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Occupational causes of sarcoidosis

Newman, Kira L.; Newman, Lee S.

Current Opinion in Allergy and Clinical Immunology: April 2012 - Volume 12 - Issue 2 - p 145–150
doi: 10.1097/ACI.0b013e3283515173
OCCUPATIONAL DISEASE: Edited by Susan M. Tarlo and Piero Maestrelli

Purpose of review Sarcoidosis, the multiorgan granulomatous disease of unknown cause, remains mysterious. Several important investigations in the past 2 years add to the accumulating evidence for both occupational and environmental causes of granulomatous inflammation.

Recent findings This review considers the most recent studies that contribute to the hypothesis that sarcoidosis occurs when individuals are exposed to foreign antigens and to inorganic particulates that promote inflammation. Major recent findings, such as those emerging from the study of World Trade Center responders, the study of nanoparticles, and cases of work-associated sarcoidosis, support the probability that occupational, as well as environmental, exposures to inflammatory stimuli trigger sarcoidosis-like illness. Major recent studies of microbially rich indoor environments, including moldy indoor workplaces and mycobacterially contaminated settings, contribute to the evidence that a variety of microbial antigens serve as targets for the hypersensitivity immune response in an inflammatory milieu.

Summary There is increasing evidence that sarcoidosis can occur in workplace settings in which there is exposure to both foreign antigens and inorganic triggers of inflammation that promote an exuberant granulomatous immune response. It is likely that sarcoidosis has more than one cause.

aEmory University School of Medicine, Atlanta, Georgia

bColorado School of Public Health and School of Medicine, University of Colorado, Aurora, Colorado, USA

Correspondence to Lee S. Newman, MD, Colorado School of Public Health, University of Colorado, Anschutz Medical Campus, 13001 East 17th Place, B-119, Aurora, CO 80045, USA. Tel: +1 720 480 0992; e-mail:

Copyright © 2012 Wolters Kluwer Health, Inc. All rights reserved.