Although many hospitals are increasingly transitioning to paperless systems, occupational exposure to dusts and vapors from carbonless copy paper (used for medical forms) have historically been linked to adverse health effects, including upper respiratory irritation, other airway obstruction, and contact urticaria (i.e., hives). Tiny micro granules of dyes and resins are released when sheets are pressed together. The released chemicals can be absorbed through the skin or released into the air and inhaled.
Recognized Controls and Work Practices
NIOSH recommends that in most cases, good industrial hygiene and work practices should be adequate to reduce or eliminate symptoms, including:
- Adequate ventilation, humidity, and temperature controls;
- Proper housekeeping;
- Minimal hand-to-mouth and hand-to-eye contact; and
- Periodic cleansing of hands
These recommendations are similar to ones that have been made by other researchers, programs, and agencies in the U.S. and abroad.
- Carbonless Copy Paper. U.S. Department of Health and Human Services (DHHS), National Institute for Occupational Safety and Health (NIOSH) Publication No. 2001-107, (December 2000). This NIOSH report reviews scientific information on health effects associated with occupational exposure to carbonless copy paper and recommends ways to reduce or eliminate symptoms.
- Morgan, M. S., & Camp, J. E. (1986). Upper respiratory irritation from controlled exposure to vapor from carbonless copy forms. Journal of Occupational Medicine: Official Publication of the Industrial Medical Association, 28(6), 415-419.
- LaMarte, F. P., Merchant, J. A., & Casale, T. B. (1988). Acute systemic reactions to carbonless copy paper associated with histamine release. JAMA, 260(2), 242-243.
- Marks, J. G., Trautlein, J. J., Zwillich, C. W., & Demers, L. M. (1984). Contact urticaria and airway obstruction from carbonless copy paper. JAMA, 252(8), 1038-1040.