Study links manual work to higher risk of sarcoidosis
Manual laborers particularly prone to pulmonary sarcoidosis, researchers find
Written by |
Manual workers are overrepresented among people with sarcoidosis, a study in France showed. The trend is more pronounced when the disease involves the lungs (pulmonary sarcoidosis).
This supports the hypothesis that occupational exposure to environmental toxins such as dust and chemicals increases the risk of sarcoidosis. It also suggests that this risk may vary between disease subtypes, which could have implications for preventive interventions.
“A more precise identification of the occupations of sarcoidosis patients is a critical step towards more accurately assessing occupational exposure and establishing new research paradigm on emerging environmental factors,” the researchers wrote.
The study, “Occupational category, job type, and sarcoidosis: Findings from a French multicenter study,” was published in Pulmonology.
Sarcoidosis is an immune disease in which clumps of inflammatory cells, called granulomas, form in tissues and organs. While the disease can affect most parts of the body, granulomas in the lungs and chest are particularly common.
Examining a ‘complex interplay’
Scientists don’t entirely understand what causes sarcoidosis, though many hypothesize that genetic predispositions and environmental exposure to toxins could contribute to the abnormal immune response in the disease. Previous research has suggested that workplace exposure to silica, mold/mildew, and pesticides may increase the risk of pulmonary sarcoidosis.
However, “despite numerous reports suggesting that the development of sarcoidosis results from a complex interplay between genetic susceptibility and environmental factors, including occupational exposure … the evidence supporting these hypotheses remains limited,” the researchers wrote.
To investigate the potential link between occupational exposure and sarcoidosis, the team used data from a French sarcoidosis registry. This large, multicenter database identified people with sarcoidosis based on diagnostic codes in their health records.
A total of 1,512 registry participants with a confirmed sarcoidosis diagnosis were included in the study. Their median age at diagnosis was 44 for men and 45.2 for women. Most (94%) showed involvement of the tissues within the thorax, and 67% had pulmonary sarcoidosis.
Employment data at the time of diagnosis was available for 1,177 patients (78%): most (92%) were employed, 7% were unemployed, and 14% were students.
Manual workers accounted for 43.5% of employed participants (57% for men and 27.5% for women), making this the most common job category. Construction work and domestic cleaning were the most common jobs among manual workers, though many patients worked in hospitals. These occupations can expose people to dust, chemicals, and other potential sarcoidosis triggers.
National statistics show that 20.3% of employed people in France were manual workers, a significantly lower proportion than in the sarcoidosis group. “This supports the hypothesis that exposure to environmental dust and toxicants may contribute to the development of granulomas and, consequently, sarcoidosis,” the researchers wrote.
Manual workers were also significantly more likely to have granulomas in certain parts of the body. Manual work was significantly associated with 60% higher odds of pulmonary sarcoidosis and a 90% higher likelihood of severe lung involvement marked by tissue scarring, or fibrosis.
“Our results highlight and confirm a significant association between sarcoidosis and manual occupations, particularly in case of severe respiratory tract involvement,” the team wrote.
Among the study’s limitations, the researchers noted that while they had access to participants’ occupations at the time of diagnosis, they didn’t have complete work histories, which could also be relevant. “The reliance on occupational status at diagnosis without lifetime histories likely underestimates cumulative exposures,” the team wrote.
The scientists also said the registry-based design didn’t allow them to conclude if a person’s current occupation caused granuloma formation, only that there was a correlation between the two.
Leave a comment
Fill in the required fields to post. Your email address will not be published.