Jitter during the reading process, jitter during the burning process, coupled with poor media, poor drives, burning too fast, and the natural decrease in the reflectivity of a cd-r compared to a pressed cd can all contribute to loss in quality.
Are these changes great? No.
Can you notice? Only in an A/B comparison. There aren't 'artifacts' such as those that exist in mp3/wma/ogg/etc. compression, it's just a general loss in clarity.
The easiest thing to notice is a decrease in high-frequency output on some media.
Also, i'm not sure if it's still an issue (mainly because i don't read up on it anymore) but when high-speed recorders first became available, there was a big difference in playback quality depending on burn speeds. New high-end recorders have adjustable laser-intensity, as well as 'writing strategies' that allow the laser to work differently according to the burn speed and media being used.