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 compared with 52% [36/69]). But those who worked with polymer-based (phenolic) papers reported mucous membrane disorders more often (81% [56/69] compared with 68% [28/41]). Solvents used in the clay paper consisted of hydrogenated terphenyls plus kerosene, and those in the polymer paper consisted of phenylxylylethane plus diisopropylnaphthalene [Norbäck et al. 1988]. Other numbers of symptoms were too small to discern patterns. Of the 35 workers who were skin-patch tested with CCP, none had positive reactions. Environmental factors such as high temperature, low humidity, and dust were thought to be contributing. The authors concluded that it was difficult to decide which symptoms could definitely be correlated with CCP. The prevalence of complaints was 4% of the 3,000 workers who came in contact with CCP; but if slight complaints of doubtful origin were ignored, the prevalence was 2.4%. Symptoms were more severe in those predisposed to allergy, but no allergy to CCP components was demonstrated. Also, the authors remarked that most of the workers interviewed had reported ill health symptoms only after the newspaper publicity had appeared.

Andersson et al. 1980. This Swedish study used a questionnaire to address CCP effects among 158 workers at an insurance office who had reported symptoms of the skin (irritation and itching of hands, forearms, and face), eyes (itching and burning), and mucous membranes (dryness of mouth and throat, nasal stuffiness, and catarrh). To obtain comparative data, the same kind of questionnaire was distributed to four other office places (183 persons). The authors examined the type of paper in question as well as other environmental factors. The prevalence of symptoms increased when subjects were exposed to CCP or to wall-to-wall carpeting. This increase was observed in both atopic and nonatopic patients.

Öberg 1980. As cited in Murray [1991], Öberg conducted a questionnaire study of 205 people; 74% handled more than 10 CCP forms per day. Forty percent of the study population reported symptoms, including itching and dryness of the hands, eyes, and mouth. Four cases of eczema were found. The author reports a dose-response relationship, but Murray suggests that information was inadequate to verify this result.

Sondergard 1981. Sondergard [1981], as cited by Murray [1991] and Olsen and Mørck [1985], conducted a questionnaire study of workers at two locations of Scandinavian Airlines Systems. The frequency of symptoms reported was 73% (68 of 93 workers studied), and the symptom frequency increased with the amount of CCP handled daily (see Table 4–6). The author noted that the dose-response connection was not statistically significant because of the small number of workers in Groups 2 and 4 (numbers were not reported by the reviewers).

Menné et al. 1981. Menné et al. [1981] administered a questionnaire survey to workers at the Danish telephone company; the authors also performed a clinical evaluation of the cases (see Section 4.2.1). Approximately 77% of the workers responded to the questionnaire. Of these, some were eliminated because they did not handle CCP. Of the remaining 1,855 respondents, 208 (11%) indicated that they had experienced skin and/or mucous membrane irritation. Analysis revealed that the symptoms were not related to the type of building in which the subjects worked. According to the authors, the number of CCP contacts per day appeared to be clearly related to the frequency of symptoms: