Airflow limitation and changes in pulmonary function among bleachery workers.

This study investigated whether chronic airflow limitation and rapid decline in pulmonary function were associated with peak exposures to ozone and other irritant gases in pulp mills. Bleachery workers potentially exposed to irritant gassings (n = 178) from three Swedish pulp mills, and a comparison group of workers not exposed to irritant gassings (n = 54) from two paper mills, were studied. Baseline surveys occurred in 1995-1996, with follow-up surveys in 1998-1999. Participants performed spirometry and answered questions regarding ozone, chlorine dioxide (ClO2), and sulphur dioxide (SO2) gassings. From regression models controlling for potential confounders, declines in both the forced expiratory volume in one second (FEV1) (-24 mL x yr(-1)) and the forced vital capacity (FVC) (-19 mL x yr(-1)) were associated with ClO2/SO2 gassings. At follow-up, the prevalence of chronic airflow limitation (i.e. FEV1/FVC less than the lower limit of normal) was elevated for participants with only pre-baseline ozone gassings and with both pre-baseline and interval ozone gassings, after controlling for potential confounders. These findings suggest that obstructive effects among bleachery workers are associated with ozone gassings, and that adverse effects on spirometry might also accompany chlorine dioxide/sulphur dioxide gassings. Peak exposures to irritant gases in pulp mills should be prevented.