PULMONARY RESPONSE TO TONER, TiO2 AND CRYSTALLINE SILICA UPON CHRONIC INHALATION EXPOSURE IN SYRIAN GOLDEN HAMSTERS

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

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.

A Cohort Study on Respiratory Symptoms and Diseases Caused by Toner-Handling Work: Longitudinal Analyses from 2003 to 2013

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.

Negligible respiratory irritation and inflammation potency of pigmentary TiO2 in mice

Titanium dioxide (TiO2) is manufactured in millions of tons yearly, and it is used widely as pigment in various applications. Until recently, TiO2 was considered toxicologically harmless and without adverse health effects. In this study, respiratory irritation and inflammation potencies of commercially available pigmentary TiO2 particles (<5 µm, rutile) were studied. Single head-only exposures (30 min) of male Crl:OF1 mice at mass concentrations 6, 11, 21, and 37 mg/m3, and repeated exposures (altogether 16 h, 1 h/day, 4 days/week for 4 weeks) of female BALB/c/Sca mice at mass concentration of 16 mg/m3 to pigmentary TiO2 were conducted. Minor sensory irritation was observed during acute and repeated exposures seen as elongation of the break after the inhalation, which is typical in sensory irritation, and caused by closure of the glottis inhibiting airflow from the lungs after inspiration. No pulmonary irritation, airflow limitation, nasal or pulmonary inflammation was observed. In conclusion, the respiratory irritation and inflammation potencies of the studied pigmentary TiO2 particles seemed to be low and thus can serve as an ideal control exposure agent in short-term studies in mice.

Pulmonary responses to printer toner particles in mice after intratracheal instillation

The release of ultrafine particles from office equipment is currently receiving great concerns due to its potential threat to human health when inhaled. Printer toner is one of the largest consumables in daily office work, and the particles released from printers and photocopiers may pose damage to respiratory system. In this study, we found the particles can be released into the surrounding environment during the printing process and the concentrations of PM(2.5) and PM(10) particles increased obviously. To evaluate the time-course pulmonary responses caused by toner particles, the toner suspension was instilled into the lungs of the male mice through intratracheally instillation every other day for four times and the pulmonary responses of the lung were monitored at days 9, 28, 56 and 84. Indeed, mice treated with toner particles displayed a slower body weight growth rate during the recovery phase. The total cell number in bronchoalveolar lavage fluids (BALF) of toner-exposed groups was much higher than the saline-treated groups. The total protein, lactate dehydrogenase and acid phosphatase in BALF exhibited significant changes (p<0.05 or p<0.01) at different time points. The nitric oxide synthase, interleukin 1-beta, and interleukin 6 in the lung tissue of the toner-exposed groups also exhibited significant changes (p<0.05 or p<0.01). The pathological examination showed that toner particles can adhere to the alveolar septal walls, then enter into the alveoli and cause pulmonary lesion. During the experimental period, particles phagocytosed by alveolar macrophages (AMs) led to an increase of both AMs number and apoptosis. The pulmonary stress still remained over time even with a clearance period for 12 weeks. These results indicate that exposure to toner particles can inhibit the normal growth of the mice and induce significant inflammatory responses and lesion in the lung tissues. The health and safety effects from working indoors in offices with fumes and particles released from photocopiers and printers need to be paid more attention.

[New investigation of the effect of toner and its by-products on human health and occupational health management of toner]

We need a new investigation of the effect of not only toner but also of its by-products on human health, because of the generation of fine particles and the release of volatile organic compounds (VOC) in the process of photocopy. Therefore, we gathered epidemiological and animal data on toner and its by-products, and examined the occupational health management of toner. We examined the effect of carbonblack as the main component of toner, and titanium dioxide and amorphous silica as surface-adhesive nanomaterials, and VOC on human health, and reviewed them. We summarize the results as follows. 1) High sensitive c-reactive protein in serum, 8-hydroxydeoxyguanosine in urine, and heart rate variability (HRV) are useful for biological monitoring of exposure to toner and its by-products. 2) Particle number concentrations have been often measured by scanning mobility particle sizer (SMPS) compared with other apparatus, although this is not measurement gold standard. Taken together, we have examined whole occupational health management of toner and its by-products.

