A cross sectional study of the respiratory health of workers handling printing toner dust

Challenges and Emerging Trends in Toner Waste Recycling: A Review

Toner waste is one of the major electronic waste materials posing serious environmental threat and health hazards. Globally, only about 20–30% of toner waste is recycled, while the remaining percentage is dumped in landfills. Recycling options are limited due to the desirably engineered durability of toners, ascribed to a complicated composition of chemicals, carbon black, and plastic particles, which in turn creates critical challenges in recycling. The World Health Organization has classified toner waste as class 2B carcinogen due to its potential health hazard. In this review, the existing challenges in toner waste recycling are discussed from the perspective of environmental, health, and feasibility aspects. In parallel, the challenges have been opening up alternative strategies to recycle toner wastes. Emerging trends in toner waste recycling include transformation of toner waste into value-added products, utilization as raw material for nanomaterial synthesis, generation of composite electrodes for power generation/storage devices, integration into construction materials, and development of microwave absorbing composites. Considering the enormous volume of toner waste generated globally every year, better recycling and transformation strategies are needed immediately. A circular economy could be established in the future by transforming the enormous toner waste into a resource for other applications. For an effective management of toner waste in the future, an integrated approach involving policies and legislations, infrastructure for collection and treatment, and financial planning among the stakeholders is needed in addition to technological innovations.

A 10-year Follow-up Cohort Study of the Health Effects in Toner-handling Workers

In this study, we compare the results of a cross-sectional survey and secular changes between toner-handling workers and non-toner-handling workers, focusing on blood tests, urinalysis, respiratory function tests, and chest imaging results as indices of health effects. Of 116 employees who participated in the survey conducted at an office equipment manufacturer in Japan, 65 male employees who could be followed up for 10 years were included in the analysis. Thirty-eight workers engaged in toner-handling operations were considered toner-handling workers, and 27 not engaged in these operations were considered non-toner-handling workers. The blood tests (WBC, CRP, IgE, KL-6, and SP-D), urinalysis (8-OHdG), respiratory function tests (PEFR, VC, %VC, FEV_1.0, and FEV_1.0%), chest radiography, and chest CT results were compared between both groups. Non-toner-handling workers had significantly higher 8-OHdG/Cre at baseline and KL-6 at year 10 than did toner-handling workers. There were no significant differences between the results of the cross-sectional survey and a longitudinal survey of respiratory function test results. We conclude that there were no adverse health effects due to toner exposure.

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.

Unusual pneumoconiosis in two patients with heavy print toner, and paper dust exposure

Workers in a print shop are exposed to photocopier toner dust and paper dust over a prolonged period of time. However, there are only rare case reports of toner and paper dust induced lung damage in humans. We reviewed our consultation files for a period of 30 years from 1987 to 2018 to look for cases with a diagnosis of giant cell interstitial pneumonia (GIP), printer toner exposure and paper dust exposure resulting in lung disease. There were two cases which met our inclusion criteria. Slides, clinical histories and imaging were reviewed. Both the patients had worked in print shops, and had no history of exposure to hard metals. Patient 1 presented with shortness of breath and cough over several months, while patient 2 was asymptomatic at presentation. Both the patients underwent surgical lung biopsies. Histopathologic examination from both the cases showed a spectrum of pathology, including features of GIP, desquamative interstitial pneumonia, chronic bronchiolitis with lymphoid hyperplasia, and particulate matter consistent with toner. Energy dispersive spectroscopy was performed on one case, and it revealed no cobalt or tungsten particles. The unusual combination of findings is very suggestive that toner particles with or without paper dust exposure were responsible for the pathologic changes in the lungs of these patients. This possibility should be explored further with additional patients who work in print shops where they are exposed to paper dust and paper toner and have signs or symptoms of diffuse lung disease.

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.

