Occupational category, job type, and sarcoidosis: Findings from a French multicenter study

OBJECTIVES: Evidence supporting an occupational hypothesis for sarcoidosis remains limited. The hypothesis of the present study was that some occupational exposures might be more prevalent among sarcoidosis patients than in the French population. METHODS: A cross-sectional observational study design was used to collect occupational data from patients enrolled in the Epidemiology ofSarcoidosis (EpiSarc) cohort study with documented sarcoidosis. The data were initiallyclassified according to the occupational classification of the French National Institute ofStatistics and Economic Studies and then compared to employment data fromthe French population for the reference year 2016. RESULTS: Among the 1,512 sarcoidosis patients included, occupational data were avail- able for 1,177 patients (78%). Of these, 1,086 (92%) were employed at time of sarcoidosis diagnosis. Notably, manual workers were significantly overrepresented compared to the general French population (40% versus 20%, p < 0.0001). Among the 471 manual workers, the distribution of occupations was as follows: construction workers (n = 165, 35%), domestic helpers and cleaners (n = 109, 23%), transportation and handling workers (n = 82, 17.5%), manufacturing labourers and industrial operators (n = 67, 14%), textile indus- try workers (n = 25, 5.5%), and other occupations (n = 23, 5%). The frequency of patients with manual working occupations varied depending on the organ involvement, being the highest in patients with lung involvement. CONCLUSION: We found that manual workers occupations with exposure to various environmental hazards that may trigger inflammation promoting an abnormal granulomatous immune response, including dust, were associated with sarcoidosis.