Ochratoxin A (OTA) is a nephrotoxin frequently contaminating grains. OTA inhalation during grain handling may therefore represent a health risk to farmers, and was the subject of this study. Airborne and settled grain dust was collected during grain work on 84 Norwegian farms. Climate and agricultural practices on each farm were registered. Penicillium spp., Aspergillus spp. and OTA in settled dust were measured. Settled dust contained median 4 microg OTA/kg dust (range 2-128), correlating with Penicillium spp. (median 40 cfu/mg; range 0-32000, rs =0.33; p