title: Cardiovascular mortality among Swedish pulp and paper mill workers.
abstract: BACKGROUND
  Malignant diseases but also cardiovascular and respiratory disorders and diabetes mellitus have been associated with work in pulp and paper production. The present cohort focuses on cardiovascular mortality in relation to various exposures in this industry.
  
  
  METHODS
  The cohort, followed-up for mortality, includes 7,107 workers, 6,350 men and 757 women, from three major old mills in the middle of Sweden.
  
  
  RESULTS
  Instead of a healthy-worker effect, a slightly increased risk for death in diseases of the circulatory system was found for male workers. Notably, work with sulfate digestion, steam and power generation and maintenance was associated with significantly increased risks. Cerebrovascular diseases showed non-significantly increased risks for maintenance and paper and paperboard production and manufacture.
  
  
  CONCLUSIONS
  The differences in risk among various parts of the production are striking although it is hard to pinpoint any specific exposures. Dust and small particles along with sulfur compounds might be suspected.
authors.affiliation: Department of Occupational and Environmental Medicine, University Hospital, Linköping, Sweden. bodil.persson@lio.se
authors.forename: Bodil
authors.initials: B
authors.lastname: Persson
authors.forename: Anders
authors.initials: A
authors.lastname: Magnusson
authors.forename: Håkan
authors.initials: H
authors.lastname: Westberg
authors.forename: Eva
authors.initials: E
authors.lastname: Andersson
authors.forename: Kjell
authors.initials: K
authors.lastname: Torén
authors.forename: Gun
authors.initials: G
authors.lastname: Wingren
authors.forename: Olav
authors.initials: O
authors.lastname: Axelson
mesh_terms: D002318:Cardiovascular Diseases / Q000401:mortality*; D015331:Cohort Studies; D019652:Extraction and Processing Industry / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D009784:Occupational Diseases / Q000453:epidemiology*; D016273:Occupational Exposure / Q000009:adverse effects* / Q000706:statistics & numerical data; D010209:Paper; D020521:Stroke / Q000401:mortality*; D013548:Sweden / Q000453:epidemiology; D014934:Wood