title: Respiratory health among bleachery workers exposed to ozone and chlorine dioxide.
abstract: OBJECTIVE
  This study investigated the possibility of occupational exposure to ozone increasing the risk of obstructive airway disease among bleachery workers. : Bleachery workers (N = 129) from two Swedish pulp mills using ozone for bleaching were studied together with referents (N = 80) from adjacent paper mills. The pulp mills had previously used chlorine dioxide as the bleaching agent. Testings included spirometry, methacholine challenge testing, and questionnaires. Area samplings showed sporadic ozone levels exceeding 0.9 ppm.
  
  
  RESULTS
  There was a greater prevalence of wheezing (25%) among the bleachery workers with a history of gassings (from ozone, chlorine, or sulfur dioxide) than among those without gassings (18%) and among the referents (13%). Among the current smokers the fraction with a slightly increased bronchial responsiveness to methacholine was greater among the bleachery workers reporting gassings than among those that had not been gassed. For the period from 1992 to 1996, when the mills were using ozone, there was an increased incidence rate of wheezing among the workers in the bleachery (incidence rate ratio 2.3, 95% confidence interval 1.6-5.8).
  
  
  CONCLUSIONS
  Repeated exposure to irritants increases the risk of asthma-like symptoms. This finding reinforces the view that repeated peak exposures to irritants must be prevented in pulp mills.
authors.affiliation: Section of Occupational and Environmental Medicine, Sahlgrenska University Hospital, Göteborg, Sweden. Anna-Carin.Olin@ymk.gu.se
authors.forename: Anna-Carin
authors.initials: AC
authors.lastname: Olin
authors.forename: Gerd
authors.initials: G
authors.lastname: Granung
authors.forename: Stig
authors.initials: S
authors.lastname: Hagberg
authors.forename: Magnus
authors.initials: M
authors.lastname: Adriansson
authors.forename: Jonas
authors.initials: J
authors.lastname: Brisman
authors.forename: Olle
authors.initials: O
authors.lastname: Dalander
authors.forename: Berndt
authors.initials: B
authors.lastname: Karlsson
authors.forename: Kjell
authors.initials: K
authors.lastname: Torén
mesh_terms: D000328:Adult; D001249:Asthma / Q000453:epidemiology / Q000209:etiology*; D017606:Chlorine Compounds / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008297:Male; D016273:Occupational Exposure / Q000009:adverse effects*; D010087:Oxides / Q000009:adverse effects*; D010126:Ozone / Q000009:adverse effects*; D015995:Prevalence; D016016:Proportional Hazards Models; D018709:Statistics, Nonparametric; D013548:Sweden / Q000453:epidemiology
chemical_list: D017606:Chlorine Compounds; D010087:Oxides; D010126:Ozone; C025109:chlorine dioxide