Sarcoidosis diagnosed after September 11, 2001 among persons exposed to the 9/11/2001 World Trade Center disaster

Background:

Sarcoid-like pulmonary disease has been reported among firefighters exposed to the 9/11/2001 World Trade Center disaster (9/11). We are investigating sarcoidosis diagnosed after 9/11 in residents, workers, and commuters exposed to 9/11.

Objective:

To determine the incidence and clinical characteristics of post-9/11 sarcoidosis in persons exposed to 9/11.

Methods:

The World Trade Center Health Registry (WTCHR) follows the health of >71,000 persons exposed to 9/11. The 2006-2007 WTCHR follow-up survey of registrants aged >=18 years included questions about sarcoidosis. Registrants who reported being diagnosed with sarcoidosis by a health professional after 9/11 were considered to have self-reported post-9/11 sarcoidosis. Published age-, race- and sex-specific sarcoidosis incidence rates were applied to the Registry population to estimate expected annual sarcoidosis incidence.

Results:

As of 10/15/07, 41509 (61%) of 67,627 registrants completed the follow-up survey; 61% were male, 71% Caucasian, 10% African American, and 11% Hispanic. Of those surveyed, 179 (0.43%) had self-reported post-9/11 sarcoidosis (average annual incidence rate 62/100,000, versus an expected annual incidence of 16/100,000). The median year of diagnosis was 2003. Case patients were 71% male, 58% Caucasian, 15% African American, and 23% Hispanic. The majority (69%) were aged 35-54 years at diagnosis. Case-patients reported 9/11 dust cloud exposure (67%) and 9/11 rubble pile work (42%) more frequently than did registrants without post-9/11 sarcoidosis (52% and 20%, respectively).

Conclusion:

Preliminary results indicate that post-9/11 sarcoidosis incidence may be higher than expected in the Registry population. Medical chart abstraction will be performed to confirm and describe these self-reported sarcoidosis cases.