Pulmonary toxicity study in rats with three forms of ultrafine-TiO2 particles: Differential responses related to surface properties

Surface properties are critical to assess effects of ultrafine-TiO(2) particles. The aim of this study was to assess lung toxicity in rats of newly developed, well characterized, ultrafine-TiO(2) particles and compare them to TiO(2) samples in two different size ranges and surface modifications. Groups of rats were intratracheally instilled with doses of 1 or 5mg/kg of either two ultrafine rutile TiO(2) particles (uf-1 or uf-2); rutile R-100 fine-TiO(2) (F-1); 80/20 anatase/rutile P25 ultrafine-TiO(2) (uf-3); or alpha-quartz particles. Phosphate-buffered saline (PBS) solution instilled rats served as vehicle controls. Following exposures, the lungs of PBS and particle-exposed rats were evaluated for bronchoalveolar lavage (BAL) fluid inflammatory markers, cell proliferation, and by histopathology at post-instillation time points of 24h, 1 week, 1 and 3 months. The ranking of lung inflammation/cytotoxicity/cell proliferation and histopathological responses was quartz>uf-3>F-1=uf-1=uf-2. Exposures to quartz and to a lesser degree, uf-3 anatase/rutile TiO(2) particles produced pulmonary inflammation, cytotoxicity and adverse lung tissue effects. In contrast, exposures to F-1 fine-TiO(2) particles or to uf-1/uf-2 ultrafine-TiO(2) particle-types produced transient inflammation. We conclude that differences in responses to anatase/rutile uf-3 TiO(2) particles versus the rutile uf-1 and uf-2 TiO(2) particles could be related to crystal structure, inherent pH of the particles, or surface chemical reactivity. Thus, based on these results, inhaled rutile ultrafine-TiO(2) particles are expected to have a low risk potential for producing adverse pulmonary health effects. Finally, the results demonstrate that exposures to ultrafine-TiO(2) particle-types can produce differential pulmonary effects, based upon their composition, and crystal structure. Thus, the lung toxicity of anatase/rutile uf-3 should not be viewed as representative for all ultrafine-TiO(2) particle-types.

Pulmonary responses of mice, rats, and hamsters to subchronic inhalation of ultrafine titanium dioxide particles

A multispecies, subchronic, inhalation study comparing pulmonary responses to ultrafine titanium dioxide (uf-TiO(2)) was performed. Female rats, mice, and hamsters were exposed to aerosol concentrations of 0.5, 2.0, or 10 mg/m(3) uf-TiO(2) particles for 6 h/day, 5 days/week, for 13 weeks. Following the exposure period, animals were held for recovery periods of 4, 13, 26, or 52 weeks (49 weeks for the uf-TiO(2)-exposed hamsters) and, at each time point, uf-TiO(2) burdens in the lung and lymph nodes and selected lung responses were examined. The responses studied were chosen to assess a variety of pulmonary parameters, including inflammation, cytotoxicity, lung cell proliferation, and histopathological alterations. Retained lung burdens increased in a dose-dependent manner in all three species and were at a maximum at the end of exposures. Mice and rats had similar retained lung burdens at the end of the exposures when expressed as mg uf-TiO(2)/mg dry lung, whereas hamsters had retained lung burdens that were significantly lower. Lung burdens in all three species decreased with time after exposure, and, at the end of the recovery period, the percentage of the lung particle burden remaining in the 10 mg/m(3) group was 57, 45, and 3% for rat, mouse, and hamster, respectively. The retardation of particle clearance from the lungs in mice and rats of the 10 mg/m(3) group indicated that pulmonary particle overload had been achieved in these animals. Pulmonary inflammation in rats and mice exposed to 10 mg/m(3) was evidenced by increased numbers of macrophages and neutrophils and increased concentrations of soluble markers in bronchoalveolar lavage fluid (BALF). The initial neutrophil response in rats was greater than in mice, whereas the relative increase of macrophages was less than in mice. The neutrophilic response of rats, but not mice, declined in a time-dependent manner correlating with declining lung burdens; however, the fraction of recovered neutrophils at 52 weeks postexposure was equivalent in the two species. Consistent increases in soluble indicators of toxicity in the BALF (LDH and protein) occurred principally in rats and mice exposed to 10 mg/m(3) and diminished with time postexposure. There were no significant changes in cellular response or with markers indicating toxicity in hamsters, reflecting the capacity of these animals to rapidly clear particles from the lung. Progressive epithelial and fibroproliferative changes were observed in rats of the 10 mg/m(3) group. These lesions consisted of foci of alveolar epithelial proliferation of metaplastic epithelial cells (so-called alveolar bronchiolization) circumscribing aggregated foci of heavily particle-laden macrophages. The observed epithelial proliferative changes were also manifested in rats as an increase in alveolar epithelial cell labeling in cell proliferation studies. Associated with these foci of epithelial proliferation were interstitial particle accumulation and alveolar septal fibrosis. These lesions became more pronounced with increasing time postexposure. Epithelial, metaplastic, and fibroproliferative changes were not noted in either mice or hamsters. In summary, there were significant species differences in the pulmonary responses to inhaled uf-TiO(2) particles. Under conditions where the lung uf-TiO(2) burdens were equivalent, rats developed a more severe inflammatory response than mice and, subsequently, developed progressive epithelial and fibroproliferative changes. Clearance of particles from the lung was markedly impaired in mice and rats exposed to 10 mg/m(3) uf-TiO(2), whereas clearance in hamsters did not appear to be affected at any of the administered doses. These data are consistent with the results of a companion study using inhaled pigmentary (fine mode) TiO(2) (Bermudez et al., 2002) and demonstrate that the pulmonary responses of rats exposed to ultrafine particulate concentrations likely to induce pulmonary overload are different from similarly exposed mice and hamsters. These differences can be explained both by pulmonary respy response and by particle dosimetry differences among these rodent species.

