{
  "abstract": "Background Sarcoidosis remains a disease of unknown cause, although current hypotheses suggest environmental triggers cause a dysfunctional immune response in genetically predisposed individuals. The role of occupational exposures, particularly respirable crystalline silica (RCS) in pulmonary sarcoidosis (PS) remains unclear, although consistent association is made.Aim To assess if occupational RCS exposure is associated with PS.Method The SANDSTONE study was a multicentre UK-regional (West Midlands) case-control study of men diagnosed with PS since 2000, compared to hospital outpatient controls. Participants completed lifetime occupational histories (LOH) and limited clinical data was collected from medical records. LOH were coded against the UK SOC 2020 and a UK-specific RCS job exposure matrix (SIMBO-JEM) applied. LOH and subsequently identified exposures for cases were limited to jobs prior to diagnosis. Multivariable Firth logistic regression controlled for age at diagnosis, ethnicity, first degree family history of sarcoidosis, smoking, highest educational attendance, rurality, and deprivation.Results A total of 171 cases and 94 controls participated, with median ages of 51 years (IQR 42–61) and 62 years (IQR 53–70), respectively (p<0.001). Occupational exposure to RCS was significantly associated with increased odds of pulmonary sarcoidosis, with an adjusted odds ratio (OR) of 1.85 (95% CI 1.01 – 3.39; p-value 0.045). A non-statistically significant trend that RCS exposure within 10 years from first exposure (OR 5.41, 95% CI 0.91–32.04, p=0.063) or within 10 years from last RCS exposure (OR 2.61, 95% CI 0.85–8.00, p=0.093) was associated with PS.Discussion RCS exposure is associated with PS. Although not statistically significant, exposure within 10 years of diagnosis, whether first or last, was linked to increased odds of PS. The relatively short latency period may suggest a distinct disease process from that observed in silicosis.",
  "authors": [
    {
      "affiliations": [
        "University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK"
      ],
      "name": "CC Huntley"
    },
    {
      "affiliations": [
        "University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK"
      ],
      "name": "K Nettleton"
    },
    {
      "affiliations": [
        "University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK"
      ],
      "name": "S Wallbanks"
    },
    {
      "affiliations": [
        "University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK"
      ],
      "name": "C Reilly"
    },
    {
      "affiliations": [
        "University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK"
      ],
      "name": "H Morgan"
    },
    {
      "affiliations": [
        "University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK"
      ],
      "name": "T Duffin"
    },
    {
      "affiliations": [
        "University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK"
      ],
      "name": "A Crawshaw"
    },
    {
      "affiliations": [
        "University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK"
      ],
      "name": "T Kharodia"
    },
    {
      "affiliations": [
        "Wye Valley NHS Trust, Hereford, UK"
      ],
      "name": "A Phillips"
    },
    {
      "affiliations": [
        "Wye Valley NHS Trust, Hereford, UK"
      ],
      "name": "S Coelho"
    },
    {
      "affiliations": [
        "Wye Valley NHS Trust, Hereford, UK"
      ],
      "name": "H Bothwell"
    },
    {
      "affiliations": [
        "Royal Wolverhampton NHS Trust, Wolverhampton, UK"
      ],
      "name": "A Fahim"
    },
    {
      "affiliations": [
        "Royal Wolverhampton NHS Trust, Wolverhampton, UK"
      ],
      "name": "U Tomo"
    },
    {
      "affiliations": [
        "University Hospitals North Midlands NHS Trust, Stoke-on-Trent, UK"
      ],
      "name": "S Bikmalla"
    },
    {
      "affiliations": [
        "University Hospitals North Midlands NHS Trust, Stoke-on-Trent, UK"
      ],
      "name": "H Stone"
    },
    {
      "affiliations": [
        "Worcestershire Acute Hospitals NHS Trust, Worcester, UK"
      ],
      "name": "S O’Hickey"
    },
    {
      "affiliations": [
        "Worcestershire Acute Hospitals NHS Trust, Worcester, UK"
      ],
      "name": "A Durie"
    },
    {
      "affiliations": [
        "Sandwell and West Birmingham NHS Trust, Birmingham, UK"
      ],
      "name": "G Hagan"
    },
    {
      "affiliations": [
        "University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK"
      ],
      "name": "G Burge"
    },
    {
      "affiliations": [
        "Applied Health Sciences, University of Birmingham, Birmingham, UK"
      ],
      "name": "AM Turner"
    },
    {
      "affiliations": [
        "University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK"
      ],
      "name": "PS Burge"
    },
    {
      "affiliations": [
        "University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK"
      ],
      "name": "GI Walters"
    }
  ],
  "title": "S111 Sarcoidosis and silica: a case-control study of occupational exposures (sandstone study)",
  "uid": "b82fea8e-2121-52a0-9577-5f74a6452766"
}