Airborne occupational exposures associated with pulmonary sarcoidosis: a systematic review and meta-analysis
Huntley, Christopher C Patel, Ketan Mughal, Aishah Z Coelho, Shirley Burge, P Sherwood Turner, Alice M Walters, Gareth I
Huntley, Christopher C
Patel, Ketan
Mughal, Aishah Z
Coelho, Shirley
Burge, P Sherwood
Turner, Alice M
Walters, Gareth I
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Affiliation
University Hospitals Birmingham; University of Birmingham; Wye Valley NHS Trust
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Publication date
2023-08-28
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Abstract
The aetiology and pathophysiology of sarcoidosis is ill defined-current hypotheses centre on complex genetic-immune-environmental interactions in an individual, triggering a granulomatous process. The aim of this systematic review is to define and describe which airborne occupational exposures (aOE) are associated with and precede a diagnosis of pulmonary sarcoidosis. The methodology adopted for the purpose was systematic review and meta-analyses of ORs for specified aOE associated with pulmonary sarcoidosis (DerSimonian Laird random effects model (pooled log estimate of OR)). Standard search terms and dual review at each stage occurred. A compendium of aOE associated with pulmonary sarcoidosis was assembled, including mineralogical studies of sarcoidosis granulomas. N=81 aOE were associated with pulmonary sarcoidosis across all study designs. Occupational silica, pesticide and mould or mildew exposures were associated with increased odds of pulmonary sarcoidosis. Occupational nickel and aluminium exposure were associated with a non-statistically significant increase in the odds of pulmonary sarcoidosis. Silica exposure associated with pulmonary sarcoidosis was reported most frequently in the compendium (n=33 studies) and was the most common mineral identified in granulomas. It was concluded that aOE to silica, pesticides and mould or mildew are associated with increased odds of pulmonary sarcoidosis. Equipoise remains concerning the association and relationship of metal dusts with pulmonary sarcoidosis.
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Huntley CC, Patel K, Mughal AZ, Coelho S, Burge PS, Turner AM, Walters GI. Airborne occupational exposures associated with pulmonary sarcoidosis: a systematic review and meta-analysis. Occup Environ Med. 2023 Aug 28:oemed-2022-108632. doi: 10.1136/oemed-2022-108632. Epub ahead of print. PMID: 37640537.
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Article