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 Has the paper quality been recently changed or has a new delivery of CCP been made? Have any of the following discomforts developed:

—Irritation of mouth, eyes, nose, or throat

—Skin problems of the face, hands, or arms

—Headache, vertigo, or exhaustion How long have the person(s) affected suffered from the symptoms? Do the symptoms disappear during weekends and/ or vacations? Do the symptoms develop especially in certain departments or at some special function? How much CCP is handled, separately or in total? Does the consumption of CCP vary during the course of a month? <li>Is there any connection between the amounts of CCP and the complaints?</li> <li>How long have you worked with the CCP that you believe to be the cause of your symptoms?</li> <li>Have similar symptoms occurred among fellow workers who do not work with CCP?</li> <li>Is the indoor climate (temperature, relative humidity, quality of the air, etc.) satisfactory?</li> <li>What is the extent of cleaning?</li> <li>Who produces the CCP?</li> <li>Who prints the CCP?</li> <li>Have the symptoms following work with CCP been reported?</li> </ul>

NIOSH recognizes that it may occasionally be necessary to limit CCP exposure in certain workers through administrative controls (such as job rotation). But in most cases, implementing normal precautions and recommendations for maintaining acceptable indoor air quality should be adequate to reduce or eliminate symptoms. Good industrial hygiene and work practices are likely to prevent symptoms from potent irritants (such as formaldehyde) that may be emitted from CCP. These include adequate ventilation, humidity, and temperature controls; proper housekeeping; minimal hand-to-mouth and hand-to-eye contact; and periodic cleansing of hands.

In addition, NIOSH recommends the following:

<ul> <li>CCP manufacturers and their suppliers are encouraged to follow best practices, such as the Product Stewardship Code of Management Practices [American Chemistry Council 2000]; they should also consider enhancing their product guidance to reﬂect that published studies indicate that irritative symptoms appear to increase with increasing exposure to CCP.</li> <li>CCP manufacturers and their suppliers should also consider how human test procedures (e.g., RIPT) can be modified </li></ul>