Assessment of environmental and ergonomic hazard associated to printing and photocopying: a review

"Knowledge is power" and distribution of knowledge is fueled by printing and photocopying industry. Even as printing and photocopying industry have revolutionized the availability of documents and perceptible image quickly at extremely inexpensive and affordable cost, the boon of its revolution has turned into a bane by irresponsible, uncontrolled and extensive use, causing irreversible degradation to not only ecosystem by continuous release of ozone and other volatile organic compounds (VOCs) but also the health of workers occupationally exposed to it. Indoor ozone level due to emission from different photocopying equipment's increases drastically and the condition of other air quality parameters are not different. This situation is particularly sedate in extremely sensitive educational and research industry where sharing of knowledge is extremely important to meet the demands. This work is an attempt to catalogue all the environmental as well as health impacts of printing or photocopying. It has been observed that printing/photocopying operation is a significant factor contributing to indoor air quality degradation, which includes increase in concentration of ozone, VOCs, semi-volatile organic compounds (SVOCs) and heavy metals such as cadmium, selenium, arsenic, zinc, nickel, and other pollutants from photocopy machines. The outcome of this study will empower the manufactures with information regarding ozone and other significant emission, so that their impact can be reduced.

Assessing the chronic respiratory health risk associated with inhalation exposure to powdered toner for printing in actual working conditions: a cohort study on occupationally exposed workers over 10 years

BACKGROUND

Little epidemiological evidence exists regarding the chronic respiratory effects of inhaled powdered toner exposure in humans, although several case reports have suggested the existence of lung disorders that might be related to exposure to toner dust.

OBJECTIVE

We aimed to estimate the chronic health risk to humans associated with routine toner dust exposure in copier industry workers under current actual work conditions.

DESIGN

A prospective observational cohort study of occupational population.

METHODS

Changes in chest radiogram, spirometry measurements and serum and urine biomarkers of biomedical responses to extrinsic stress, as well as subjective symptoms were longitudinally observed for up to 10 years in Japanese copier industry workers responsible for the manufacturing, maintenance or recycling of powdered toner or toner-using machines. A total of 694 subjects who did not change their work category during the follow-up and were free from chronic respiratory diseases at the baseline survey provided reliable results on at least three survey occasions during 3 years or more of follow-up.

RESULTS

Typical fibrosis findings associated with pneumoconiosis was not observed on chest radiograms. No significant differences associated with toner exposure were noted in the frequency of new incidence of either non-specific findings on chest radiogram or serum fibrosis biomarkers (sialylated carbohydrate antigen KL-6 and surfactant protein D). However, the exposed subjects tended to show increases in the frequency of respiratory symptoms and reduced spirometry results during the follow-up compared with the control group, although significant differences were only seen in chronic cough.

CONCLUSIONS

Under the current reasonably controlled work environmental conditions, lung fibrotic changes caused by inhaled dust exposure, including powdered toner, appear to be relatively uncommon; however, non-specific temporal irritation causing subjective symptoms and inflammatory responses might exist.

Effects of occupational exposure to noise and dust on blood pressure in Chinese industrial workers

Along with the rapid development of economy and urbanization, noise and air pollution are becoming major occupational health hazards in the process of industrial production. In this study, we collected data from 7293 industrial workers in China. The association between occupational exposure of noise and dust and blood pressure was investigated. Controlling for demographic variables, including sex, age, and length of service, a stepwise regression model with backward elimination was constructed. The results showed that both noise and dust decreased the level of systolic blood pressure (p < 0.001). This finding prompted the manufacturing industry to reduce noise and dust hazards and protect the occupational health of workers. Prospective studies in different populations are still required to verify the net contribution of noise and dust to the decrease in blood pressure.

