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Int J Environ Res Public Health. 2019 Apr 10;16(7). pii: E1291. doi: 10.3390/ijerph16071291.

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

Author information

1
Department of Medicine, New York University, New York, NY 10016, USA. kerry.hena@nyulangone.org.
2
Department of Medicine, New York University, New York, NY 10016, USA. scarlett.murphy@nyulangone.org.
3
Department of Population Health and Environmental Medicine, New York University, New York, NY 10016, USA. yian.zhang@nyulangone.org.
4
Department of Population Health and Environmental Medicine, New York University, New York, NY 10016, USA. yongzhao.shao@nyulangone.org.
5
Department of Medicine, New York University, New York, NY 10016, USA. angeliki.kazeros@nyulangone.org.
6
Department of Medicine, New York University, New York, NY 10016, USA. joan.reibman@nyulangone.org.
7
Department of Population Health and Environmental Medicine, New York University, New York, NY 10016, USA. joan.reibman@nyulangone.org.

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

PMID:
30974916
DOI:
10.3390/ijerph16071291
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Conflict of interest statement

The authors declare no conflict of interest. The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript, or in the decision to publish the results.

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