Estimation of indoor air pollutant during photocopy/printing operation: a computational fluid dynamics (CFD)-based study

Population form a homeostat with environment where they live and exchange continuous gas for their respiration, which is the primary pathway for the pollutants to enter into human metabolism. The pollution present indoor is due to multiple sources like electronic and electrical equipment, clothes, furniture and other anthropogenic activity. The concentration of these pollutants changes with time and depends mainly on source type (continuous/intermittent), time of the operation and release/ventilation/wind velocity/pollutant dispersion and anthropogenic activity. It has been observed that equipment like printers, printing machines, photocopiers, etc., releases several pollutants like volatile organic compounds (VOCs), ozone (O₃), semi-volatile organic compounds, benzene (C₆H₆), toluene and suspended particulate matter during operation. This work represents the emissions of VOCs, benzene, and toluene during photocopy. The numerical validation of results was done using Fluent, which is an application-based software which helps in physical modeling describing air flow and effect of multiple parameter on it like temperature and no of printing/photocopy (in proposed experiment) with respect to time. It has been observed from the results that the emissions of VOCs, benzene, and toluene increase from 0.09 to 1.13 PPM, 0.17 to 1.87 PPM and 30 to 235 PPM, respectively, as the operating duration, temperature (35-40 °C) and rate of printing/photocopying increase (120-200/h), and it is because printer/photocopy machine uses heat and pressure to fix an image on the paper surface which subsequently result in higher emission. Multiple adverse health, safety and environmental impacts due to operation of photocopy/printing call for in-depth study, guidance, and monitoring of the workers occupationally associated with this operation for their well-being.

Measurements and health impacts of carbon black and BTEXs in photocopy centers

The purpose of this study was to measure the concentration of carbon black and BTEXs at three photocopy centers and to assess the health risk following exposure. Air samples were collected by sampling in the breathing zone of workers during the class and examination periods. The results found that the concentration of carbon black before operation was higher than morning and afternoon in both class and examination periods. These levels are considerably lower than the suggested limited value set by OSHA. Toluene had the highest concentration but did not exceed of recommended exposure limit by NIOSH. The carbon black and toluene concentrations were higher in examination period than during the normal class period. The results from interview indicate that cough and sneeze are the highest symptom among workers. Carbon black and toluene concentrations in photocopy centers should be concerned in terms of indoor air quality and human health.

Emergency Department Switching and Duplicate Computed Tomography Scans in Patients With Kidney Stones

OBJECTIVE

To test whether duplicate imaging relates to a lack of information sharing among providers, we measured the association between emergency department (ED) switching during a kidney stone episode and receipt of a repeat computed tomography (CT) scan.

METHODS

Using the MarketScan Commercial Claims and Encounters Database, we identified adults between the ages 18 and 64 with an ED visit for a diagnosis of kidney stones. Among patients who had an abdominal or pelvic CT scan at their initial encounter, we then determined the subset that made an ED revisit within 30 days of their first, distinguishing between those to the same vs a different ED. Finally, we fit multivariable logistic regression models to estimate the risk of receiving a repeat CT scan associated with ED switching.

RESULTS

Twelve percent of patients who received a CT scan at their initial ED encounter had a revisit within 30 days of discharge. One-third of their revisits were made to a different ED than the index one. Duplicate CT scans were obtained at nearly 40% of all revisits. On multivariable analysis, the risk of receiving a repeat CT was 12% higher if this revisit was made to a different ED (risk ratio, 1.12; 95% confidence interval, 1.03-1.21; P = .010).

CONCLUSION

Our study reveals that ED switching during an acute kidney stone episode is associated with higher levels of repeat CT imaging. These findings support the role of better health information exchange among providers to help reduce waste in the health-care system.

Using caution with copy and paste

Copy-and-pasting safely. Implement mechanisms that clearly identify copy-and-pasted content and offer data on the source of the text. Train staff on when it's safe to copy and when it's important to manually replicate text. Monitor copy-and-paste use among your staff and warn staff who may be abusing the functionality.

Cytogenetic damage in the buccal cells of photocopying workers in Lahore, Pakistan

OBJECTIVE

To assess the genotoxic effects associated with workers in relation to the emissions at photocopying centres.

