In the pulp and paper-producing industry, workers are exposed to a wide variety of hazardous substances. Due to the possible adverse effects on human lungs, fiber-containing dusts are of special interest in occupational medicine. Animal experiments with cellulose fibers and cellulose fiber products (Isofloc; Okologische Bautechnik; Hess, Lichtenan, Germany) showed a relatively high biopersistence. Moreover, granulomatous pneumonia and minimal interstitial fibrosis as well as alveolar cell-type hyperplasia were found in rats.
In the literature, there is limited evidence for an increased prevalence of respiratory symptoms in paper workers. Some authors described adverse effects on lung function; however, the intensity and type of the reported effects have been inconsistent, While some authors found a more obstructive pattern, others described a decreased lung elastic recoil pressure and decreased residual volume. Due to multiple exposure to substances including chemicals, ozone, and fiber-containing dusts, the mechanisms that are responsible for these effects and the causal relationships with certain exposures could not yet be described.
The aim of our study was therefore to evaluate the potential impact of exposure to these substances on lung function of workers employed in nine soft tissue plants in Germany. These findings were correlated with information on the corresponding dust and fiber exposure and smoking habits.
Materials and Methods
The study group was recruited from soft tissue paper-producing companies from different parts of Germany. In every company, pure cellulose was the main basis of the production process. Recycled paper was not a relevant component of the products.
At first, cellulose is put into pulping machines and high amounts of water are added. The pulp is then brought into huge paper machines, where the dehydrating and drying process is performed. The result of this process are so-called “mother rolls” (huge paper rolls). Afterwards, the converting process begins with printing and cutting the product in combiner machines. Finally the soft tissue products are packed. During this production process, high dust concentrations appear especially at the paper machine and during the converting process, depending on the location and activity taking place.