NIOSH conducted a survey of the incidence of sarcoidosis among US Navy personnel in response to a request made in 1992 by the US Navy on behalf on a black enlisted male who had been diagnosed with sarcoidosis in 1974. The patient, who had been stationed aboard an aircraft carrier, had received a medical discharge for sarcoidosis from the Navy in 1975. The patient was diagnosed with pneumoconiosis in 1987 after mineral dust deposits were found in a lung biopsy. The records of the US Naval Health Research Center (NHRC) were searched to identify all white and black enlisted men diagnosed with sarcoidosis while on activity duty from 1965 to 1992; 1,126 sarcoidosis cases were identified. Incidence rates were calculated for the period 1971 through 1993. The average annual age specific sarcoidosis rates for 21 to 30yr old US Navy black enlistees decreased from 73.3 to 13.2 cases per 100,000 between 1971 and 1993. The incidence rates for white US Navy enlisted men remained relatively stable during this period, varying only from around 9 to 4 cases/100,000. When compared to a random sample of 10,000 controls identified from NHRC records, blacks accounted disproportionately for sarcoidosis cases during the 1965 to 1993 period, 47.3% of the cases versus 11.4% of the cases. Those with sarcoidosis had served in the Navy significantly longer than the controls, 10.7 versus 5.5yr. An analysis of 426 sarcoidosis cases and controls who had ever served aboard a US Navy aircraft carrier revealed that serving on an aircraft crier was significantly associated with an increased risk for sarcoidosis, relative risk (RR) 1.5. The risk was greater for blacks than for whites, RRs 1.7 versus 1.2. The authors conclude that there were substantially higher sarcoidosis incidence rates for black than for white US Navy enlisted men and a clear decreases in incidence rates for blacks over time. There was an excess risk associated with serving aboard aircraft carriers.