[1976] gathered information about the components of CCP and came to the following conclusions:
- None of the substances present in CCP at that time had known irritant or allergenic effects.
- The problems of skin and mucous membrane irritation are most common in the winter when the humidity is low.
- None of the substances gave rise to large amounts of dust.
- None of the substances would lead one to expect vapors to be generated at room temperatures.
- The odor reported by some may originate from the solvents in the adhesives or the inks.
Despite these negative conclusions, the Swedish Board noted that further attention to the question was warranted, "since problems with the skin and mucous membranes are still being reported by persons working with carbonless paper." Thus they also issued advice and instructions related to the handling of CCP [National Swedish Board of Occupational Safety and Health 1976].
In February 1980, the Swedish Trade Union called for a ban on CCP [Göthe et al. 1981], which was claimed to be the cause of numerous conditions including the following [Göthe et al. 1981; Kanerva et al. 1993]:
| Itching | Headache |
| Redness of the skin | Joint pain |
| Breathing difficulty | Rapid heart beat |
| Hoarseness and airway obstruction | Burning of the nose, eyes, mouth, and chest |
| Chest tightness and pain | Unpleasant smell and taste |
| Asthma | Contact urticaria |
| Fatigue | Allergic Contact dermatitis |
| Nausea | Irritant contact dermatitis |
Government and public concerns have waxed and waned in response to various reports in the literature as well as anecdotal information. The Danish, French, Swedish, and German governments have offered recommendations for reducing exposure to CCP (summarized in Chapter 6) that rely on simple work practices, personal hygiene, substitution, administrative controls, and increased ventilation as preventive measures. The Danish, French, and German governments have also recognized alleged health effects from CCP exposure as compensable according to the seriousness of the worker's reaction [Norbäck et al. 1983b].
At the first symposium on CCP (which was held in Stockholm and attended by producers, labor, government, and representatives from nine nations), Göthe et al. [1981] commented that strong forces had been mobilized in Sweden 2 years before the meeting to ban CCP or find a substitute for it. They noted that support for such resolutions has "often been anxiousness enhanced by unverified rumors or alarming mass-media reports about dramatic and serious diseases caused by work with carbonless copy papers." On the basis of their field investigations, Göthe et al. [1981] indicated that handling large amounts of CCP might induce dose-related but benign and nonallergic irritative symptoms, particularly in the mucous membranes of the nose and mouth. These authors did not consider these symptoms to be specific for CCP: they could also be elicited by handling large amounts of ordinary paper. But it appeared that a higher percentage of CCP workers might develop these symptoms than workers exposed to ordinary paper. These
