title: Association Between Occupational Exposures and Sarcoidosis: An Analysis From Death Certificates in the United States, 1988-1999.
abstract: Sarcoidosis is a disease that is associated with occupational and environmental antigens, in the setting of a susceptible host. The aim of this study was to examine the association between sarcoidosis mortality and previously reported occupational exposures based on sex and race.
  
  
  
  The decedents enrolled in this study were derived from United States death certificates from 1988-1999. Cause of death was coded according to ICD-9 and ICD-10. The usual occupation was coded with Bureau of the Census Occupation Codes. Mortality odds ratio (MOR) were determined and multiple Poisson regression were performed to evaluate the independent exposure effects after adjustment for age, sex, race and other occupational exposures.
  
  
  
  Of the 7,118,535 decedents in our study, 3,393 were identified as sarcoidosis-related, including 1,579 identified as sarcoidosis being the underlying cause of death. The sarcoidosis-related MOR of any occupational exposure was 1.52 (95% CI, 1.35-1.71). Women with any exposure demonstrated an increased MOR compared to women without (MOR 1.65, 95% CI, 1.45-1.89). The mortality risk was significantly elevated in those with employment involving metal working, health care, teaching, sales, banking, and administration. Higher sarcoidosis-related mortality risks associated with specific exposures were noted in women vs men and blacks vs whites.
  
  
  
