Background: In a family study of sarcoidosis in African-Americans, we detected a positive association between sarcoidosis and ever working in a sales or clerical occupation. This finding, and case reports of granulomatous lung disease in patients with photocopier toner dust exposure, led us to hypothesize that sarcoidosis risk may increase as a result of photocopier exposure.
Methods: Retrospective data on photocopier use and maintenance were collected from African-American sarcoidosis cases and their first degree relatives. The study sample consisted of 181 African-American sibships where one or more members had a history of sarcoidosis (n = 540).
Results: Sarcoidosis was statistically significantly associated with ever using a photocopier (Odds Ratio [OR] = 1.74, 95% confidence interval [CI]: 1.23-2.46), and ever changing photocopier toner or carrying out photocopier maintenance (OR = 2.88, 95% CI 1.83-4.54). In a conditional logistic regression model that adjusted for age and sex, the OR associated with a sarcoidosis history and being in the highest tertile of photocopier exposure ranged from 1.83 to 2.19 depending on the exposure measure used.
Conclusions: These results suggest that photocopier toner dust may be a previously unrecognized antigen in the pathophysiology of some patients diagnosed with sarcoidosis.