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 surfaces of the papers. Tests on the ingredients of the papers were negative. The authors attribute the reactions to nonspecific irritation of the skin.

Maggio et al. 1978. Maggio et al. [1978] reported an investigation of the chemical composition of CCP in Italy. They identified organic dyes dissolved in mineral oil or PCBs enclosed in the microcapsules made of urea-formaldehyde resins or gelatin. The symptoms reported by those using CCP were skin complaints such as acne and general complaints such as headache, nausea, and uncomfortable olfactory sensations. The authors assumed the symptoms to be related to the PCB exposure.

Andanson et al. 1979. In France, Andanson et al. [1979] described the chemical composition of CCP and the spectrum of symptoms resulting from handling sheets of CCP directly or possibly from contact with vapor. The onset of symptoms (reported by 27 of 35 exposed workers) varied but generally developed a few weeks after first exposure. The authors mentioned symptoms of the skin (pruritus of uncovered areas on the hands, face, forearms, thorax, and legs), eyes (pruritus, conjunctival hyperemia with tearing and photophobia), and respiratory system (pruritus, burning, prickling, dysphagia, throat constriction accompanied by rhinorrhea, nasal obstruction, glottal edema, and one case of true immediate asthma). The authors noted that chemical information from the manufacturers was inadequate to relate the symptoms to the exposure and that office environments involved nonexistent or inadequate ventilation. The authors reported that symptoms disappeared soon after exposure ended. They considered the irritant symptoms definitive but performed no tests to assess the allergic potential. The authors concluded that while some of the cases were relatively severe, they did not consider them "a great historic pathology."

Calnan 1979, 1981. Calnan [1979, 1981] reported on three episodes of complaints from various types of office workers in the United Kingdom who attributed their symptoms to the use of CCP. The first episode occurred in 1965 in a group of nine women who worked with business forms in an enclosed computer room at an insurance company. Within a few weeks of the introduction of CCP, several of the women complained of itchy hands, swollen eyelids, and headaches. Skin-patch testing to the paper and all of its constituents was negative. At the time, the solvent for the ink was chlorobiphenyl (a PCB), which was suspected as the causal agent. When ventilation in the workroom was improved, the episode subsided. Soon afterwards, the PCB use was discontinued by all manufacturers.

A second episode occurred in 1975 and involved two men working intensively over a long, hot weekend checking a large number of forms in a small office. One reported a burning sensation on his face and forehead, fatigue, thirst, sore throat and tongue, chills, and aching limbs. He recovered in a few days without treatment, returned to the office to continue his work, and suffered a recurrence of the same symptoms. The other man was similarly but less severely affected and had small, itchy blisters on the centers of his palms.

The third episode described by Calnan occurred in 1976 in a small office where all four workers complained of similar symptoms whenever they handled large amounts of CCP. They reported a burning sensation of the lips and tongue, sore eyes, dry throat, and some dryness of the skin.

Calnan [1979] also reported on complaints from three users of CCP made in Japan. The complaints included nausea, sore eyes and throat, and skin irritation (see Table 4–1).