"Sarcoid like" granulomatous pulmonary disease in World Trade Center disaster responders.
Crowley LE; Herbert R; Moline JM; Wallenstein S; Shukla G; Schechter C; Skloot GS; Udasin I; Luft BJ; Harrison D; Shapiro M; Wong K; Sacks HS; Landrigan PJ; Teirstein AS
Am J Ind Med 2011 Mar; 54(3):175-184
Background: More than 20,000 responders have been examined through theWorld Trade Center (WTC) Medical Monitoring and Treatment Program since September 11, 2001. Studies on WTC firefighters have shown elevated rates of sarcoidosis. The main objective of this study was to report the incidence of ''sarcoid like'' granulomatous pulmonary disease in other WTC responders. Methods: Cases of sarcoid like granulomatous pulmonary disease were identified by: patient self-report, physician report and ICD-9 codes. Each case was evaluated by three pulmonologists using the ACCESS criteria and only ''definite'' cases are reported. Results: Thirty-eight patients were classified as ''definite'' cases. Six-year incidence was 192/100,000. The peak annual incidence of 54 per 100,000 person-years occurred between 9/11/2003 and 9/11/2004. Incidence in black responders was nearly double that of white responders. Low FVC was the most common spirometric abnormality. Conclusions: Sarcoid like granulomatous pulmonary disease is present among the WTC responders. While the incidence is lower than that reported among firefighters, it is higher than expected.
Emergency-responders; Fire-fighters; Medical-monitoring; Medical-rescue-services; Paramedical-services; Psychological-effects; Psychological-reactions; Pulmonary-disorders; Pulmonary-system-disorders; Quantitative-analysis; Respiratory-infections; Respiratory-irritants; Respiratory-system-disorders; Statistical-analysis; Surveillance-programs;
Author Keywords: a case control etiologic study of sarcoidosis (ACCESS); forced vital capacity (FVC); granulomatous disease; sarcoidosis; World Trade Center (WTC)
Laura E. Crowley, MD, The Mount Sinai Medical Center, P.O. Box 1057, One Gustave L. Levy Place, New York, NY 10029
Cooperative-Agreement-Number-U10-OH-008232; Cooperative-Agreement-Number-U10-OH-008225; Cooperative-Agreement-Number-U10-OH-008239; Cooperative-Agreement-Number-U10-OH-008275; Cooperative-Agreement-Number-U10-OH-008216; Cooperative-Agreement-Number-U10-OH-008223
American Journal of Industrial Medicine
Mount Sinai School of Medicine - New York