METHODS

This case-control study was conducted at the Lahore College for Women University, Lahore, Pakistan, from August to November 2015, and comprised photocopying operators and controls. Micronuclei and other nuclear abnormalities in exfoliated buccal cells were analysed. A structured questionnaire was designed and interviews were conducted face-to-face. Statistical analysis was conducted to evaluate the significance of differences.

RESULTS

Of the 200 participants, there were 100(50%) in each group. There were 24(24%) smokers and 76(76%) non-smokers among the controls compared to 29(29%) smokers and 71(71%) non-smokers among the cases. The mean age was 31.08±10.97 years and 28.19±7.58 years in the controls and the cases, respectively. The frequency of deoxyribonucleic acid damage and cell death parameters was high in photocopying operators compared to the controls (p<0.05). Positive correlation was observed between work span and the frequency of deoxyribonucleic acid damage (r=0.226) and cell death parameters (r=0.115). Smoking was positively associated with the frequencies of deoxyribonucleic acid damage (r=0.65) and cell death parameters (r=0.37). The differences were statistically significant (p<0.001).

CONCLUSIONS

A highly significant difference was observed in deoxyribonucleic acid damage and cell death of workers associated with photocopy profession.

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.

Occupational exposure to nanoparticles at commercial photocopy centers

Photocopiers emit high levels of nanoparticles (PM0.1). To-date little is known of physicochemical composition of PM0.1 in real workplace settings. Here we perform a comprehensive physicochemical and morphological characterization of PM0.1 and raw materials (toners and paper) at eight commercial photocopy centers that use color and monochrome photocopiers over the course of a full week. We document high PM0.1 exposures with complex composition and several ENM in toners and PM0.1. Daily geometric mean PM0.1 concentrations ranged from 3700 to 34000 particles/cubic-centimeter (particles/cm(3)) (GSD 1.4-3.3), up to 12 times greater than background, with transient peaks >1.4 million particles/cm(3). PM0.1 contained 6-63% organic carbon, <1% elemental carbon, and 2-8% metals, including iron, zinc, titania, chromium, nickel and manganese, typically in the <0.01-1% range, and in agreement with toner composition. These findings document widespread ENM in toner formulations and high nanoparticle exposures are an industry-wide phenomenon. It further calls attention to the need to substantially redesign the interface of this technology with workers and consumers.

Effect of body position on vocal tract acoustics: Acoustic pharyngometry and vowel formants

The anatomic basis and articulatory features of speech production are often studied with imaging studies that are typically acquired in the supine body position. It is important to determine if changes in body orientation to the gravitational field alter vocal tract dimensions and speech acoustics. The purpose of this study was to assess the effect of body position (upright versus supine) on (1) oral and pharyngeal measurements derived from acoustic pharyngometry and (2) acoustic measurements of fundamental frequency (F0) and the first four formant frequencies (F1-F4) for the quadrilateral point vowels. Data were obtained for 27 male and female participants, aged 17 to 35 yrs. Acoustic pharyngometry showed a statistically significant effect of body position on volumetric measurements, with smaller values in the supine than upright position, but no changes in length measurements. Acoustic analyses of vowels showed significantly larger values in the supine than upright position for the variables of F0, F3, and the Euclidean distance from the centroid to each corner vowel in the F1-F2-F3 space. Changes in body position affected measurements of vocal tract volume but not length. Body position also affected the aforementioned acoustic variables, but the main vowel formants were preserved.

[Effectiveness assessment of 3-D cone beam CT used in human bite marks identification]

The present study was aimed to use the 3-D cone beam CT (CBCT) as a new method in human bite marks identification which was carried out in experimental pigskin to assess its effectiveness in our laboratory. Bite marks were digital photographed according to American Board of Forensic Odontology (ABFO) guidelines. In this study, the data of the suspect's dental casts were collected by scanning in two ways: one was after plate scanning, in which the comparison overlays were generated by Adobe Photoshop 8.0 software; the other was by CBCT, which generated comparison overlays automatically. The bite marks were blind identified with the two kinds of data of the suspect's dental casts respectively. ROC curve was used to analyze the sensitivity, specificity, and 95% confidence interval. The results showed that CBCT method got a larger area under the ROC curve: 0.784 (SE = 0.074, 95% CI = 0.639-0.929), and got a very high specificity (specificity 98.7%, 95% CI = 94.5%-99.8%). Thus, this study illustrates that the CBCT used in bite mark identification is an effective and accurate tool and has stronger ability to exclude suspects compared with the conventional method, but the comparison process needs further study to enhance its effectiveness in bite mark identification.