  Findings of prior occupations and risk of sarcoidosis were verified using sarcoidosis mortality rates. There were significant differences in risk for sarcoidosis mortality by occupational exposures based on sex and race.
authors.affiliation: Division of Environmental and Occupational Health Sciences, National Jewish Health, Denver, CO; Department of Epidemiology and Biostatistics, China Medical University, Shenyang, China.
authors.forename: Hongbo
authors.initials: H
authors.lastname: Liu
authors.affiliation: Division of Pulmonary, Critical Care and Sleep Medicine, University of Florida, Gainesville, FL.
authors.forename: Divya
authors.initials: D
authors.lastname: Patel
authors.affiliation: Division of Environmental and Occupational Health Sciences, National Jewish Health, Denver, CO.
authors.forename: Alison M
authors.initials: AM
authors.lastname: Welch
authors.affiliation: Department of Biostatistics, National Jewish Health, Denver, CO.
authors.forename: Carla
authors.initials: C
authors.lastname: Wilson
authors.affiliation: Division of Environmental and Occupational Health Sciences, National Jewish Health, Denver, CO.
authors.forename: Margaret M
authors.initials: MM
authors.lastname: Mroz
authors.affiliation: Division of Environmental and Occupational Health Sciences, National Jewish Health, Denver, CO; Division of Pulmonary and Critical Care Sciences, Colorado School of Public Health, University of Colorado, Aurora, CO.
authors.forename: Li
authors.initials: L
authors.lastname: Li
authors.affiliation: Division of Environmental and Occupational Health Sciences, National Jewish Health, Denver, CO; Division of Pulmonary and Critical Care Sciences, Colorado School of Public Health, University of Colorado, Aurora, CO; School of Medicine, and Environmental and Occupational Health, Colorado School of Public Health, University of Colorado, Aurora, CO.
authors.forename: Cecile S
authors.initials: CS
authors.lastname: Rose
authors.affiliation: School of Medicine, and Environmental and Occupational Health, Colorado School of Public Health, University of Colorado, Aurora, CO.
authors.forename: Michael
authors.initials: M
authors.lastname: Van Dyke
authors.affiliation: Pulmonary Division, National Jewish Health, Denver, CO; Division of Pulmonary and Critical Care Sciences, Colorado School of Public Health, University of Colorado, Aurora, CO.
authors.forename: Jeffrey J
authors.initials: JJ
authors.lastname: Swigris
authors.affiliation: Division of Environmental and Occupational Health Sciences, National Jewish Health, Denver, CO; Division of Pulmonary and Critical Care Sciences, Colorado School of Public Health, University of Colorado, Aurora, CO.
authors.forename: Nabeel
authors.initials: N
authors.lastname: Hamzeh
authors.affiliation: Division of Environmental and Occupational Health Sciences, National Jewish Health, Denver, CO; Division of Pulmonary and Critical Care Sciences, Colorado School of Public Health, University of Colorado, Aurora, CO; School of Medicine, and Environmental and Occupational Health, Colorado School of Public Health, University of Colorado, Aurora, CO. Electronic address: maierl@njhealth.org.
authors.forename: Lisa A
authors.initials: LA
authors.lastname: Maier
mesh_terms: D000293:Adolescent; D000328:Adult; D001741:Black or African American / Q000706:statistics & numerical data; D000368:Aged; D000067012:Banking, Personal; D002423:Cause of Death; D003132:Commerce; D003644:Death Certificates; D005260:Female; D019981:Health Care Sector; D006801:Humans; D038801:International Classification of Diseases; D008297:Male; D008670:Metals; D008875:Middle Aged; D009026:Mortality; D016273:Occupational Exposure / Q000706:statistics & numerical data*; D016017:Odds Ratio; D016012:Poisson Distribution; D012044:Regression Analysis; D012307:Risk Factors; D012507:Sarcoidosis / Q000453:epidemiology / Q000401:mortality*; D012737:Sex Factors; D013663:Teaching; D014481:United States / Q000453:epidemiology; D044465:White People / Q000706:statistics & numerical data; D055815:Young Adult
chemical_list: D008670:Metals
keywords: mortality; mortality OR; occupational exposure; sarcoidosis
references.citation: Ann Intern Med. 1959 Apr;50(4):879-90
references.pmid: 13637563
references.citation: Am J Epidemiol. 2012 Oct 1;176(7):635-41
references.pmid: 22967742
references.citation: Sarcoidosis Vasc Diffuse Lung Dis. 2012 Oct;29(2):119-27
references.pmid: 23461074
references.citation: Occup Environ Med. 1998 Oct;55(10):657-60
references.pmid: 9930085
references.citation: Sarcoidosis. 1992 Sep;9(2):101-3
references.pmid: 1344050
references.citation: Am J Prev Med. 1998 Apr;14(3):176-83
references.pmid: 9569217
references.citation: Am J Respir Crit Care Med. 2004 Dec 15;170(12):1324-30
references.pmid: 15347561
references.citation: J Toxicol Environ Health A. 2006 Jul;69(13):1261-84
references.pmid: 16754540
references.citation: Am J Respir Crit Care Med. 2011 Jun 1;183(11):1524-30
references.pmid: 21330454
references.citation: Mil Med. 2000 Aug;165(8):630-2
references.pmid: 10957860
references.citation: Chest. 2007 May;131(5):1414-23
references.pmid: 17400664
references.citation: J Occup Environ Med. 2005 Mar;47(3):226-34
references.pmid: 15761318
references.citation: J Ophthalmol. 2014;2014:236905
references.pmid: 24987524
references.citation: Am J Epidemiol. 1997 Feb 1;145(3):234-41
references.pmid: 9012596
references.citation: Lancet. 2014 Mar 29;383(9923):1155-67
references.pmid: 24090799
references.citation: N Engl J Med. 1997 Apr 24;336(17):1224-34
references.pmid: 9110911
references.citation: Chest. 2004 Nov;126(5):1431-8
references.pmid: 15539709
references.citation: Am J Respir Crit Care Med. 1999 Aug;160(2):736-55
references.pmid: 10430755
references.citation: Toxicol Sci. 2003 Nov;76(1):91-101
references.pmid: 12857937
references.citation: Chest. 2003 May;123(5):1527-35
references.pmid: 12740270
references.citation: Am J Ind Med. 1987;11(3):329-42
references.pmid: 3555020
references.citation: Am J Ind Med. 2011 Mar;54(3):175-84
references.pmid: 21298693
references.citation: J Occup Environ Med. 1995 Dec;37(12):1342-7
references.pmid: 8749739
references.citation: Respir Med. 2003 Aug;97(8):978-82
references.pmid: 12924527
references.citation: Clin Genet. 2008 May;73(5):401-12
references.pmid: 18312452
references.citation: Postgrad Med J. 2014 Oct;90(1068):582-9
references.pmid: 25230946
references.citation: J Occup Environ Med. 2011 Sep;53(9):966-74
references.pmid: 21860326
references.citation: Semin Respir Infect. 1998 Sep;13(3):212-20
references.pmid: 9764952
references.citation: J Immunol. 1996 Feb 15;156(4):1540-8
references.pmid: 8568258
references.citation: Chest. 1999 Nov;116(5):1183-93
references.pmid: 10559074
references.citation: Z Erkr Atmungsorgane. 1986;166(2):186-93
references.pmid: 3716495
references.citation: J Womens Health (Larchmt). 2013 Jul;22(7):578-86
references.pmid: 23829184
references.citation: Am J Hum Genet. 2003 Oct;73(4):720-35
references.pmid: 14508706
references.citation: Am J Respir Crit Care Med. 2007 Jan 1;175(1):40-4
references.pmid: 17023727
references.citation: Chest. 2015 Feb;147(2):438-49
references.pmid: 25188873
references.citation: Med Hypotheses. 2012 Jan;78(1):36-8
references.pmid: 22000713
references.citation: Am J Epidemiol. 1981 Jul;114(1):144-8
references.pmid: 7246522
references.citation: Am Rev Respir Dis. 1993 Oct;148(4 Pt 1):974-80
references.pmid: 8214953
references.citation: Occup Environ Med. 2003 Feb;60(2):122-9
references.pmid: 12554840
references.citation: Respir Med. 2000 Aug;94(8):815-20
references.pmid: 10955759
references.citation: J Toxicol Environ Health A. 2004 Jul 9;67(13):1001-26
references.pmid: 15205031
references.citation: Toxicol Sci. 2004 Jul;80(1):34-48
references.pmid: 15056807
references.citation: Respir Med. 2011 Sep;105(9):1373-9
references.pmid: 21704503
references.citation: Free Radic Biol Med. 2003 Jun 15;34(12):1507-16
references.pmid: 12788471
references.citation: Am J Med. 1996 Apr;100(4):423-7
references.pmid: 8610729
references.citation: Curr Opin Allergy Clin Immunol. 2012 Apr;12(2):145-50
references.pmid: 22314258