OBJECTIVES: To assess the relation between exposure to carbonless copy paper (CCP), paper dust, and fumes from photocopiers and printers (FPP), and the occurrence of sick building syndrome (SBS)-related symptoms, chronic respiratory symptoms and respiratory infections. METHODS: A population-based cross-sectional study with a random sample of 1016 adults, 21-63 years old, living in Pirkanmaa District in South Finland was conducted. This study focused on 342 office workers classified as professionals, clerks or administrative personnel according to their current occupation by the International Standard Classification of Occupations-88. They answered a questionnaire about personal information, health, smoking, occupation, and exposures in the work environment and at home. RESULTS: In logistic regression analyses adjusting for age, sex and a set of other confounders, all three exposures were related to a significantly increased risk of general symptoms (headache and fatigue). Exposure to paper dust and to FPP was associated with upper respiratory and skin symptoms, breathlessness, tonsillitis and middle ear infections. Exposure to CCP increased the risk of eye symptoms, chronic bronchitis and breathlessness. It was also associated with increased occurrence of sinus and middle ear infections and diarrhoea. A dose-response relations was observed between the number of exposures and occurrence of headache. The risk of tonsillitis and sinus infections also increased with increasing number of exposures. All chronic respiratory symptoms, apart from cough, were increased in the highest exposure category (including all three exposures). CONCLUSIONS: This study provides new evidence that exposure to paper dust and to FPP is related to the risk of SBS symptoms, breathlessness and upper respiratory infections. It strengthens the evidence that exposure to CCP increases the risk of eye symptoms, general symptoms, chronic respiratory symptoms and some respiratory infections. Reduction of these exposures could improve the health of office workers.