Health Risks Awareness of Electronic Waste Workers in the Informal Sector in Nigeria

Insight into the health risk awareness levels of e-waste workers is important as it may offer opportunities for better e-waste recycling management strategies to reduce the health effects of informal e-waste recycling. Therefore, this study assessed the knowledge, attitude, and practices associated with occupational health risk awareness of e-waste workers compared with a control group (butchers) in the informal sector in Nigeria. A cross-sectional study was used to assess health risk awareness of 279 e-waste workers (repairers and dismantlers) and 221 butchers from the informal sector in three locations in Nigeria in 2015. A questionnaire was used to obtain information on socio-demographic backgrounds, occupational history, knowledge, attitude, and work practices. The data was analysed using Analysis of Variance. The three job designations had significantly different knowledge, attitude, and practice mean scores (p = 0.000), with butchers consistently having the highest mean scores. Only 43% of e-waste workers could mention one or more Personal Protective Equipment needed for their job compared with 70% of the butchers. The health risk awareness level of the e-waste workers was significantly lower compared with their counterparts in the same informal sector. A positive correlation existed between the workers’ knowledge and their attitude and practice. Therefore, increasing the workers’ knowledge may decrease risky practices.

A cohort study of the acute and chronic respiratory effects of toner exposure among handlers: a longitudinal analyses from 2004 to 2013

This study examines the acute and chronic respiratory effects of toner exposure based on markers for interstitial pneumonia, oxidative stress and pulmonary function tests. A total of 112 subjects working in a Japanese toner and photocopier manufacturing company participated in this study in 2004. We annually conducted personal exposure measurements, pulmonary function tests, chest X-ray examinations, biomarkers, and questionnaires on respiratory symptoms to the subjects. We report in this paper the results of the analysis of combined annual survey point data from 2004 to 2008 and data from three annual survey points, 2004, 2008, and 2013. During these survey periods, we observed that none of subjects had a new onset of respiratory disease or died of such a disease. In both the analyses, there were no significant differences in each biomarker and pulmonary function tests within the subjects, nor between a toner-handling group and a non-toner-handling group, except for a few results on pulmonary function tests. The findings of this study suggest that there were no acute and chronic respiratory effects of toner exposure in this cohort group, although the number of subjects was small and the level of toner exposure in this worksite was low.

A 4-Year Follow-up Cohort Study of the Respiratory Functions in Toner-handling Workers

BACKGROUND

Focusing on the respiratory function for health effect indices, we conducted a cross-sectional study on workers who did and did not handle toner to compare the longitudinal changes.

METHODS

Among 116 individuals who worked for a Japanese business equipment manufacturer and participated in the study, the analysis included 69 male workers who we were able to follow up for 4 years. We categorized the 40 workers engaged in toner-handling work as the exposed group and the 29 workers not engaged in these tasks as the referent group, and compared their respiratory function test results: peak expiratory flow rate (PEFR), vital capacity (VC), predicted vital capacity (%VC), forced expiratory volume in 1 second (FEV1), and forced expiratory volume in 1 second as a percent of forced vital capacity (FEV1%).

RESULTS

The cross-sectional study of the respiratory function test results at the baseline and at the 5(th) year showed no statistically significant differences in PEFR, VC, %VC, FEV1, and FEV1% between the exposed and referent workers. Also, respiratory function time-course for 4 years was calculated and compared between the groups. No statistically significant differences were shown.

CONCLUSION

Our study does not suggest any toner exposure effects on respiratory function. However, the number of subjects was small in our study; studies of larger populations will be desired in the future.

A cohort study using pulmonary function tests and x-ray examination in toner-handling workers: cross-sectional and longitudinal analyses from 2003 to 2008

OBJECTIVES

This study uses pulmonary function tests and chest x-ray examinations to examine the relationship between toner-handling work and its health effects.

METHODS

The subjects were 1504 male workers in a Japanese toner and photocopier manufacturing company, in the age range from 19 to 50 years in 2003. Personal exposure measurements, pulmonary function tests, chest x-ray examinations, biomarker measurements, and a questionnaire about respiratory symptoms were conducted. The present study reports the results of pulmonary function tests and chest x-ray examinations conducted in the subjects, which includes a cross-sectional study on the toner handling and non-handling workers and a longitudinal study from 2003 to 2008.

RESULTS

Few significant findings were suspected to be caused by toner exposure found in pulmonary function indices in both the cross-sectional and longitudinal studies. Any obvious fibrotic findings in chest x-ray findings related to the toner exposure could not be found out.

