TY - JOUR
T1 - Post-9/11 sarcoidosis in WTC-exposed firefighters and emergency medical service workers
AU - Webber, Mayris P.
AU - Yip, Jennifer
AU - Zeig-Owens, Rachel
AU - Moir, William
AU - Ungprasert, Patompong
AU - Crowson, Cynthia S.
AU - Hall, Charles B.
AU - Jaber, Nadia
AU - Weiden, Michael D.
AU - Matteson, Eric L.
AU - Prezant, David J.
N1 - Funding Information:
This work was supported by the National Institute for Occupational Safety and Health (NIOSH) Cooperative Agreement U01 OH010513 and the National Institute on Aging grant R01 AG034676 . The content of this article is solely the responsibility of the authors and does not necessarily reflect the official views of NIOSH or the NIH.
Funding Information:
This work was supported by the National Institute for Occupational Safety and Health (NIOSH) Cooperative Agreement U01 OH010513 and the National Institute on Aging grant R01 AG034676. The content of this article is solely the responsibility of the authors and does not necessarily reflect the official views of NIOSH or the NIH.
Publisher Copyright:
© 2017 Elsevier Ltd
PY - 2017/11
Y1 - 2017/11
N2 - Introduction The World Trade Center (WTC) disaster released a huge quantity and variety of toxicants into the environment. To-date, studies from each of the three major cohorts of WTC-exposed workers have suggested “greater than expected” numbers of post-9/11 cases in some workers. We undertook this study to estimate the incidence of post-9/11 sarcoidosis in ∼13,000 male firefighters and EMS workers enrolled in The Fire Department of the City of New York (FDNY) WTC Health Program; to compare FDNY incidence to rates from unexposed, demographically similar men in the Rochester Epidemiology Project (REP); and, to examine rates by level of WTC exposure. Methods We calculated incidence of sarcoidosis diagnosed from 9/12/2001 to 9/11/2015, and generated expected sex- and age-specific rates based on REP rates. Standardized incidence ratios (SIR) based on REP rates, and 95% confidence intervals (95% CI) were estimated. Two sensitivity analyses limited cases to those with intra-thoracic symptoms or biopsy confirmation. Results We identified 68 post-9/11 cases in the FDNY cohort. Overall, FDNY rates were significantly higher than expected rates (SIR = 2.8; 95% CI = 2.2, 3.6). Including only symptomatic cases, the SIR decreased (SIR = 2.2; 95% CI = 1.5, 3.0), but remained significantly elevated. SIRs ranged from 2.7 (95% CI = 2.0, 3.5) in the lower WTC exposure group to 4.2 (95% CI = 1.9, 8.0) in the most highly exposed. Conclusions We found excess incident post-9/11 sarcoidosis in WTC-exposed workers. Continued surveillance, particularly of those most highly exposed, is necessary to identify those with sarcoidosis and to follow them for possible adverse effects including functional impairments and organ damage.
AB - Introduction The World Trade Center (WTC) disaster released a huge quantity and variety of toxicants into the environment. To-date, studies from each of the three major cohorts of WTC-exposed workers have suggested “greater than expected” numbers of post-9/11 cases in some workers. We undertook this study to estimate the incidence of post-9/11 sarcoidosis in ∼13,000 male firefighters and EMS workers enrolled in The Fire Department of the City of New York (FDNY) WTC Health Program; to compare FDNY incidence to rates from unexposed, demographically similar men in the Rochester Epidemiology Project (REP); and, to examine rates by level of WTC exposure. Methods We calculated incidence of sarcoidosis diagnosed from 9/12/2001 to 9/11/2015, and generated expected sex- and age-specific rates based on REP rates. Standardized incidence ratios (SIR) based on REP rates, and 95% confidence intervals (95% CI) were estimated. Two sensitivity analyses limited cases to those with intra-thoracic symptoms or biopsy confirmation. Results We identified 68 post-9/11 cases in the FDNY cohort. Overall, FDNY rates were significantly higher than expected rates (SIR = 2.8; 95% CI = 2.2, 3.6). Including only symptomatic cases, the SIR decreased (SIR = 2.2; 95% CI = 1.5, 3.0), but remained significantly elevated. SIRs ranged from 2.7 (95% CI = 2.0, 3.5) in the lower WTC exposure group to 4.2 (95% CI = 1.9, 8.0) in the most highly exposed. Conclusions We found excess incident post-9/11 sarcoidosis in WTC-exposed workers. Continued surveillance, particularly of those most highly exposed, is necessary to identify those with sarcoidosis and to follow them for possible adverse effects including functional impairments and organ damage.
KW - Fire Department of the City of New York
KW - Rochester Epidemiology Project
KW - Sarcoidosis
KW - World Trade Center
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U2 - 10.1016/j.rmed.2017.06.004
DO - 10.1016/j.rmed.2017.06.004
M3 - Article
C2 - 28622920
AN - SCOPUS:85020683242
SN - 0954-6111
VL - 132
SP - 232
EP - 237
JO - British Journal of Tuberculosis and Diseases of the Chest
JF - British Journal of Tuberculosis and Diseases of the Chest
ER -
