Rhinoconjunctivitis can be caused by allergenic as well as non-allergenic factors. When no allergy is involved, it is important to ask the patient about possible daily exposure to factors that may irritate the mucous membranes. The work environment may play a part, but other things may also be provoking factors, including paper tissues, which, besides the fibres of the paper itself, may contain chemical substances that irritate the mucous membranes. The treatment is to replace the paper tissues with well-washed cotton handkerchiefs. The use of a nasal steroid may be necessary for a short time.