Associations between occupational and environmental exposures and organ involvement in sarcoidosis: a retrospective case-case analysis

Abstract

<b>Background:</b> Sarcoidosis is a systemic disease characterized by the formation of immune granulomas, most frequently in lungs and intrathoracic lymph nodes, but the eyes, skin, liver, spleen, heart, and other organs can also be affected. Many occupational and environmental exposures have been linked to sarcoidosis but their relationship with the disease phenotype has barely been studied. <b>Aims and objectives:</b> Investigating the associations between occupational and environmental exposures and various organ involvements. <b>Methods:</b> We retrospectively studied patients seen at a sarcoidosis clinic between 2017 and 2020. In a case–case analysis using multivariable logistic regression we calculated odds ratios (OR) of prespecified exposure categories (based on expert ascertainment) for cases with a given organ involvement <i>versus</i> cases without this organ involvement. <b>Results:</b> We included 238 sarcoidosis patients. Sarcoidosis limited to lung involvement was associated with exposure to inorganic dust (OR 2.11; <i>P</i>=0.026). Patients with liver involvement had higher odds of contact with livestock (OR 3.68; <i>P</i>=0.047) or having jobs with close human contact (OR 4.33; <i>P</i>=0.003) than patients without liver involvement. Similar associations were found for splenic involvement (livestock: OR 4.94; <i>P</i>=0.008; close human contact: OR 3.78; <i>P</i>=0.005). Cardiac sarcoidosis was associated with exposure to reactive chemicals (OR 5.08; <i>P</i>=0.016) or livestock (OR 9.86; <i>P</i>=0.004). Active smokers had more ocular sarcoidosis (OR 3.26; <i>P</i>=0.008). <b>Conclusions:</b> Our study indicates that, in sarcoidosis patients, different exposures might be related to different organ involvements.