Molecular mechanisms underpinning laser printer and photocopier induced symptoms, including chronic fatigue syndrome and respiratory tract hyperresponsiveness: pharmacological treatment with cinnamon and hydrogen

Emissions of laser printers and photocopiers (LP&P) may be associated with health problems. The aim of this review is to describe the clinical picture that is triggered by exposure to LP&P and the molecular mechanisms underpinning the symptoms. Exposure to LP&P to vulnerable subjects may cause a symptom complex consisting of 1) irritation and hyperresponsiveness of the upper and lower respiratory tract; and 2) chronic fatigue (syndrome, CFS). Symptoms occur within hours after L&P exposure and may last for some days or become chronic with exacerbations following LP&P exposure. Substances that can be found in toners or are generated during the printing process are Silica nanoparticles, Titanium Dioxide nanoparticles, Carbon Black, metals, ozone, volatile organic compounds (VOC), etc. The latter may generate oxidative and nitrosative stress (O&NS), damage-associated molecular patterns molecules, pulmonary and systemic inflammation, and modulate Toll Like Receptor 4 (TRL4)‑related mechanisms. It is concluded that LP&P emissions may cause activation of the TLR4 Radical Cycle and thus be associated with the onset of chronic inflammatory and O&NS illnesses, such as CFS, in some vulnerable individuals. Cinnamon, an antagonist of the TLR4 complex, and Hydrogen, a potent antiinflammatory and oxygen radical scavenger, may have efficacy treating LP&P-induced illness.

An experimental test of the accumulated copying error model of cultural mutation for Acheulean handaxe size

Archaeologists interested in explaining changes in artifact morphology over long time periods have found it useful to create models in which the only source of change is random and unintentional copying error, or 'cultural mutation'. These models can be used as null hypotheses against which to detect non-random processes such as cultural selection or biased transmission. One proposed cultural mutation model is the accumulated copying error model, where individuals attempt to copy the size of another individual's artifact exactly but make small random errors due to physiological limits on the accuracy of their perception. Here, we first derive the model within an explicit mathematical framework, generating the predictions that multiple independently-evolving artifact chains should diverge over time such that their between-chain variance increases while the mean artifact size remains constant. We then present the first experimental test of this model in which 200 participants, split into 20 transmission chains, were asked to faithfully copy the size of the previous participant's handaxe image on an iPad. The experimental findings supported the model's prediction that between-chain variance should increase over time and did so in a manner quantitatively in line with the model. However, when the initial size of the image that the participants resized was larger than the size of the image they were copying, subjects tended to increase the size of the image, resulting in the mean size increasing rather than staying constant. This suggests that items of material culture formed by reductive vs. additive processes may mutate differently when individuals attempt to replicate faithfully the size of previously-produced artifacts. Finally, we show that a dataset of 2601 Acheulean handaxes shows less variation than predicted given our empirically measured copying error variance, suggesting that other processes counteracted the variation in handaxe size generated by perceptual cultural mutation.

Copying medical summaries on deceased infants to bereaved parents

AIM

When an infant dies following neonatal intensive care, a detailed medical summary about the infant's life and death is sent to the general practitioner (GP). Our practice is to send an exact copy of this summary to the parents also. We evaluated the opinions of bereaved parents and their GPs on this practice.

METHODS

We carried out a postal questionnaire survey of bereaved parents who had been sent a copy of our medical summary on their deceased infant and their GPs. Parents were asked to rate the summary for its helpfulness, their understanding of it and how distressing it was to receive. We concurrently surveyed via e-mail all paediatricians in our region to ask whether they routinely copied letters to bereaved parents.

RESULTS

Only 3 of 32 (9%) paediatricians routinely copied summaries to bereaved parents. Thirteen of 21 (62%) parents responded: all but one found the copied summary very helpful, most did not find it especially distressing and most reported a fair understanding of it despite its detailed medical content. Almost all their GPs supported copying the summaries to parents.

