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4 HEALTH EFFECTS

Table 4-9. Dose-response relationship between CCP handling and mucous membrane and skin symptoms in two form-printing shops
CCP handling frequency
(sheets per day)
Total number of workers Workers with symptoms
Skin and mucous membrane symptoms Skin symptoms
Number % Number %
0-5 26 0 0 0 0
6-20 26 0 0 0 0
21-75 28 9 32.1 5 17.9
76-250 25 14 56.0 10 40.0
251-2000 24 17 70.8 14 58
Total 129 40 31.0 29 22.5

Source: Olsen and Mørck [1985].

membrane symptoms in a cross-sectional study of 20 Danish government workers who were highly exposed to CCP and a comparison group of 20 workers who were generally not exposed. These groups were matched for sex, age, location of workplace, known skin diseases, history of childhood asthma, known allergy to nickel, asthmatic conditions, chronic bronchitis, eye diseases, nettle rash, and use of tanning facilities. Double-blind dermatological exams included observations and histories, skin-prick tests for allergens, scratch tests for CCP and its components versus ordinary paper, objective measures of dermal erythema after occluded testing, and skin-patch tests. Temperature, humidity, formaldehyde, and total dust were measured. Two groups of workers were exposed to CCP. Over a period of 4 weeks, the first group of 5 sent out 120,000 identical forms printed on CCP that had been stored in the work area. Their work consisted of tearing off forms from a continuous paper web and stuffing the forms into envelopes (about 1,200 per day per worker). The second exposure group of 15 workers processed the 42,000 returned forms over a 2-week period, checking and entering information into computers (about 280 per day per worker). The comparison group was selected from 122 employees who worked in the same large office building and had returned completed questionnaires about symptoms and exposure to CCP. These questionnaires were administered weekly during the exposure periods. They included questions about CCP exposure, work with computers and photocopying, and subjective symptoms of skin and respiratory irritation. Temperature was 23.5 °C and humidity was about 40% in both offices. These were reported along with six formaldehyde measurements, (including both area and personal samples) ranging from 0.1 to 0.62 mg/m³. Total dust measurements were 0.34 mg/m³ in the study office and 0.28 mg/m³ in the comparison group office. Table 4-10 shows the incidence of symptoms during both exposure periods among the exposed workers and their matched comparison workers. A significantly greater incidence of skin irritation (P=0.03) and pruritus (P=0.007) occurred in the exposed group during the first exposure period. However, no differences occurred in the incidence of

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