CONCLUSION

No evidence of adverse effects on pulmonary function indices and chest x-rays was present in the toner-handling workers as compared to the nonspecifically exposed workers. Although the toner exposure concentration is quite low in the current well-controlled working environment, even among the toner-handling workers, we would like to continue this study in the future to verify the toner exposure health effects.

Chronic exposure to emissions from photocopiers in copy shops causes oxidative stress and systematic inflammation among photocopier operators in India

BACKGROUND

We assessed indoor air quality in photocopier centers and investigated whether occupational exposure to emissions from photocopiers is associated with decline in lung function or changes in haematological parameters, oxidative stress and inflammatory status.

METHODS

Indoor air quality was monitored in five photocopier centers. Pulmonary function was assessed by spirometry in 81 photocopier operators (64 male and 17 female) and 43 healthy control (31 male and 12 female) subjects. Hematological status, serum thio-barbituric acid reactive substances (TBARS), total ferric reducing antioxidant capacity (FRAC), leukotriene B4 (LTB4), 8-isoprostane, C reactive protein (CRP), interleukin 8 (IL-8), clara cell protein (CC-16), intercellular adhesion molecule 1 (ICAM-1) and eosinophilic cationic protein (ECP) were analyzed. Relationships between cumulative exposure, lung function and inflammatory markers were assessed.

RESULTS

PM10 and PM2.5 were above the permissible levels in all the photocopier centers, whereas the levels of carbon monoxide, nitrogen oxides, ozone, sulphur dioxide, lead, arsenic, nickel, ammonia, benzene and benzo(a)pyrene were within Indian ambient air quality standards. Lung function was similar in the photocopier operators and control subjects. Serum TBARS was significantly higher and FRAC was lower among photocopier operators when compared to healthy controls. Plasma IL-8, LTB4, ICAM-1 and ECP were significantly higher in the photocopier exposed group.

CONCLUSIONS

Photocopiers emit high levels of particulate matter. Long term exposure to emissions from photocopiers was not associated with decreased lung function, but resulted in high oxidative stress and systemic inflammation leading to high risk of cardiovascular diseases.

State of toner exposure of workers who handle toners

OBJECTIVES

The aim of this study was to ascertain the actual state of toner exposure of workers who handle toner.

METHODS

Personal exposure measurements were conducted on workers handling toner in which the respirable dust (RD) concentration by work type was determined. Targeted work types consisted of "machine recycling", "toner manufacturing", "toner research/development", "machine design/development" and "servicing." The implementation period lasted from April 2003 to March 2011, and measurements were conducted annually. The measurement method conformed to the Japanese Working Environment Measurement Standards (new standards adopted starting in 2005).

RESULTS

Comparing the RD concentrations for fiscal year 2003 by work, significant differences were found between machine recycling and the other four work types, as well as in toner manufacturing and the other four work types. Similarly, based on the new legislative standards applied in Japan from fiscal year 2005, significant differences were found between machine recycling and the other four work types, as well as in toner manufacturing and the other four work types.

DISCUSSION

It is clear that workers engaged in machine recycling and toner manufacturing are exposed to toner, and that a certain level of exposure is continuing. Although it cannot be said that workers involved in toner research/development, machine design/development and servicing have no toner exposure, the concentration is of an extremely low level.

CONCLUSIONS

At present, toner exposure levels by work type can be divided into two groups-one consisting of machine recycling and toner manufacturing, and the other consisting of toner research/development, machine design/development and servicing.

Fine and ultrafine particles emitted from laser printers as indoor air contaminants in German offices

PURPOSE

Various publications indicate that the operation of laser printers and photocopiers may be associated with health effects due to the release of gaseous components and fine and ultrafine particles (UFP). However, only sparse studies are available that evaluate the possible exposure of office workers to printer emissions under real conditions. Therefore, the aim of our study was to assess the exposure of office workers to particulate matter released from laser printers and photocopiers.

METHODS

Concentrations of fine particles and UFP were measured before, during, and after the operation of laser printing devices in 63 office rooms throughout Germany. Additionally, the particles were characterized by electron microscopy and energy-dispersive X-ray spectroscopy.

