Chest
Original Research: World Trade Center-Related Pulmonary DiseaseWorld Trade Center “Sarcoid-Like” Granulomatous Pulmonary Disease in New York City Fire Department Rescue Workers
Section snippets
Case Ascertainment
For annual incidence rates, the population at risk was the entire FDNY rescue workforce present at any time during the WTC disaster rescue, recovery, and cleanup operation between September 11, 2001, and July 1, 2002. This number totaled 15,048, composed of 11,193 fire personnel (firefighters and officers), 2,972 EMS personnel (emergency medical technicians, paramedics, and officers), and 883 recent retirees. Employee head counts in each of the 5 years after the WTC disaster were similar to
Results
Between September 9, 2001, and September 11, 2006, 26 WTC dust-exposed FDNY rescue workers were found to have pathologic evidence of sterile granulomatous pulmonary disease consistent with the diagnosis of sarcoidosis or SLGPD (Table 1). Thirteen patients presented in the first year after WTC dust exposure (September 11, 2001, to September 10, 2002), 1 patient presented in the second year (2003), 4 patients presented in the third year (2004), 4 patients presented in the fourth year (2005), and
Discussion
Sarcoidosis is a multisystem noncaseating granulomatous disease affecting young to middle-age adults. It predominantly involves the lungs, lymph nodes, and skin, all of which are portals of entry for many immunologically active occupational and environmental agents. Although the etiology of sarcoidosis is not well understood, occupational and environmental factors have been implicated.7 Occupational clusters, with presumptive toxic or infectious exposures, have been reported for sarcoidosis or
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The authors have no conflicts of interest to disclose.
This work was supported by grants from the National Institute for Occupational Safety and Health (OH-08232) and the September Eleventh Recovery Grant of the American Red Cross Liberty Disaster Relief Fund.
The sponsors had no involvement in the design and conduct of the study; in the collection, management, analysis, and interpretation of the data; or in the preparation of the manuscript.
Reproduction of this article is prohibited without written permission from the American College of Chest Physicians (www.chestjournal.org/misc/reprints.shtml).