title: Endotoxins isolated from the air of a Danish paper mill and the relation to change in lung function: an 11-year follow-up.
abstract: BACKGROUND
  A decline in lung function has been associated with farming, cotton spinning, and work in the animal feed industry. The aim of the study was to reveal if loss of lung function was associated to work at a paper mill.
  
  
  METHODS
  Ninety-seven male paper workers (PW), and 55 control workers were examined. Hygiene samples included total dust, endotoxins, and microorganisms. Interview, pulmonary function testing, and skin prick test (SPT) were performed and yearly decline in lung function was calculated.
  
  
  RESULTS
  The exposure for endotoxin (LPS) ranged from Median (Max-Min) 69 (370-6) EU/m3, in the wet-end of the paper machines to 6 (19-16) in the pulping area. The lung function decline among the controls was comparable to the decrements among the maintenance and repair workers at the paper factory, around 51-54 and 37-38 ml/year among smokers' and non-smokers, respectively. After adjustment for baseline FEV1, the variables associated to an increased loss of FEV1 were age smoking and cough. For FVC we found an inverse relation between exposure and yearly decline.
  
  
  CONCLUSIONS
  No increase in loss of lung function is seen among workers exposed to up to 200 EU/m3 of LPS.
authors.affiliation: Institute of Environmental and Occupational Health, University of Aarhus, Aarhus C, Denmark. TS@MIL.AU.DK
authors.forename: Torben
authors.initials: T
authors.lastname: Sigsgaard
authors.forename: Lone Donbaek
authors.initials: LD
authors.lastname: Jensen
authors.forename: Anette
authors.initials: A
authors.lastname: Abell
authors.forename: Helle
authors.initials: H
authors.lastname: Würtz
authors.forename: Gert
authors.initials: G
authors.lastname: Thomsen
mesh_terms: D000395:Air Pollutants, Occupational / Q000009:adverse effects / Q000032:analysis*; D003718:Denmark; D004731:Endotoxins / Q000032:analysis* / Q000302:isolation & purification; D005500:Follow-Up Studies; D019981:Health Care Sector; D006281:Health Occupations; D006801:Humans; D008168:Lung / Q000502:physiology* / Q000503:physiopathology; D008171:Lung Diseases / Q000209:etiology / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D010209:Paper; D012129:Respiratory Function Tests; D012867:Skin / Q000382:microbiology
chemical_list: D000395:Air Pollutants, Occupational; D004731:Endotoxins