Another reason to take an extra long holiday break this year: Some commonly used office items -- carbonless (self-copying) paper, photocopiers, display terminals -- can cause a range of health problems, results of a study suggest. Exposure to self-copying paper may trigger headache, eye problems, or respiratory symptoms such wheezing and acute bronchitis in workers. Photocopying appears to be linked to nasal irritation, and working at a video display terminal may be linked to eye symptoms, headache, and lethargy.

The investigators found that handling self-copying paper increases the risk of chronic respiratory symptoms as well as respiratory infections, such as sinusitis and acute bronchitis. For example, workers who handled self-copying paper on a regular basis were at more than 80% higher risk for sore or scratchy throats than unexposed co-workers. Workers in regular contact with self-copying paper also complained more often of eye and skin irritation, headache, and lethargy. They speculate that self-copying paper contains solvents and other chemicals that are inhaled by workers or absorbed via the fingers into eyes and skin.

The actual mechanisms by which these chemicals might trigger symptoms are not known. However, previous studies seem to have ruled out an allergic response as the culprit, pointing instead to the chemicals' toxic effects as a probable cause of illness. The researchers also found that workers who spent a lot of time around copy machines were at high risk for nasal irritation. Previous research has suggested that photocopiers emit chemicals, such as volatile organic compounds, ozone, particles, and resin.

Finally, they found that exposures of at least 11 hours per week to video display terminals -- computer monitors -- was associated with a more than 50% rise in the incidence of headache, compared with workers with little or no exposure to computers. Employees who spent their workdays staring into computer screens were also at a 26% higher risk for fatigue compared with other workers, according to the researchers. Many of the symptoms experienced by the study subjects fall into a general pattern of work-related illness commonly known as 'sick building syndrome.'

While computer screens and photocopiers have been linked to the syndrome in the past, the researchers say associations with self-copying paper have not, to our knowledge, been addressed before. Based on their findings, they suggest that reduction of exposure to carbonless copy paper would be beneficial for office workers.

American Journal of Epidemiology December 1999;150:1223-1228.