI) 1.21 to 7.47 (medium exposure), and 5.0, 95% CI 1.66 to 12.65 (high exposure); for nasal symptoms 3.13, 1.25 to 7.25 (medium), and 8.50, 3.19 to 18.64 (high); and for pharyngeal symptoms 2.0, 0.92 to 4.14 (medium) and 5.20, 1.95 to 11.99 (high). The results suggest that relatively low daily levels of malodorous sulfur compounds (TRS > 10 micrograms/m3) cause exposure-related short-term adverse effects.

We assessed the role of long-term exposure to ambient air malodorous sulfur compounds released from pulp mills as a determinant of eye and respiratory symptoms and headache in children. Adverse health effects of environmental exposure to these compounds in children have not been reported previously. The parents of 134 children living in a severely polluted (n = 42), moderately polluted (n = 62) and rural nonpolluted (n = 30) community responded to a cross-sectional questionnaire. The response rate was 83%. The adjusted odds ratios (OR) for symptoms experienced during the previous 4 weeks and 12 months in the severely versus nonpolluted community were estimated in logistic regression analysis controlling for age and gender. The risk of nasal symptoms (4 weeks OR 1.40, 95% CI 0.59-3.31; 12 months OR 2.47, 95% CI 0.93-6.53), cough (4 weeks OR 1.83, 95% CI 0.75-4.45; 12 months OR 2.28, 95% CI 0.95-5.47), eye symptoms (12 months OR 1.15, 95% CI 0.43-3.05), and headache (12 months OR 1.77, 95% CI 0.69-4.54) was considerably increased in the severely polluted community, although not quite reaching statistical significance. The results suggest that exposure to malodorous sulfur compounds may affect the health of children.

The paper mills in South Karelia, the southeast part of Finland, are responsible for releasing a substantial amount of malodorous sulfur compounds such as hydrogen sulfide (H2S), methyl mercaptan (CH3SH), and methyl sulfides [(CH3)2S and (CH3)2S2], into ambient air. In the most polluted residential area the annual mean concentrations of hydrogen sulfide and methyl mercaptan are estimated to be 8 and 2 to 5 micrograms/m3 and the highest daily average concentration 100 and 50 micrograms/m3. The annual mean and highest daily concentrations of sulfur dioxide (SO2) are very low. We studied the effects of malodorous sulfur compounds on eye, nasal and respiratory symptoms, and headache in adults. A cross-sectional self-administered questionnaire was distributed in February 1987 and responded to by 488 adults living in a severely (n = 198), a moderately (n = 204), and a nonpolluted community (n = 86). This included questions about occurrence of the symptoms of interest during the previous 4 wk and 12 months and individual, behavioral, and other environmental determinants of the symptoms. The response rate was 83%. The odds ratios (OR) for symptoms experienced often or constantly in severely versus nonpolluted and moderately versus nonpolluted communities were estimated in logistic regression analysis controlling potential confounders. The odds ratios for eye (moderate exposure OR 11.70, Cl95% 2.33 to 58.65; severe exposure OR 11.78, Cl95% 2.35 to 59.09) and nasal symptoms (OR 2.01, Cl95% 0.97 to 4.15; OR 2.19, Cl95% 1.06 to 4.55) and cough (OR 1.89, Cl95% 0.61 to 5.86; OR 3.06, Cl95% 1.02 to 9.29) during the previous 12 months were increased, with a dose-response pattern.(ABSTRACT TRUNCATED AT 250 WORDS)