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Terunuma N, Ikegami K, Kitamura H, Ando H, Kurosaki S, Masuda M, Kochi T, Yanagi N, Fujino Y, Ogami A, Higashi T. Effects of toner-handling work on respiratory function, chest X-ray findings, and biomarkers of inflammation, allergy, and oxidative stress: a 10-year prospective Japanese cohort study. BMC Pulm Med 2020; 20:280. [PMID: 33109132 PMCID: PMC7590607 DOI: 10.1186/s12890-020-01320-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Accepted: 10/19/2020] [Indexed: 01/08/2023] Open
Abstract
Background Exposure to toner, a substance used in photocopiers and printers, has been associated with siderosilicosis and other adverse effects. However, these findings are limited, and there is insufficient evidence on the long-term effects of toner exposure. Using longitudinal analysis, this study aimed to examine the effects of work involving toner exposure on the respiratory system over time. Methods We conducted a prospective cohort study in a Japanese toner and copier manufacturing enterprise between 2003 and 2013. The cohort included a total of 1468 workers, which comprised 887 toner-handling workers and 581 non-toner-handling workers. We subdivided the toner-handling workers into two groups according to the toner exposure concentration, based on the baseline survey in 2003. We compared the chest X-ray results, respiratory function indicators, and serum and urinary biomarkers of inflammation, allergy, and oxidative stress among the three groups: high-concentration toner exposure group, low-concentration toner exposure group, and non-toner-handling group. To consider the effects of individual differences on the longitudinal data, we used a linear mixed model. Results Similar chest X-ray results, the biomarkers, and most of the respiratory function indicators were found in the non-toner-handling and toner-handling groups. There were no significant yearly changes in the percentage of vital capacity (%VC) in the high-concentration toner exposure group, while there was a significant yearly increase in %VC in the low-concentration toner exposure group and non-toner-handling group. The yearly change in each group was as follows: high-concentration toner exposure group, − 0.11% (95% confidence interval [CI], − 0.29 to 0.08; P = 0.250); low-concentration toner exposure group, 0.13% (95% CI, 0.09–0.17; P < 0.001); and non-toner-handling group, 0.15% (95% CI, 0.01–0.20; P < 0.001). Conclusions In our 10-year prospective study, toner-handling work was not associated with the deterioration of respiratory function and an increase in biomarker values for inflammation, allergy, and oxidative stress. This finding suggests that toner-handling work is irrelevant to the onset of respiratory disease and has minimal adverse effects on the respiratory system under a well-managed work environment. Supplementary Information Supplementary information accompanies this paper at10.1186/s12890-020-01320-6.
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Affiliation(s)
- Niina Terunuma
- Department of Work Systems and Health, Institute of Industrial Ecological Sciences, University of Occupational and Environmental Health, Kitakyushu, 807-8555, Japan.
| | - Kazunori Ikegami
- Department of Work Systems and Health, Institute of Industrial Ecological Sciences, University of Occupational and Environmental Health, Kitakyushu, 807-8555, Japan
| | - Hiroko Kitamura
- Department of Work Systems and Health, Institute of Industrial Ecological Sciences, University of Occupational and Environmental Health, Kitakyushu, 807-8555, Japan
| | - Hajime Ando
- Department of Work Systems and Health, Institute of Industrial Ecological Sciences, University of Occupational and Environmental Health, Kitakyushu, 807-8555, Japan
| | - Shizuka Kurosaki
- Department of Work Systems and Health, Institute of Industrial Ecological Sciences, University of Occupational and Environmental Health, Kitakyushu, 807-8555, Japan
| | - Masashi Masuda
- Human Resources Department, AEON Co. Ltd., Chiba, 261-8515, Japan
| | - Takeshi Kochi
- Department of Work Systems and Health, Institute of Industrial Ecological Sciences, University of Occupational and Environmental Health, Kitakyushu, 807-8555, Japan
