The incidence, prevalence, and severity of sarcoidosis in New York City firefighters

Chest. 1999 Nov;116(5):1183-93. doi: 10.1378/chest.116.5.1183.


Objective: The etiology of sarcoidosis is unknown, but epidemiology suggests that environmental agents are a factor. Because firefighters are exposed to numerous toxins, we questioned whether sarcoidosis was increased in this cohort.

Setting: The New York City Fire Department (FDNY), employing > 11,000 firefighters and nearly 3,000 emergency medical services (EMS) health-care workers (HCWs).

Design: In 1985, FDNY initiated a surveillance program to determine the incidence, prevalence, and severity of biopsy-proven sarcoidosis in firefighters. In 1995, EMS HCWs were added as control subjects.

Results: Between 1985 and 1998, 4 prior cases and 21 new cases of sarcoidosis were found in FDNY firefighters. Annual incidence proportions ranged from 0 to 43.6/100,000, and averaged 12.9/100,000. On July 1, 1998, the point prevalence was 222/100,000. For EMS HCWs, annual incidence proportions were zero. Radiographic stage 0 or stage 1 sarcoidosis was found in 19 firefighters (76%), and stage 3 was found in 1 firefighter (4%). Pulmonary function (FVC, FEV(1), and diffusing capacity for carbon monoxide) was normal in 17 firefighters (68%), and reduced to </= 65% predicted in 2 firefighters (8%). Maximum oxygen consumption (MVO(2)) was normal in 10 of 17 firefighters (59%), and reduced to 65% predicted in 3 firefighters (12%). Five of seven firefighters (71%) with abnormal MVO(2) had gas exchange abnormalities, and none had O(2) desaturation. All returned to fire fighting.

Conclusions: Annual incidence proportions and point prevalence were increased in FDNY firefighters as compared to EMS HCWs and historical controls. Radiographs and physiologic measurements demonstrated only minimal impairment.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Biopsy
  • Exercise Test
  • Female
  • Fires*
  • Humans
  • Incidence
  • Male
  • Middle Aged
  • New York City / epidemiology
  • Occupational Diseases / diagnosis
  • Occupational Diseases / epidemiology
  • Occupational Diseases / etiology
  • Occupational Exposure / adverse effects
  • Prevalence
  • Radiography, Thoracic
  • Respiratory Care Units / statistics & numerical data
  • Respiratory Function Tests
  • Retrospective Studies
  • Sarcoidosis, Pulmonary / diagnosis
  • Sarcoidosis, Pulmonary / epidemiology*
  • Sarcoidosis, Pulmonary / etiology
  • Severity of Illness Index*
  • Urban Population