Table 8.
Occupational Proportion of Granulomatous Disease Diagnosed as Sarcoidosis
| First Author, Year, Location (Reference) | Study Type | Cases (N) | Disease Definition | Exposure/Job Information | Comments | Occupational Burden (%) |
|---|---|---|---|---|---|---|
| Fireman, 2003, Israel (190) | Case series | 47 | Tissue diagnosis with positive beryllium lymphocyte transformation test | Possible occupational exposure to beryllium | Case series from one outpatient clinic | 6.4 |
| Kucera, 2003, USA (185) | Sibling case–control | 303 | Clinicoradiographic presentation consistent with sarcoidosis | Structured occupational history questionnaire | ACCESS questionnaire for occupational history | 37 |
| Barnard, 2005, USA (183) | Case–control | 706 | Tissue diagnosis with negative beryllium lymphocyte proliferation test | Structured occupational history questionnaire | Multicenter study, ACCESS questionnaire for occupational history | 51.6 |
| Müller-Quernheim, 2006, Germany (189) | Case series | 84 | Clinicoradiographic presentation consistent with sarcoidosis and positive beryllium lymphocyte proliferation test | Possible occupational exposure to beryllium, determined by questionnaire | Prospective study over 7 yr | 40.4 |
| Ribeiro, 2011, Canada (188) | Case series | 121 | Clinicoradiographic presentation consistent with sarcoidosis and positive beryllium lymphocyte proliferation test | Possible occupational exposure to beryllium, determined by questionnaire | No positive beryllium lymphocyte proliferation test results | 0 |
| Cherry, 2015, Canada (193) | Case-referent | 63 | Medical record review, cases with diagnosis of sarcoidosis, referents with other chronic lung disease | Patient interview, employment in an industry with possible exposure to beryllium | Chronic beryllium disease diagnosis based on Glu69 status | 46 |
| Liu, 2016, USA (181) | Population-based mortality | 3,393 | Sarcoidosis death based on cause of death listed on death certificate | Usual occupation on death certificate | Large national dataset | 53.8 |
Definition of abbreviations: ACCESS = A Case-Control Etiologic Study of Sarcoidosis; USA = United States.
Occupational burden is derived from the proportion of occupationally attributed cases in series or derived from a reported odds ratio and proportion of exposed cases. The overall burden of occupationally attributed sarcoidosis is 30% (95% confidence interval, 17–45%).