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 blinded, provocative, cutaneous challenges with alkylphenol novolac resin, a component of CCP. Subsequently, both workers developed hoarseness as a response to other chemicals such as paint, wall paper adhesives, and colognes. Job rotation to positions with minimal or no contact with CCP effectively alleviated health problems in all four workers.

Kanerva et al. 1990a,b; 1993. Kanerva et al. [1990a,b; 1993] investigated the case of a 43-year-old machinist in Finland whose work involved the manufacture of CCP and who developed occupational dermatitis on the hands. The worker was a healthy man with no previous skin disease. He had been employed by the same paper-making company for 23 years. During the last 4 years, he was exposed to the agents used in the CCP manufacturing system—initially, just on the weekends. After a new microcapsule machine was introduced, the patient was given the responsibility of getting the machine into operation. Because of problems with the new machine, his exposure exceeded what would have been expected in normal use. He had direct contact with the microcapsule dispersion and contracted hand dermatitis within a month of the installation of this new machine. Vesicular eczema developed on both hands but cleared over a 3-month sick leave followed by vacation. Upon returning to work, the worker relapsed.

Skin-prick testing was negative for 20 common allergens and natural rubber latex. On skin-patch testing using a series of standard European allergens and CCP, both CCP and one of the chemicals used to produce the microcapsules of CCP provoked a strong (3+) allergic reaction. Analysis of the paper showed that it contained enough DETA to induce allergic contact dermatitis. The patient tested negative to ethylenediamine, para-phenylenediamine, hexamethylenetetramine, 4-tolyldiethanolamine, and triethanolamine; but he cross-reacted to triethylenetetramine and diaminodiphenylmethane. Twenty control subjects were skin-patch tested with the microcapsule dispersion substance, the microcapsule paste, and the paper. They all reacted negatively.

The source of the DETA in this case was its use as a cross-linking agent that was added to a solution of color formers in a suitable organic solvent and then mixed with a polyisocyanate. The authors commented that DETA remained even though the vendor claimed that the process ensures that all of the polyisocyanate has reacted. The authors recommended that workers who handle CCP and develop symptoms of contact dermatitis be skin-patch tested with DETA. This patient was the only one who reacted to DETA among the 20 to 30 subjects tested each year since 1986 at the facility–except for a painter who also tested positive to ethylenediaminetetraacetic acid (EDTA), which was a component of the hardener in an epoxy resin paint.

Burton and Malkin 1993. Burton and Malkin [1993] responded to a management request based on a report that a former worker at the Michigan Printers in Chicago, Illinois, had suffered adverse reactions to CCP and solvents. They conducted an industrial hygiene and medical survey. The facility employed 12 workers in check printing and other offset printing on CCP. Samples of personal breathing zone and area air quality were analyzed for printing solvents and metal particles. Workers were interviewed and work practices were observed. The ventilation units appeared to be operating well and were well maintained. The authors concluded that workers were not overexposed to organic solvents or metals at the time of the survey. Of the 11 workers interviewed, 1 reported chest tightness and cough. The former employee (on which the investigation was based) had reportedly experienced cough,