RESULTS

A significant increase of fine particles and UFP was identified in ambient workplace air during and after the printing processes. Particle fractions between 0.23 and 20 μm emitted by the office machines significantly affect particle mass concentrations while printing 500 pages, i.e., during the printing process, PM(0.23-20), PM(2.5), and PM(10) concentrations increased in 43 out of the evaluated 62 office rooms investigated. Additionally, a significant increase was observed in submicrometer particles, with median particle number concentrations of 6,503 particles/cm(3) before and 18,060 particles/cm(3) during the printing process.

CONCLUSIONS

Our data indicate that laser printers and photocopiers could be a relevant source of fine particles and particularly UFP in office rooms.

Fine and ultrafine particles emitted from laser printers as indoor air contaminants in German offices

PURPOSE

Various publications indicate that the operation of laser printers and photocopiers may be associated with health effects due to the release of gaseous components and fine and ultrafine particles (UFP). However, only sparse studies are available that evaluate the possible exposure of office workers to printer emissions under real conditions. Therefore, the aim of our study was to assess the exposure of office workers to particulate matter released from laser printers and photocopiers.

METHODS

Concentrations of fine particles and UFP were measured before, during, and after the operation of laser printing devices in 63 office rooms throughout Germany. Additionally, the particles were characterized by electron microscopy and energy-dispersive X-ray spectroscopy.

RESULTS

A significant increase of fine particles and UFP was identified in ambient workplace air during and after the printing processes. Particle fractions between 0.23 and 20 μm emitted by the office machines significantly affect particle mass concentrations while printing 500 pages, i.e., during the printing process, PM(0.23-20), PM(2.5), and PM(10) concentrations increased in 43 out of the evaluated 62 office rooms investigated. Additionally, a significant increase was observed in submicrometer particles, with median particle number concentrations of 6,503 particles/cm(3) before and 18,060 particles/cm(3) during the printing process.

CONCLUSIONS

Our data indicate that laser printers and photocopiers could be a relevant source of fine particles and particularly UFP in office rooms.

Genotoxic effects of three selected black toner powders and their dimethyl sulfoxide extracts in cultured human epithelial A549 lung cells in vitro

Until now, the adverse effects of toner powders on humans have been considered to be minimal. However, several recent reports have suggested possible significant adverse health effects from toner dust inhalation. The aim of this study was to evaluate the genotoxic potential of black toner powders in vitro. For the study of DNA damage, A549 cells were exposed to toner-powder suspensions and to their DMSO extracts, and then subjected to the comet assay and to the in-vitro cytokinesis block micronucleus test (CB-MNvit). Cytotoxic effects of the toner samples were assessed by the erythrosin B assay. Furthermore, size, shape, and composition of the toner powders were investigated. None of the three toner powders or their DMSO extracts reduced cell viability; however, they did induce DNA damage and formed micronuclei at concentrations from 80 to 400 μg cm(-2) , although to a varying extent. All toner powders contain considerable amounts of the pigments carbon black and magnetite (Fe(3) O(4) ) as well as small amounts of polycyclic aromatic hydrocarbons (PAHs). The overall results of our in-vitro study suggest that the investigated toner-powder samples are not cytotoxic but genotoxic. From the results of the physical and chemical characterization, we conclude that metals and metalloids as components of magnetite, or PAHs as components of the carbon-bearing material, are responsible for the genotoxic effects. Further research is necessary to determine the relevance of these in-vitro observations for private and occupational toner powder exposure.

Submesothelial deposition of carbon nanoparticles after toner exposition: case report

Inhalation of carbon nanoparticles (CNP) from toner dust has been shown to have impact on the respiratory health of persons exposed. Office printers are known emitters of CNP. We report about a female open office worker who developed weight loss and diarrhoea. Laparoscopy done for suspected endometriosis surprisingly revealed black spots within the peritoneum. Submesothelial aggregates of CNP with a diameter of 31-67 nm were found by scanning and transmission electron microscopy in these tissue specimens. Colon biopsies showed inflammatory bowel disease with typically signs of Crohn disease, but no dust deposits. Transport of CNP via lymphatic and blood vessels after inhalation in the lungs has to be assumed. In this case respiratory symptoms were not reported, therefore no lung function tests were done. We have shown that workers with toner dust exposure from laser printers can develop submesothelial deposition of CNP in the peritoneum. Impact of toner dust exposure on the respiratory health of office workers, as suspected in other studies, has to be evaluated further.

