NIOSH Hazard Review: Carbonless Copy Paper

by Centers for Disease Control and Prevention

NIOSH Hazard Review

Carbonless Copy Paper

U.S. Department of Health and Human Services

Public Health Service • Centers For Disease Control and Prevention

National Institute for Occupational Safety and Health

December 2000

[Ordering Information]

Ordering Information

To receive documents or other information about occupational safety and health topics, contact the National Institute for Occupational Safety and Health (NIOSH) at

NIOSH—Publications Dissemination
4676 Columbia Parkway
Cincinnati, OH 45226-1998

Telephone: 1-800-35-NIOSH (1-800-356-4674)
Fax: 1-513-533-8573
E-mail: pubstaft@cdc.gov

or visit the NIOSH Web site at www.cdc.gov/niosh

This document is in the public domain and may be freely copied or reprinted.

---

Disclaimer: Mention of any company or product does not constitute endorsement by NIOSH.

DHHS (NIOSH) Publication No. 2001-107

Contents

Foreword					iii
Executive Summary					iv
Tables					xiii
Figures					xv
Abbreviations					xvi
Acknowledgments					xix
1	Introduction				1
	1.1	Background			1
	1.2	Development and production of CCP			1
	1.3	Reported health effects			2
	1.4	Information sources and types			4
2	The Technology of CCP⁠				5
	2.1	How CCP works			5
	2.2	CCP production			5
	2.3	Microcapsule production			6
	2.4	CCP production process			7
	2.5	Forms production			8
	2.6	Other forms and variations of CCP technology			8
	2.7	Desensitizing inks			9
	2.8	Summary of chemical components of CCP			9
	2.9	Brand names or trademarks for CCP			12
3	Exposure				13
	3.1	Introduction			13
	3.2	Exposure data			13
		3.2.1	Published studies		13
			Jujo Paper Company, Ltd. 1979		13
			Molhave and Grunnet 1981		13
			Gothe et al. 1981 and Norback et al. 1983b		16
			Gockelet al. 1981		16
			Chrostek and Moshell 1982		16
			Norback et al. 1983b		16
			Norback and Gothe 1983		17
			Olsen and Morck 1985		19
			Apol and Thoburn 1986, Chovil et al. 1986, and Burton and Malkin 1993		19
			Omland et al. 1993		19
			Zimmer and Hadwen 1993		19
			Thompson 1996		20
		3.2.2	NIOSH docket submissions		21
			3.2.2.1	Winfield 1983	21
			3.2.2.2	Hazelton Laboratories 1985	21
				Product test methods	21
				Product testing	22
				Office activities	24
	3.3	Conclusions			25
4	Health Effects				28
	4.1	Introduction			28
	4.2	Human studies			29
		4.2.1	Published case reports and case series		29
			Magnusson 1974		30
			Hannuksela 1975		30
			Wahlberg 1975		30
			Hirvonen et al. 1976		30
			Maggio et al. 1978		36
			Andanson et al. 1979		36
			Calnan 1979, 1981		36
			Cronin 1980		37
			Dodds and Butler 1981		37
			Marks 1981		37
			Menne' et al. 1981		37
			Chrostek and Moshell 1982		38
			Levy and Hanoa 1982		38
			Roure et al. 1982		39
			Certin and Zissu 1983		39
			Norback et al. 1983a,b,c; 1988		39
			Jeansson et al. 1983, 1984		40
			Marks et al. 1984; Trautlein et al. 1984		40
			Messite and Baker 1984; Messite and Fannick 1980		40
			Menne' and Hjorth 1985		41
			Olsen and Morck 1985		41
			Apol and Thoburn 1986		41
			Bennett and Chrostek 1986		42
			ChoViletal.1986		42
			Shehade et al. 1987		42
			LaMarte et al. 1988		43
			Hammel 1990		43
			Kanerva et al. 1990a,b; 1993		44
			Burton and Malkin 1993		44
			Sim and Echt 1993		45
			Zimmer and Hadwen 1993		45
			Ziem and McTamney 1997		45
			Smith et al. 1999		46
		4.2.2	NIOSH docket submissions		46
			4.2.2.1	Unpublished case reports and case series submitted by individuals	46
			4.2.2.2	Inquires about health effects submitted by CCP manufacturers	47
				Appleton Papers, Inc., 1987	47
				Moore Business Forms, Inc., 1987	47
				CCP Manufacturers 1998	47
		4.2.3	Cross-sectional studies		48
			4.2.3.1	Cross-sectional studies of indoor air contaminants	57
				Skov et al. 1987, 1989	57
				Zweers et al. 1992	58
				Mendell 1991 and Fiske et al. 1993	58
				Omland et al. 1993	58
				Jaakkola and Jaakkola 1999	58
			4.2.3.2	Cross-sectional studies of CCP exposures	61
				Fristedt and Pettersson 1980	61
				Andersson et al. 1980	63
				Cberg 1980	63
				Sondergard 1981	63
				Menne' et al. 1981	63
				Gothe et al. 1981 and Norback et al. 1983b	64
				Kolmodin-Hedman et al. 1981	66
				Kleinman and Horstman 1982	66
				Pryor et al. 1983	67
				Olsen and Morck 1985	67
				Omland et al. 1993	67
				Apol and Thoburn 1986	71
		4.2.4	Laboratory studies in humans		71
4.2.4.1			Peer-reviewed literature studies	71
			Nilzen 1975	71
	Jeansson et al. 1983, 1984		74
	Morgan and Camp 1986		75
4.2.4.2	NIOSH docket submissions		75
	RIPT studies		75
	Tests under simulated conditions of use		98
4.2.4.3	Summary		99
4.3	Animal Studies			99
	4.3.1	Published studies		99
		Hasegawa et al. 1982a		99
		Hasegawa et al. 1982b		99
		Lofroth 1982		99
		Certin and Zissu 1983		100
		Cameron et al. 1986		101
		Wolkoffet al. 1988		101
		Anderson 1992		101
	4.3.2	NIOSH docket submissions		102
	4.3.3	Summary		105
5	Summary and Conclusions⁠				107
	5.1	Irritation of the skin, eyes, and upper respiratory tract			107
		5.1.1	Strength of the association		110
		5.1.2	Consistency		110
		5.1.3	Specificity		110
		5.1.4	Relationship in time (temporality)		111
		5.1.5	Biological gradient		111
		5.1.6	Biological plausibility		111
		5.1.7	Coherence		112
		5.1.8	Experimental evidence		112
		5.1.9	Reasoning by analogy		113
		5.1.10	Summary		113
	5.2	Allergic contact dermatitis			113
	5.3	Systemic reactions			114
	5.4	Conclusions			114
6	Recommendations				117
	6.1	Historical recommendations in the scientific literature			117
	6.2	NIOSH recommendations			118
References					120
Other publications examined					129