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This article focuses on various allergic reactions induced by carbonless copy paper. Carbonless copy paper was introduced in the 1950s to replace the need for carbon paper. The top paper is coated on the undersurface with a suspension of microcapsules containing a colorless dye. The receiving paper is coated on the front surface with a color-developing material. When pressure is applied to the top sheet, the microcapsules are broken, allowing the colorless dye to react chemically with the color-developing material on the bottom sheet. Two types of reactions have been reported from this material. One reaction is allergic contact dermatitis to the chemical color former, paratoluene sulfinate of Michler's hydrol.

Background: Alopecia areata is a common disease and may be associated with autoimmune disease, atopy, Down syndrome, emotional stress, and foci of sepsis., Methods: Seven cases of alopecia areata were diagnosed among workers in the Water and Effluent Treatment Sector (WETS) of a paper factory, representing a 0.6% incidence, when the value for the population at large is 0.1%. Three of these workers are assigned to the WETS on a permanent basis and four provide maintenance services. One of the latter patients had alopecia areata that fully regressed. Because biologic treatment of water and effluents involves saprophytic bacteria and fungi as well as chemical substances such as acrylamide, a clinical examination and laboratory tests were performed on all workers assigned permanently to the WETS (N = 9) and on 25% of the workers, selected at random providing services to the sector (N = 14)., Results: There was no association between alopecia areata and atopy, dermatophytosis, or bacteria isolated. Toxicologic evaluation revealed an acrylamide-like substance in 7 workers with alopecia areata, with a statistically significant correlation. Measures were taken at the workplace to decrease worker contact with the mists (probably containing acrylamide) in the pulp-pressing room; no other cases of alopecia areata had been detected 1 year after the study., Conclusions: A survey of the literature did not show reports of alopecia areata as an occupational dermatosis, but our conclusion is, that this dermatosis could be due to the professional activities of the workers at the paper factory studied.