Association of metal working with sarcoidosis and chronic beryllium disease

<bold>Background:</bold> The cause of sarcoidosis is yet unknown. Occupation has been suggested to play a role. Chronic beryllium disease (CBD), which is almost identical to sarcoidosis, is caused by inhalation of beryllium. Our aim was to find occupations associated with these diseases. <bold>Methods:</bold> 2 populations were retrospectively analysed: Of 323 patients with sarcoidosis, 255 could be classified according to the 2010 German Classification of Occupations (KldB). These were compared to the 2021 microcensus, a survey of the general German population. In patients who received beryllium lymphocyte proliferation tests for suspected beryllium exposure, of 87 patients with CBD and 106 with sarcoidosis, 80 and 91, respectively could be classified and compared with each other. <bold>Results:</bold> Metal working (KldB 24) was positively associated with sarcoidosis (9.4% vs. 2.9%, OR 3.46 (2.28-5.24)), education/social work (KldB 83) negatively (0.8% vs. 5.3%, OR. 14 (.03-.49)). Other occupations did not significantly differ from the general population KldB 24 was more frequent in CBD than sarcoidosis (52.5% vs. 34.1%, OR 2.14 (1.14-3.94)), although after adjustment for multiple comparison, this difference was not significant (p =. 36). Other occupations did not differ between groups. <bold>Discussion:</bold> Metal working was associated with sarcoidosis, suggesting a possible aetiological link. When beryllium exposure was suspected, the proportion of classic metal workers appeared even higher in CBD than in sarcoidosis, although the sample size was too small to reach significance. These results suggest testing for beryllium sensitisation but also considering causal exposition to other metals in metal workers with apparent sarcoidosis, to further explore the aetiology of sarcoidosis.