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.
Keywords: Biomarkers; Cohort study; Laser printer; Occupational health; Photocopier; Pneumoconiosis; Respiratory function; Toner; Toner-handling work.