Persistent health complaints attributed to the use of carbonless copy paper by office workers on the campus of the University of Washington led to this preliminary study. The goals were to estimate the extent of the problem in a population of known carbonless copy paper users; to describe those health problems which the users attribute to the use of carbonless copy paper; and to make a preliminary determination of the chemical constituents of the paper. Participants were asked to complete a health questionnaire and to attach to it copies of the forms they used. A minimum estimate of 10.7 health complainants per 100 users was similar to that found by investigators in Denmark, but lower than that reported by other investigators and of anecdotal material reported to the study group. There was a statistically significant association between complainants and the amount of paper used. Reports of headaches and irritation of the skin, eye and respiratory tract were similar to those reported elsewhere. Concurrent factors such as poor ventilation, high temperature and/or low humidity need to be investigated for possible synergistic or additive effects.
Work-related asthma in aluminium potroom workers, is reviewed and discussed, mainly on the basis of own investigations. The occurrence of work-related asthma has been shown to be associated with the duration of potroom employment, although the prevalence of asthmatic symptoms is not significantly different from that of the general population. Typical manifestations of occupational asthma are described in potroom workers, and a close relationship between the levels of fluoride exposure and work-related asthmatic symptoms has been observed. The existence of occupational asthma in aluminium potroom workers has been confirmed by characteristic patterns of repeated peak flow measurements, supported by changes in methacholine responsiveness in workers with suspected work-related asthma. However, no immunological test is available to establish the diagnosis. Methacholine challenge appears to be inappropriate for screening aluminium potroom workers in order to detect work-related asthma. Current smoking, but not self-reported allergy, is a risk factor for potroom asthma. A family history of asthma and previous occupational exposure may have some effect on the risk of developing symptoms. The prognosis of potroom asthma seems to depend on early replacement to unexposed work. The pathogenetic mechanisms are unknown, although some studies indirectly imply a hypersensitivity reaction. Future studies involving specific bronchial challenge appear to be necessary to find the causal agent(s) of aluminium potroom asthma.