CONCLUSION

Most bereaved parents welcome an exact copy of the detailed medical summary that provides a complete record of their baby's clinical course, brief life and terminal events.

Minke whale (Balaenoptera acutorostrata) boings detected at the Station ALOHA Cabled Observatory

Minke whales (Balaenoptera acutorostrata) in the tropical North Pacific are elusive and difficult to detect visually. The recent association of a unique sound called the "boing" to North Pacific minke whales has made it possible to use passive acoustics to investigate the occurrence of this species in Hawaiian waters. One year of recordings (17 February 2007-18 February 2008) made at the Station ALOHA Cabled Observatory were examined to investigate the characteristics of boings and temporal patterns in their occurrence at this site, located 100 km north of Oahu. Characteristics of boings exhibited low variability. Pulse repetition rate and duration measurements matched those for "central" or "Hawaii" boing types. Boings were detected from October until May, with a peak in March. Although no boings were detected from June to September, the absence of boings does not necessarily indicate the absence of minke whales. Significant diel variation in boing rate was not observed. The absence of a diel pattern in boing production suggests that day- or night-time acoustic surveys are equally acceptable methods for studying minke whale occurrence. Future research should include efforts to determine what other sounds are produced by minke whales in this area, and which age/sex classes produce boings.

Automatic estimation of the first subglottal resonance

This letter focuses on the automatic estimation of the first subglottal resonance (Sg1). A database comprising speech and subglottal data of native American English speakers and bilingual Spanish/English speakers was used for the analysis. Data from 11 speakers (five males and six females) were used to derive an empirical relation among the first formant frequency, fundamental frequency, and Sg1. Using the derived relation, Sg1 was automatically estimated from voiced sounds in English and Spanish sentences spoken by 22 different speakers (11 males and 11 females). The error in estimating Sg1 was less than 50 Hz, on average.

A generalized baleen whale call detection and classification system

Passive acoustic monitoring allows the assessment of marine mammal occurrence and distribution at greater temporal and spatial scales than is now possible with traditional visual surveys. However, the large volume of acoustic data and the lengthy and laborious task of manually analyzing these data have hindered broad application of this technique. To overcome these limitations, a generalized automated detection and classification system (DCS) was developed to efficiently and accurately identify low-frequency baleen whale calls. The DCS (1) accounts for persistent narrowband and transient broadband noise, (2) characterizes temporal variation of dominant call frequencies via pitch-tracking, and (3) classifies calls based on attributes of the resulting pitch tracks using quadratic discriminant function analysis (QDFA). Automated detections of sei whale (Balaenoptera borealis) downsweep calls and North Atlantic right whale (Eubalaena glacialis) upcalls were evaluated using recordings collected in the southwestern Gulf of Maine during the spring seasons of 2006 and 2007. The accuracy of the DCS was similar to that of a human analyst: variability in differences between the DCS and an analyst was similar to that between independent analysts, and temporal variability in call rates was similar among the DCS and several analysts.

Assessment of the charged aerosol value in copy centers

This study was performed to examine the potential health effects of copiers on their users and relevant workers by evaluating the charged aerosol current generation characteristics and indoor air quality (IAQ) in the copy center. In the 10 copy centers and one control site that were investigated in this study, the charged aerosol generation characteristics (effective levels, charged aerosol current, and charged aerosol concentration) and air pollutants (fine particles, ozone, and nitrogen oxide) were measured indoors and outdoors, and compared. In addition, a six-day continuous measurement was performed in a copy center to assess the charged aerosol generation characteristics according to the copying volume and the copier operation, and their correlation with indoor air pollutants. The indoor and outdoor charged aerosol effective levels in the 10 copy centers were 93.4% and 82.4%, respectively, and they were about 1.4 times higher than the charged aerosol effective level in the indoor control site (66.2%). The comparison of the negative and positive ion currents by space showed that the positive ion current was about 4.2 times higher indoors than outdoors, and about 2.5 times higher during the operation time than during the non-operation time. The indoor charged aerosol concentration (1,512.3 ions/cm(3)) was about 4.6 times higher than the outdoor concentration (325.8 ions/cm(3)), and 19.5 times higher than the indoor charged aerosol concentration in the control site (77.3 ions/cm(3)). Based on these results, it was found that the operation of the copier was an important influential factor of the charged aerosol generation level in the copy center, and that the positive ions were dominant. In the analysis of the correlation between the indoor charged aerosol generation and the air pollutants, the effective level had high positive correlations with the charged aerosol concentration (r=0.938, p<0.01) and O(3) (r = 0.870, p<0.05). The charged aerosol concentration had positive correlations with O(3) (r=0.700) and PM(10) (r=0.479), although the correlations were not statistically significant. In conclusion, it seems that the ultra-fine particles (UFPs, d < 0.1 um ≤ 100 nm) may affect the human respiratory and circulatory systems because they have charged aerosol characteristics. Based on these results, it was found that the operation of the copier was an important influential factor of the charged aerosol generation level in the copy center, and that the positive ions were dominant.