| | - Nobuaki Yanagi
- Department of Work Systems and Health, Institute of Industrial Ecological Sciences, University of Occupational and Environmental Health, Kitakyushu, 807-8555, Japan
| | - Yoshihisa Fujino
- Department of Environmental Epidemiology, Institute of Industrial Ecological Sciences, University of Occupational and Environmental Health, Kitakyushu, 807-8555, Japan
| | - Akira Ogami
- Department of Work Systems and Health, Institute of Industrial Ecological Sciences, University of Occupational and Environmental Health, Kitakyushu, 807-8555, Japan
| | - Toshiaki Higashi
- Department of Work Systems and Health, Institute of Industrial Ecological Sciences, University of Occupational and Environmental Health, Kitakyushu, 807-8555, Japan
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A Cohort Study on Respiratory Symptoms and Diseases Caused by Toner-Handling Work: Longitudinal Analyses from 2003 to 2013. ATMOSPHERE 2019. [DOI: 10.3390/atmos10110647] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The purpose of this study was to examine the effects of toner-handling work on respiratory symptoms and diseases. We conducted a prospective cohort study of 1468 workers between 2003 and 2013. The cohort included 887 toner-handling workers and 581 non-toner-handling workers, employed in one toner and copier manufacturing enterprise. Toner-handling workers were subdivided into two groups based on the 8-h time-weighted average toner exposure concentration for each work category in the baseline survey. We compared the incidence of respiratory disease and longitudinal changes in the prevalence of subjective respiratory symptoms among three groups, as follows: High-concentration toner exposure group, the low-concentration toner exposure group, and a control group. The incidence of respiratory disease and changes in the prevalence of subjective respiratory symptoms were not significantly different between the non-toner-handling group and the toner-handling group. In contrast, the odds ratio for yearly changes in the prevalence of wheezing without asthmatic response was significantly lower in the high-concentration toner exposure group than in the control group. At the study site, dust scattering was well controlled and workers used respiratory protection appropriately. These findings suggest that toner-handling work had little adverse effect on respiratory function in a work environment with sufficiently controlled ventilation.
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Karrasch S, Simon M, Herbig B, Langner J, Seeger S, Kronseder A, Peters S, Dietrich-Gümperlein G, Schierl R, Nowak D, Jörres RA. Health effects of laser printer emissions: a controlled exposure study. INDOOR AIR 2017; 27:753-765. [PMID: 28054389 DOI: 10.1111/ina.12366] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/05/2016] [Accepted: 12/22/2016] [Indexed: 06/06/2023]
Abstract
Ultrafine particles emitted from laser printers are suspected to elicit adverse health effects. We performed 75-minute exposures to emissions of laser printing devices (LPDs) in a standardized, randomized, cross-over manner in 23 healthy subjects, 14 mild, stable asthmatics, and 15 persons reporting symptoms associated with LPD emissions. Low-level exposures (LLE) ranged at the particle background (3000 cm-3 ) and high-level exposures (HLE) at 100 000 cm-3 . Examinations before and after exposures included spirometry, body plethysmography, transfer factors for CO and NO (TLCO, TLNO), bronchial and alveolar NO, cytokines in serum and nasal secretions (IL-1β, IL-5, IL-6, IL-8, GM-CSF, IFNγ, TNFα), serum ECP, and IgE. Across all participants, no statistically significant changes occurred for lung mechanics and NO. There was a decrease in volume-related TLNO that was more pronounced in HLE, but the difference to LLE was not significant. ECP and IgE increased in the same way after exposures. Nasal IL-6 showed a higher increase after LLE. There was no coherent pattern regarding the responses in the participant subgroups or single sets of variables. In conclusion, the experimental acute responses to short but very high-level LPD exposures were small and did not indicate clinically relevant effects compared to low particle number concentrations.
