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

Hena Hena,Reibman Reibman,Kazeros Kazeros,Murphy Murphy,Zhang Zhang,Shao Shao

doi:10.3390/ijerph16071291

Hena Hena, Reibman Reibman + Show 4 more

Open Access

https://doi.org/10.3390/ijerph16071291

Copy DOI

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.

Highlights

Sarcoidosis is a multisystem granulomatous disease of unknown etiology that is currently considered a genetically primed abnormal immune response to an antigenic exposure or trigger [1].Rather than a single disease entity, sarcoidosis may be a constellation of “sarcoidoses,” with a characteristic pattern of organ involvement, depending upon the underlying genotype and triggering exposure
September 2001 (9/11) has been suggested to be one such trigger with sarcoidosis diagnoses described in World-Trade Center (WTC)-exposed members of the Fire Department of the City of New York (FDNY), those involved in rescue and recovery efforts, and community members (“survivors”) with WTC dust exposure [2,3,4,5,6,7]
We report a case series of community members in the WTC Environmental Health Center (EHC) with a diagnoses of post 9/11 sarcoidosis to further characterize the clinical presentation of sarcoidosis in this unique population

Summary

Introduction

Sarcoidosis is a multisystem granulomatous disease of unknown etiology that is currently considered a genetically primed abnormal immune response to an antigenic exposure or trigger [1].Rather than a single disease entity, sarcoidosis may be a constellation of “sarcoidoses,” with a characteristic pattern of organ involvement, depending upon the underlying genotype and triggering exposure. Exposure to the dust and fumes from the destruction of the World Trade Center (WTC) on 11. 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. Conclusions: WTC-exposed sarcoidosis in community members is often characterized by severe pulmonary disease and a high rate of diverse extrathoracic involvement

Methods

Results

Discussion

Conclusion