The respiratory health status was studied in 376 female shoe workers. The mean age of workers was 32 years and the mean exposure 12 years. A significantly higher prevalence of all chronic respiratory symptoms and diseases was found in exposed compared to control workers. This was particularly pronounced for chest tightness (exposed: 44.7%; control: 0%), dyspnoea (exposed: 42.6%; control: 2.0%) and rhinitis (exposed: 46.3%; control: 2.4%). In exposed workers there was also a high prevalence of acute symptoms which developed during work shift, particularly irritation of the throat (56.6%), dryness of the throat (61.4%), dryness of the nose (56.4%), and eye irritation (63.6%). The prevalence of acute and chronic respiratory symptoms and diseases increased with duration of exposure. There were also statistically significant acute reductions in all ventilatory capacity tests (FVC, FEV1, FEF50, FEF25) during work shift. The measured ventilatory capacity values in exposed workers were significantly lower in comparison with the predicted values (P < 0.01). Lung function severity increased with duration of employment. The data suggest that occupational exposure to atmospheric pollution in the shoe manufacturing industry may be responsible for the development of acute and chronic respiratory impairment.