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Affiliation(s)
- S Karrasch
- Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, Inner City Clinic, University Hospital of Munich, Ludwig-Maximilians-Universität, Munich, Germany
- Institute of Epidemiology I, Helmholtz Zentrum München - German Research Center for Environmental Health, Neuherberg, Germany
| | - M Simon
- Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, Inner City Clinic, University Hospital of Munich, Ludwig-Maximilians-Universität, Munich, Germany
| | - B Herbig
- Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, Inner City Clinic, University Hospital of Munich, Ludwig-Maximilians-Universität, Munich, Germany
| | - J Langner
- Division Materials and Air Pollutants, BAM Federal Institute for Materials Research and Testing, Berlin, Germany
| | - S Seeger
- Division Materials and Air Pollutants, BAM Federal Institute for Materials Research and Testing, Berlin, Germany
| | - A Kronseder
- Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, Inner City Clinic, University Hospital of Munich, Ludwig-Maximilians-Universität, Munich, Germany
| | - S Peters
- Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, Inner City Clinic, University Hospital of Munich, Ludwig-Maximilians-Universität, Munich, Germany
| | - G Dietrich-Gümperlein
- Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, Inner City Clinic, University Hospital of Munich, Ludwig-Maximilians-Universität, Munich, Germany
| | - R Schierl
- Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, Inner City Clinic, University Hospital of Munich, Ludwig-Maximilians-Universität, Munich, Germany
| | - D Nowak
- Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, Inner City Clinic, University Hospital of Munich, Ludwig-Maximilians-Universität, Munich, Germany
- Comprehensive Pneumology Center Munich (CPC-M), Member of the German Center for Lung Research, Munich/Neuherberg, Germany
| | - R A Jörres
- Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, Inner City Clinic, University Hospital of Munich, Ludwig-Maximilians-Universität, Munich, Germany
- Comprehensive Pneumology Center Munich (CPC-M), Member of the German Center for Lung Research, Munich/Neuherberg, Germany
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Morfeld P, Bruch J, Levy L, Ngiewih Y, Chaudhuri I, Muranko HJ, Myerson R, McCunney RJ. Translational toxicology in setting occupational exposure limits for dusts and hazard classification - a critical evaluation of a recent approach to translate dust overload findings from rats to humans. Part Fibre Toxicol 2015; 12:3. [PMID: 25925672 PMCID: PMC4443602 DOI: 10.1186/s12989-015-0079-3] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2014] [Accepted: 01/12/2015] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND We analyze the scientific basis and methodology used by the German MAK Commission in their recommendations for exposure limits and carcinogen classification of "granular biopersistent particles without known specific toxicity" (GBS). These recommendations are under review at the European Union level. We examine the scientific assumptions in an attempt to reproduce the results. MAK's human equivalent concentrations (HECs) are based on a particle mass and on a volumetric model in which results from rat inhalation studies are translated to derive occupational exposure limits (OELs) and a carcinogen classification. METHODS We followed the methods as proposed by the MAK Commission and Pauluhn 2011. We also examined key assumptions in the metrics, such as surface area of the human lung, deposition fractions of inhaled dusts, human clearance rates; and risk of lung cancer among workers, presumed to have some potential for lung overload, the physiological condition in rats associated with an increase in lung cancer risk. RESULTS The MAK recommendations on exposure limits for GBS have numerous incorrect assumptions that adversely affect the final results. The procedures to derive the respirable occupational exposure limit (OEL) could not be reproduced, a finding raising considerable scientific uncertainty about the reliability of the recommendations. Moreover, the scientific basis of using the rat model is confounded by the fact that rats and humans show different cellular responses to inhaled particles as demonstrated by bronchoalveolar lavage (BAL) studies in both species. CONCLUSION Classifying all GBS as carcinogenic to humans based on rat inhalation studies in which lung overload leads to chronic inflammation and cancer is inappropriate. Studies of workers, who have been exposed to relevant levels of dust, have not indicated an increase in lung cancer risk. Using the methods proposed by the MAK, we were unable to reproduce the OEL for GBS recommended by the Commission, but identified substantial errors in the models. Considerable shortcomings in the use of lung surface area, clearance rates, deposition fractions; as well as using the mass and volumetric metrics as opposed to the particle surface area metric limit the scientific reliability of the proposed GBS OEL and carcinogen classification.
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Affiliation(s)
- Peter Morfeld
- Institute for Occupational Epidemiology and Risk Assessment of Evonik Industries, AG Rellinghauser Straße 1-11, Essen, 45128, Germany.
- Institute and Policlinic for Occupational Medicine, Environmental Medicine and Preventive Research, University of Cologne, Cologne, Germany.
| | - Joachim Bruch
- University Duisburg-Essen, Medical Faculty, Essen, Germany.
- IBE GmbH, Cologne, Germany.
| | - Len Levy
- Cranfield University, ᅟ, Cranfield, UK.
| | | | | | | | - Ross Myerson
- Department of Occupational Health, MedStar Washington Hospital Center, Washington, DC, USA.
- The George Washington University School of Public Health, Washington, DC, USA.
| | - Robert J McCunney
- Massachusetts Institute of Technology, Cambridge, MA, USA.
- Brigham and Women's Hospital, Boston, MA, USA.
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