A biomathematical model of particle clearance and retention in the lungs of coal miners

To understand better the factors influencing the relationships among airborne particle exposure, lung burden, and fibrotic lung disease, we developed a biologically based kinetic model to predict the long-term retention of particles in the lungs of coal miners. This model includes alveolar, interstitial, and hilar lymph node compartments. The 131 miners in this study had worked in the Beckley, West Virginia, area and died during the 1960s. The data used to develop this model include exposure to respirable coal mine dust by intensity and duration within each job, lung and lymph node dust burdens at autopsy, pathological classification of fibrotic lung disease, and smoking history. Initial parameter estimates for this model were based on both human and animal data of particle deposition and clearance and on the biological and physical factors influencing these processes. Parameter estimation and model fit to the data were determined using least squares. Results show that the end-of-life lung dust burdens in these coal miners were substantially higher than expected from first-order clearance kinetics, yet lower than expected from the overloading of alveolar clearance predicted from rodent studies. The best-fitting and most parsimonious model includes processes for first-order alveolar-macrophage-mediated clearance and transfer of particles to the lung interstitium. These results are consistent with the particle retention patterns observed previously in the lungs of primates. The findings indicate that rodent models extrapolated to humans, without adjustment for the kinetic differences in particle clearance and retention, would be inadequate for predicting lung dust burdens in humans. Also, this human lung kinetic model predicts greater retained lung dust burdens from occupational exposure than predicted from current human models based on lower exposure data. This model is useful for risk assessment of particle-induced lung diseases, by estimating equivalent internal doses in rodents and humans and predicting lung burdens in humans with occupational dust exposures.

Comparison of human and rodent lung dosimetry models for particle clearance and retention

Interspecies differences in the kinetics and/or mechanisms of particle retention can influence the amount and location of particle retention in the lungs, which can also influence the tissue response to a given particle burden. Dosimetric models may be used to adjust for differences in the exposure-dose relationships in different species, thus allowing for comparison of lung responses at equivalent doses. Although the rat is one of the most frequently used animal models for assessing the risk of exposures to hazardous substances in humans, few data are available for comparison of human and animal responses to inhaled particles. A biologically-based human dosimetric lung model was developed to describe the fate of respirable particles in the lungs of humans, using data from U.S. coal miners and assumptions about the overloading of alveolar clearance from studies in rats. This model includes alveolar, interstitial, and hilar lymph node compartments. The form of the model that provides the best fit to the lung dust burden data in these coal miners includes a first-order interstitialization process and either no dose-dependent decline in alveolar clearance or much less decline than expected from rodent studies. These findings are consistent with the particle retention patterns observed previously in the lungs of primates. This human lung dosimetry model is useful for investigating the factors that may influence the relationships between the airborne particle exposure, lung dust burden, and fibrotic lung disease.