[Occupational exposure to ozone in workers using photocopiers and printers]

BACKGROUND

The issue of occupational exposure to ozone in workers using photocopiers or printers is not frequently addressed in the Polish medical literature. Eye irritation and disorders of upper respiratory system, fatigue and its consequences (headache, malaise, concentration disorders) are the most frequently described health problems.

MATERIAL AND METHODS

Ozone concentrations in particular offices were measured to assess potential health effects of occupational exposure.

RESULTS AND CONCLUSIONS

The obtained results indicate a very low level of ozone concentration in the studied offices (0.012-0.035 mg/m3) hence it can be suggested that the occupational exposure to ozone in those premises is not hazardous to workers. Our own data are close to the observations made by others authors.

Utilization of calcium carbonate particles from eggshell waste as coating pigments for ink-jet printing paper

The effective treatment and utilization of biowaste have been emphasized in our society for environmental and economic concerns. Recently, the eggshell waste in the poultry industry has been highlighted because of its reclamation potential. This study presents an economical treatment process to recover useful bioproducts from eggshell waste and their utilization in commercial products. We developed the dissolved air floatation (DAF) separation unit, which successfully recovered 96% of eggshell membrane and 99% of eggshell calcium carbonate (ECC) particles from eggshell waste within 2 h of operation. The recovered ECC particles were utilized as coating pigments for ink-jet printing paper and their impact on the ink density and paper gloss were investigated. The addition of the ECC particles as coating pigments enhances the optical density of cyan, magenta and yellow inks while decreasing the black ink density and the gloss of the coated paper.

[Study on analysis of copy paper by Fourier transform infrared spectroscopy]

A new method of fast identification of copy papers by Fourier transform infrared spectroscopy (FTIR) was developed. The kinds of filler and the cellulosic degree of crystallinity were analyzed by FTIR, and the ageing curves of cellulosic paper were studied with heating and ultraviolet light. The cellulosic degree of crystallinity was showed by the ratio of absorbance at 1 429 cm(-1) to that at 893 cm(-1), the standard deviation of different brands of copy papers was 0.010 7-0.016 0, and the standard deviation of the same brands of copy papers was 0.014 8. The kinds of filler and the cellulosic degree of crystallinity were different in copy papers from different brands of different manufacturing plants, different brands of same manufacturing plants and different manufacturing times of the same brands from the same manufacturing plants, and the curves of ageing were different with heating and ultraviolet light. The results of fast identification of copy papers by FTIR are satisfactory.

An investigation into the characteristics and formation mechanisms of particles originating from the operation of laser printers

While current research has demonstrated that the operation of some laser printers results in emission of high concentrations of ultrafine particles, fundamental gaps in knowledge in relation to the emissions still remain. In particular, there have been no answers provided to questions such as the following: (1) What is the composition of the particles? (2) What are their formation mechanisms? (3) Why are some printers high emitters, while others are low? Considering the widespread use of printers and human exposure to these particles, understanding the process of particle formation is of critical importance. This study, using state-of-the-art instrumental methods, has addressed these three points. We present experimental evidence that indicates that intense bursts of particles are associated with temperature fluctuations and suggest that the difference between high and low emitters lies in the speed and sophistication of the temperature control. We have also shown, for the first time, that the particles are volatile and are of secondary nature, being formed in the air from VOC originating from both the paper and hot toner. Some of the toner is initially deposited on the fuser roller, after which the organic compounds evaporate and then form particles, through one of two main reaction pathways: homogeneous nucleation or secondary particle formation involving ozone.

