A case control etiologic study of sarcoidosis - Environmental and occupational risk factors
A case control etiologic study of sarcoidosis - Environmental and occupational risk factors
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DOI：
10.1164/rccm.200402-249oc
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发表时间：
2004-12-15
影响因子：
24.7
通讯作者：
Cherniack, R
中科院分区：
文献类型：
--
作者：
Newman, LS;Rose, CS;Cherniack, R
过去的研究表明，环境因素可能与结节病的风险有关。我们进行了一项病例对照研究，以检验环境和职业暴露与结节病相关的先验假设。10个中心招募了706例新诊断的结节病患者和相同数量的年龄、种族和性别匹配的对照组。访谈人员进行问卷调查，其中包含我们在单变量和多变量分析中评估的职业和非职业暴露问题。我们观察到结节病与特定职业之间存在正相关（例如，农业就业，比值比[OR] 1.46，置信区间[CI] 1.13-1.89），暴露（例如，工作中的杀虫剂，OR 1.52，CI 1.14-2.04，以及霉菌/霉菌暴露的工作环境[可能暴露于微生物生物气溶胶的环境]，OR 1.61，CI 1.13-2.31）。吸烟史在病例组中的发生率低于对照组（OR 0.62，CI 0.50-0.77）。在多变量建模中，我们观察到在发霉气味（OR 1.62，CI 1.24-2.11）和职业暴露于杀虫剂（OR 1.61，CI 1.13-2.28）的区域工作的OR升高，而与吸烟相关的OR降低（OR 0.65，CI 0.51-0.82）。该研究没有确定结节病的单一主要原因。我们确定了几种与结节病风险相关的暴露，包括杀虫剂、农业就业和微生物生物气溶胶。
Past research suggests that environmental factors may be associated with sarcoidosis risk. We conducted a case control study to test a priori hypotheses that environmental and occupational exposures are associated with sarcoidosis. Ten centers recruited 706 newly diagnosed patients with sarcoidosis and an equal number of age-, race-, and sex-matched control subjects. Interviewers administered questionnaires containing questions regarding occupational and nonoccupational exposures that we assessed in univariable and multivariable analyses. We observed positive associations between sarcoidosis and specific occupations (e.g., agricultural employment, odds ratio [OR] 1.46, confidence interval [CI] 1.13-1.89), exposures (e.g., insecticides at work, OR 1.52, CI 1.14-2.04, and work environments with mold/mildew exposures [environments with possible exposures to microbial bioaerosols], OR 1.61, CI 1.13-2.31). A history of ever smoking cigarettes was less frequent among cases than control subjects (OR 0.62, CI 0.50-0.77). In multivariable modeling, we observed elevated ORs for work in areas with musty odors (OR 1.62, CI 1.24-2.11) and with occupational exposure to insecticides (OR 1.61, CI 1.13-2.28), and a decreased OR related to ever smoking cigarettes (OR 0.65, CI 0.51-0.82). The study did not identify a single, predominant cause of sarcoidosis. We identified several exposures associated with sarcoidosis risk, including insecticides, agricultural employment, and microbial bioaerosols.