# The Impact of Environmental Exposures on Sarcoidosis Incidence and Mortality

> **NIH NIH R01** · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · 2023 · $101,570

## Abstract

PROJECT ABSTRACT
Sarcoidosis, a multiorgan disease with an uncertain etiology and variable clinical outcomes, is potentially
influenced by environmental exposures, such as organic fuel burning or inorganic dust. The higher incidence
and prevalence of sarcoidosis among veterans than in civilians provides a rationale to examine the role of
service-related toxic exposures in the natural history of the disease. Such studies are consistent with the goals
of the recently approved PACT Act, which recognizes sarcoidosis as a service-related illness and calls for studies
of service-related exposures as risk factors for lung disease. The Veteran's Health Administration (VHA), the
largest integrated healthcare system in the U.S., obtains comprehensive longitudinal data on millions of veterans,
including their unique history of service-related toxic exposures. This wealth of data enables the exploration of
these relationships with high precision. My central hypothesis is that service-related toxic exposures affect the
incidence of sarcoidosis and all-cause mortality. I propose two specific aims: (1) to determine in a nested case-
control study whether service-related exposures increase sarcoidosis incidence risk among veterans and (2) to
identify predictors of all-cause mortality among veterans with sarcoidosis using a time-dependent Cox
proportional hazards model and two other machine learning models; in two subaims, I will determine whether
individual clinical features predict all-cause mortality and whether incorporating the service-related exposures
into the models will improve this prediction. This study will reveal the effects of toxic exposures on sarcoidosis
incidence, develop predictive models for all-cause mortality, and stratify veterans into risk subgroups—which will
improve longitudinal care and guide efforts to identify new sarcoidosis phenotypes. The findings will lay the
foundation for a Career Development Award proposal focusing on real-world, evidence-based management
strategies for sarcoidosis.

## Key facts

- **NIH application ID:** 10834640
- **Project number:** 3R01HL157533-02S1
- **Recipient organization:** UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
- **Principal Investigator:** LAURA L KOTH
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2023
- **Award amount:** $101,570
- **Award type:** 3
- **Project period:** 2023-08-21 → 2026-03-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10834640

## Citation

> US National Institutes of Health, RePORTER application 10834640, The Impact of Environmental Exposures on Sarcoidosis Incidence and Mortality (3R01HL157533-02S1). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10834640. Licensed CC0.

---

*[NIH grants dataset](/datasets/nih-grants) · CC0 1.0*