A comparison of finger 2D:4D by self-report direct measurement and experimenter measurement from photocopy: methodological issues

The ratio of 2nd and 4th digit length (2D:4D) is sexually dimorphic and may be a correlate of prenatal sex steroids. 2D:4D is often calculated from measurements of photocopies of fingers. However, 2D:4D from photocopies is lower than 2D:4D from direct measurements of the fingers. A new and promising source of 2D:4D measures is self-reports from Internet studies. This necessitates self-report of direct finger measurements and such measurements may be unreliable. In the present study, we compared 2D:4D from self-reported finger lengths measured directly from the fingers (S-R 2D:4D) and experimenter-measured finger lengths from photocopies of the fingers (photo 2D:4D). There were 329 participants (77 men, 252 women) recruited from a first-year undergraduate psychology pool. Compared to photo 2D:4D, (1) S-R 2D:4D tended to include some extreme values; (2) S-R 2D:4D was higher; (3) S-R 2D:4D showed weak similarities which increased when extreme values of S-R 2D:4D were removed; (4) photo 2D:4D and S-R 2D:4D showed lower values for males compared to females but the dimorphism was significant for the former but not for the latter. We conclude that, insofar as S-R 2D:4D has similarities to 2D:4D from Internet studies, the 2D:4D from Internet studies will show extreme values which should be removed, mean 2D:4D will be higher than from photocopy studies, and the sexual dimorphism will be weaker than in photo 2D:4D. We suggest that large samples are necessary in Internet studies of 2D:4D because measurement error will reduce effect sizes.

[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.

Negative Effect of Long-Term Inhalation of Toner on Formation of 8-Hydroxydeoxyguanosine in DNA in the Lungs of Rats In Vivo

We assessed the effects of long-term inhalation of toner on the pathological changes and formation of 8-hydroxydeoxyguanosine (8-OH-Gua) in DNA in a rat model. Female Wistar rats (10 wk old) were divided evenly into a high concentration exposure group (H: 15.2 mg/m(3)), a low concentration exposure group (L: 5.5 mg/m(3)), and a control group. The mass median aerodynamic diameter of the toner was 4.5 microm. The rats were sacrificed at the termination of a 1-yr or 2-yr inhalation period. Pathological examination was performed on the left lung, and the level of 8-OH-Gua in DNA from the right lung was measured using a high-performance liquid chromatography (HPLC) column. The pathological findings showed that lung cancer was not observed in any of the exposed or control groups, though pleural thickening and small foci of collagen were observed in toner-exposed rat lungs. Inhalation of the toner for 1 and even 2 yr did not induce the formation of 8-OH-Gua in DNA in rat lungs. These data suggest that long-term inhalation of toner may not induce lung tumors.

Photocopy machines and occupational antiphospholipid syndrome

Two patients who worked for several years in the operation and maintenance of photocopy machines developed an autoimmune disease. In both, early manifestations were thromboembolic phenomena associated with anticardiolipin antibodies. Joint and kidney involvement emerged later, with the appearance of other autoantibodies. These two patients were occupationally exposed to ultraviolet irradiation, ozone emission, and possibly some oxides of heavy metals. To our knowledge this is the first report of occupational autoimmune disease in photocopy machine workers, and the first description of antiphospholipid syndrome as an occupational disease. The possible cause-effect inter-relationship between their occupational exposure and autoimmune disease is discussed.

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.

Occupational vocal cord dysfunction due to exposure to wood dust and xerographic toner

OBJECTIVES

Vocal cord dysfunction is a poorly understood entity that is often misdiagnosed as asthma. Both irritant and non-irritant vocal cord dysfunction have been described. This report presents two cases of irritant vocal cord dysfunction secondary to specific environmental exposure, the first to iroko and western red cedar wood (a carpenter) and the second to xerographic printing toner (a secretary).

