Johns Hopkins University researchers are studying the causes of death among workers in the nation's pulp and paper mills, the largest industrywide occupational mortality study ever undertaken in the United States.
The seven-year study will track the health of about 100,000 former, current and future employees of 50 mills in 20 states.
The American Paper Institute, a trade association that is paying for the $8.8 million study, announced the project last week.
Dr. Genevieve M. Matanoski, an epidemiologist and occupational health physician at the School of Hygiene and Public Health who heads the study, said researchers will go back to 1974 to collect data and names of workers.
Former workers with at least 10 years of service, whose names would be maintained in company records for pension benefits, will be tracked in the survey, along with current and future employees of the 50 mills.
"The workers' privacy will be strictly guarded," said Dr. John Festa, API's project coordinator. Workers will not be interviewed, nor will their medical records be examined, he said, and causes of death will be taken from death certificates, which are public records. Names of workers will not be released by the study.
"The results are all based on mortality, on the cause of death," he said. Health problems of living workers or retirees will not be charted, he emphasized.
Rates for causes of death will be compared to area and national statistics to see if significant variations exist. High rates for particular medical conditions that could be work-related will then be investigated.
By creating standardized job descriptions for all participants, researchers will be able to determine where they worked and what conditions or chemicals they may have been exposed to, Dr. Festa explained.
"Not much is known about the paper and pulp industry in terms of particular health risks," Dr. Matanoski observed. Several limited studies over the past two decades have failed to produce consistent results, she noted. Some found a higher-than-average rate of one medical problem, while others found a much lower rate of that ailment.
While it is known that paper-mill workers are exposed to sulfur compounds, for example, studies so far have not documented a high number of respiratory problems that might be expected, she explained.
Steve Trawick, safety and health director for the United Paperworkers International Union, said that even though previous health studies have produced varied results, "we are beginning to see some patterns of elevated diseases in the paper mills." Employee diseases of the digestive system and the blood-forming tissue have been cited by these studies, he noted.
"We're certainly glad the industry is doing this [study]. . . . We want to wait and see what they come up with," he said.
Thomas Kraner, an API spokesman, said "There is no evidence that would lead the industry to believe that there is a health concern at its mills.
"The study is designed to look at the health patterns of workers in the industry" and see if they are measurably different from the general population, he said. No specific processes or chemicals used in paper mills are being targeted, he added.
The industry uses or produces as byproduct some chemicals associated with adverse health effects -- dioxin, chlorine and chloroform, acetone, toluene and methanol. But most concern about these chemicals has focused on the environment or the public after discharge from the plant rather than on worker health, Dr. Matanoski pointed out.
The National Institute of Occupational Safety and Health is studying pulp and paper-mill workers exposed to dioxin, a chemical found to cause cancer in laboratory animals. The chemical is created by chlorine-bleaching of paper.
The massive, multicompany study planned by API was possible because jobs, processes and products of the pulp and paper industry do not vary widely between manufacturers, Dr. Festa said.
Researchers hope to have preliminary results, primarily from th experiences of older workers, by 1994, Dr. Matanoski said.