Sarcoidosis in Northern Ontario hard‐rock miners: A case series

Sarcoidosis is a rare multisystem granulomatous disease traditionally considered to be of unknown etiology. The notion that sarcoidosis has no known cause is called into question with the increasing number of case reports and epidemiologic studies showing associations between occupational exposures...

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Bibliographic Details
Published in:American journal of industrial medicine 2022-04, Vol.65 (4), p.268-280
Main Authors: Oliver, L. Christine, Sampara, Paul, Pearson, Donna, Martell, Janice, Zarnke, Andrew M.
Format: Article
Language:English
Subjects:
Aged
Air sampling
Aluminum
Case Report
Case Reports
clinical phenotype
Construction industry
Diatomaceous earth
Dust - analysis
Emergency response
Epidemiology
Etiology
Exposure
granulomatous disease
hard‐rock miner
Heavy metals
Humans
Hypercalciuria
Male
McIntyre Powder
Miners
Occupational exposure
Occupational Exposure - adverse effects
Occupational Exposure - analysis
Occupational health
Ontario - epidemiology
Powders
Prophylaxis
respirable crystalline silica
Rocks
Sarcoidosis
Sarcoidosis - epidemiology
Sarcoidosis - etiology
Silica
Silicon dioxide
Silicon Dioxide - adverse effects
Silicon Dioxide - analysis
Silicosis
Uranium
Workers
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Summary:Sarcoidosis is a rare multisystem granulomatous disease traditionally considered to be of unknown etiology. The notion that sarcoidosis has no known cause is called into question with the increasing number of case reports and epidemiologic studies showing associations between occupational exposures and disease published in the past 10–20 years. Occupational exposures for which associations are strongest and most consistent are silica and other inorganic dusts, World Trade Center (WTC) dust, and metals. Occupations identified as at‐risk for sarcoidosis include construction workers; iron‐foundry and diatomaceous earth workers; WTC emergency responders; and metal workers. We report here 12 cases of sarcoidosis in a cohort of hard‐rock miners in Northern Ontario, Canada. To our knowledge sarcoidosis has not been reported previously in hard‐rock miners. The cases are all male and Caucasian, with average age 74 years. At the time of diagnosis, two were never smokers; six, former smokers; and four, current smokers. Five have extrapulmonary sarcoidosis: two cardiac and three endocrine (hypercalciuria). Using occupational histories and air sampling data from the gold, uranium, and base‐metal mines in which they worked, we examined exposure of each case to respirable crystalline silica (RCS). The annual mean RCS exposure for the 12 cases was 0.14 mg/m3 (range: 0.06–1.3 mg/m3); and the mean cumulative RCS exposure was 1.93 mg/m3 years (range: 0.64–4.03 mg/m3 years). We also considered their exposure to McIntyre Powder, an aluminum powder used for silicosis prophylaxis.
ISSN:0271-3586
1097-0274
DOI:10.1002/ajim.23333