METHODS

Several tests were performed, including chest radiographs, measurements of total serum immunoglobulin E, skin prick tests with common pneumoallergens (as well as iroko and western red cedar in the first case), pulmonary function studies, methacholine challenge testing, specific inhalation challenge performed with suspected agents in a single-blinded fashion, and peak expiratory flow testing and fiberoptic rhinolaryngoscopy (in case 1).

RESULTS

During the specific inhalation challenge, the patients showed dysphonia, chest tightness, inspiratory stridor, and flattening of the inspiratory limb of the maximum flow-volume loop in spirometry, with no significant decreases in the level of forced expiratory volume in 1 second; fiberoptic rhinolaryngoscopy confirmed the diagnosis of vocal cord dysfunction in case 1.

CONCLUSIONS

It is important to know that agents that can cause occupational asthma can also cause vocal cord dysfunction. The mechanisms by which these agents produce vocal cord dysfunction are unknown. The differences in the clinical presentation of the patients described relative to the reported cases suggest that more than one pathophysiological mechanism may be implicated in the genesis of this entity.

Enhancing resilience: families and communities as agents for change

In this article, the Linking Human Systems (LINC) Community Resilience model, a theoretical framework for initiating and sustaining change in communities that have undergone rapid and untimely transition or loss, is presented. The model assumes that individuals, families, and communities are inherently competent and resilient, and that with appropriate support and encouragement, they can access individual and collective strengths that will allow them to transcend their loss. This competence can be nurtured by helping people regain a sense of connectedness with one another; with those who came before them; with their daily patterns, rituals, and stories that impart spiritual meaning; and with tangible resources within their community. Rather than imposing artificial support infrastructures, LINC interventions engage respected community members to act as natural agents for change. These "community links" provide a bridge between outside professionals, families, and communities, particularly in circumstances in which outside intervention may not be welcomed. The article illustrates how LINC interventions successfully have been used in communities around the world.

The film-based printout using Tetenal Printing Solution II

Digital radiography continues to gain in importance in today's surgeries. Compared to conventional x-ray films, it has the following advantages: archiving is improved, film processing is redundant, image post-processing is possible, radiographic images can be sent electronically, and radiation exposure times are shorter. Even though radiographic images are usually interpreted on the monitor, printouts are still required--as experience in general radiology shows--when patient's radiographs are passed on. Of course, printouts of digital images using a standard printer and ordinary paper are not suitable for assessment, due to the properties of the paper. Owing to the structures in the paper, a printout is not transparent, and loses all diagnostic value when inspected on a view box.

Office work exposures [corrected] and respiratory and sick building syndrome symptoms

OBJECTIVES

To assess the relation between exposure to carbonless copy paper (CCP), paper dust, and fumes from photocopiers and printers (FPP), and the occurrence of sick building syndrome (SBS)-related symptoms, chronic respiratory symptoms and respiratory infections.

METHODS

A population-based cross-sectional study with a random sample of 1016 adults, 21-63 years old, living in Pirkanmaa District in South Finland was conducted. This study focused on 342 office workers classified as professionals, clerks or administrative personnel according to their current occupation by the International Standard Classification of Occupations-88. They answered a questionnaire about personal information, health, smoking, occupation, and exposures in the work environment and at home.

RESULTS

In logistic regression analyses adjusting for age, sex and a set of other confounders, all three exposures were related to a significantly increased risk of general symptoms (headache and fatigue). Exposure to paper dust and to FPP was associated with upper respiratory and skin symptoms, breathlessness, tonsillitis and middle ear infections. Exposure to CCP increased the risk of eye symptoms, chronic bronchitis and breathlessness. It was also associated with increased occurrence of sinus and middle ear infections and diarrhoea. A dose-response relations was observed between the number of exposures and occurrence of headache. The risk of tonsillitis and sinus infections also increased with increasing number of exposures. All chronic respiratory symptoms, apart from cough, were increased in the highest exposure category (including all three exposures).

CONCLUSIONS

This study provides new evidence that exposure to paper dust and to FPP is related to the risk of SBS symptoms, breathlessness and upper respiratory infections. It strengthens the evidence that exposure to CCP increases the risk of eye symptoms, general symptoms, chronic respiratory symptoms and some respiratory infections. Reduction of these exposures could improve the health of office workers.