Cross-sectional study on respiratory effect of toner exposure

In this baseline study, part of a cohort study to clarify the effect of toner exposure on the respiratory system, we surveyed 803 male toner workers and 802 referents with regard to their subjective respiratory symptoms and chest X-ray results. We also examined individual exposure history, current working conditions, and personal exposure levels to toner. There was a significantly higher prevalence of "coughing and sputum" related complaints among toner-exposed workers in the 30 and 40-year age groups. The group with toner-exposure history showed a higher odds ratio, by logistic regression, in relation to all questions regarding coughing. Mild fibrotic changes were observed in the chest X-rays of four workers who had engaged in toner-exposure work for at least a decade or more, and all four had reported allergic disease. Although we observed a tendency of higher prevalence of "coughing and sputum" in toner-exposed workers, the possibility of information bias cannot be eliminated. It should also be noted that this tendency did not exceed that of the general public. Further analysis is required in this ongoing 10-year cohort study to clarify the effect of toner exposure on the respiratory system.

Cross-sectional study on respiratory effect of toner-exposed work in manufacturing plants, Japan: pulmonary function, blood cells, and biochemical markers

The aim of the study is to examine the relationship between toner-exposed work and health indices related to respiratory disorders and to confirm the baseline of a cohort study to clarify the effect of toner exposure in manufacturing plants. Subjects were 1614 male workers (809 toner-exposed workers and 805 referents) who were engaged in toner manufacturing plants in Japan (Fuji Xerox Co., Ltd). The age of subjects was from 19 to 59 years, and the average age was 40.2 years(median 40 years, SD 7.67). We conducted a pulmonary function test (PEFR, VC, FVC, FEV(1.0)%, V25/Ht) and a blood cell test (RBC, Hb, Hct, Plt, WBC, cell contents of WBC) and measured biochemical indices in blood (ALT, AST, gamma-GTP, CRP, IgE) and 8-hydroxy-2'-deoxyguanosine (8-OHdG) in urine. Student t-test and logistic regression analysis were applied to compare between the toner-exposed workers and the referents and to analyze the relationship among indices of effects and independent factors. There was no significant difference between the two groups in blood cell count and biochemical indices. Inflammation- and allergy-related markers such as 8OHdG and IgE also showed no significant difference between toner-exposed workers and the referents. The influence of smoking on pulmonary function indices was observed, but there was no relationship between the pulmonary function and toner-exposed work. In this article, we report a preliminary cross-sectional analysis in the subjects of a cohort study. No difference in pulmonary function indices was observed between the toner-exposed workers and the referents, and there was no consistent relationship between the exposure status and examined indices; however, the prevalence of subjective respiratory symptoms was higher in the exposed workers as presented in another report. Further analysis is important in the ongoing cohort study to clarify the effect of toner exposure on respiratory systems.

[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.

A cross-sectional study of respiratory and irritant health symptoms in photocopier workers in Taiwan

Photocopy workers are potentially exposed to high concentrations of a variety of pollutants emitted from photocopiers. The purpose of this study was to assess whether or not there is an excess of adverse health outcomes amongst photocopy employees. A cross-sectional health survey was undertaken to investigate the prevalence of chronic respiratory symptoms and acute irritative symptoms among 74 photocopy workers (exposure group) and 69 employees working in a optical store (control group) near three universities in Kaohsiung, Taiwan. Our study showed that occupational exposure to pollutants emitted from photocopiers was not significantly associated with an excess of chronic respiratory symptoms and acute irritative symptoms in photocopy employees. This study results suggest that the current exposure levels in photocopy centers may be sufficiently safe in well-controlled work environments, especially if the photocopier is handled carefully.