Cardiovascular mortality among Swedish pulp and paper mill workers

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.