Clinical Evaluation of Sarcoidosis in Community Members with World Trade Center Dust Exposure

Int J Environ Res Public Health. 2019 Apr 10;16(7):1291. doi: 10.3390/ijerph16071291.

Abstract

Background: Sarcoidosis is a granulomatous disease involving intrathoracic and extrathoracic organs. Genetic and environmental factors, such as exposure to World-Trade Center (WTC) dust after 9/11, may play a role in clinical presentation. Characterization of sarcoidosis in community members with exposure to the WTC dust can provide further insight into the relationship between environmental exposure and sarcoidosis. Methods: Patients with documented sarcoidosis were identified in the WTC Environmental Health Center (EHC), a treatment program for community members. Demographic and clinical data were collected from standardized questionnaires and chart review. Organ involvement was assessed with a standard instrument. Results: Among patients in the WTC EHC, 87 were identified with sarcoidosis after 9/11. Sarcoidosis cases were more likely African-American, local workers, and had more respiratory symptoms, compared with non-sarcoidosis WTC EHC patients. Many (46%) had ≥ Scadding stage 3 on chest imaging, and had reduced lung function measures. Extrathoracic involvement was identified in 33/87 (38%) with a diversity of organs involved. Conclusions: WTC-exposed sarcoidosis in community members is often characterized by severe pulmonary disease and a high rate of diverse extrathoracic involvement. Further analysis is required to characterize the course of disease progression or resolution.

Keywords: Scadding stage; World Trade Center (WTC); cardiac sarcoidosis; extrathoracic sarcoidosis; lung function; sarcoidosis; severe lung disease.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Dust
  • Environmental Exposure / adverse effects*
  • Female
  • Humans
  • Lung / physiopathology
  • Lung Diseases / diagnosis*
  • Lung Diseases / physiopathology
  • Male
  • Middle Aged
  • Respiratory Function Tests
  • Sarcoidosis / diagnosis*
  • Sarcoidosis / physiopathology
  • September 11 Terrorist Attacks*

Substances

  • Dust