Occupational toxic particle exposure linked to increased pulmonary sarcoidosis risk in meta-analysis

This systematic review and meta-analysis examined the relationship between occupational exposures to toxic particles and the risk of developing pulmonary sarcoidosis. The analysis included 13 studies published in English from January 2000 to January 2025. The primary outcome assessed was the odds of developing pulmonary sarcoidosis associated with various occupational exposures, including chemicals, inorganic dusts, metals, and organic dusts.

Results indicated that occupational silica exposure was associated with increased odds of pulmonary sarcoidosis, although this risk appeared attenuated in high-quality studies. Similarly, exposure to pesticides and mould/mildew was associated with increased odds, with sensitivity analyses confirming the robustness of the mould association. Exposure to World Trade Center (WTC) dust also showed an association with increased odds, which was confirmed as robust in sensitivity analyses. Conversely, gold exposure was identified as a protective factor against the development of the condition.

Specific effect sizes, absolute numbers, and p-values were not reported in the source data. Safety data, adverse events, and tolerability were not reported. Limitations included the assessment of risk of bias across all included studies and the stratification of sensitivity analyses by study quality. The study aimed to identify specific occupational toxic particles associated with an increased risk of developing pulmonary sarcoidosis.

Future research should prioritize gene-environment interactions and granuloma mineralogy to refine preventive strategies and disease management. Clinicians should interpret these findings with caution regarding causality, as the evidence relies on observational data where confounding factors may influence the observed associations.