Health hazards associated with wood dust exposure have been investigated in various industries. This study surveyed wood dust exposure levels and pulmonary effects among joss stick workers. Greater dust concentrations, as measured by six-stage cascade impactors, were observed in work areas where joss sticks were produced and incense was mixed than in other work areas. Total dust concentrations for these two high dust activities ranged from 9.9 to 42.7 mg/m3, and respirable proportions were between 2.0% and 54.6%. Higher dust levels were observed for dry joss stick production methods than for wet production methods. Dust levels for all other performance areas were lower than the permissible exposure level of 10 mg/m3. Although symptoms of cough and phlegm were higher in smoking workers than in nonsmoking workers, the prevalence of respiratory symptoms for exposed workers was not significantly higher than for the controls. The prevalence of pulmonary function deficits and the values of FEF25% and FEF75% in the exposed workers were significantly worse than those in the controls. But no difference was found between the male controls and the male exposed workers, the high-exposure group. Respiratory symptoms and pulmonary function also did not show a dose-response trend with the exposure levels estimated by correlation with worker job titles and duration of employment. No suspected case of pneumoconiosis was found from the chest radiographs. These results suggest that wood dust exposure in the joss stick industries might not lead to significant pulmonary damage.