World Trade Center "sarcoid-like" granulomatous pulmonary disease in New York City Fire Department rescue workers

Gabriel Izbicki, Robert Chavko, Gisela I. Banauch, Michael D. Weiden, Kenneth I. Berger, Thomas K. Aldrich, Charles B. Hall, Kerry J. Kelly, David J. Prezant

Research output: Contribution to journalArticle

200 Citations (Scopus)

Abstract

Background: Previous reports suggest that sarcoidosis occurs with abnormally high frequency in firefighters. We sought to determine whether exposure to World Trade Center (WTC) "dust" during the collapse and rescue/recovery effort increased the incidence of sarcoidosis or "sarcoid-like" granulomatous pulmonary disease (SLGPD). Methods: During the 5 years after the WTC disaster, enrollees in the Fire Department of New York (FDNY) WTC monitoring and treatment programs who had chest radiograph findings suggestive of sarcoidosis underwent evaluation, including the following: chest CT imaging, pulmonary function, provocative challenge, and biopsy. Annual incidence rates were compared to the 15 years before the WTC disaster. Results: After WTC dust exposure, pathologic evidence consistent with new-onset sarcoidosis was found in 26 patients: all 26 patients had intrathoracic adenopathy, and 6 patients (23%) had extrathoracic disease. Thirteen patients were identified during the first year after WTC dust exposure (incidence rate, 86/100,000), and 13 patients were identified during the next 4 years (average annual incidence rate, 22/100,000; as compared to 15/100,000 during the 15 years before the WTC disaster). Eighteen of 26 patients (69%) had findings consistent with asthma. Eight of 21 patients (38%) agreeing to challenge testing had airway hyperreactivity (AHR), findings not seen in FDNY sarcoidosis patients before the WTC disaster. Conclusion: After the WTC disaster, the incidence of sarcoidosis or SLGPD was increased among FDNY rescue workers. This new information about the early onset of WTC-SLGPD and its association with asthma/AHR has important public health consequences for disease prevention, early detection, and treatment following environmental/occupational exposures.

Original languageEnglish (US)
Pages (from-to)1414-1423
Number of pages10
JournalChest
Volume131
Issue number5
DOIs
StatePublished - May 2007

Fingerprint

Lung Diseases
Sarcoidosis
Disasters
Dust
Incidence
Thorax
Asthma
Firefighters
Environmental Exposure
Occupational Exposure
Early Diagnosis
Public Health
Biopsy
Lung
Therapeutics

Keywords

  • Airway hyperreactivity
  • Asthma
  • Emergency medical services workers
  • Firefighters
  • Granulomatous pneumonitis
  • Sarcoidosis
  • World Trade Center

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine

Cite this

Izbicki, G., Chavko, R., Banauch, G. I., Weiden, M. D., Berger, K. I., Aldrich, T. K., ... Prezant, D. J. (2007). World Trade Center "sarcoid-like" granulomatous pulmonary disease in New York City Fire Department rescue workers. Chest, 131(5), 1414-1423. https://doi.org/10.1378/chest.06-2114

World Trade Center "sarcoid-like" granulomatous pulmonary disease in New York City Fire Department rescue workers. / Izbicki, Gabriel; Chavko, Robert; Banauch, Gisela I.; Weiden, Michael D.; Berger, Kenneth I.; Aldrich, Thomas K.; Hall, Charles B.; Kelly, Kerry J.; Prezant, David J.

In: Chest, Vol. 131, No. 5, 05.2007, p. 1414-1423.

Research output: Contribution to journalArticle

Izbicki, G, Chavko, R, Banauch, GI, Weiden, MD, Berger, KI, Aldrich, TK, Hall, CB, Kelly, KJ & Prezant, DJ 2007, 'World Trade Center "sarcoid-like" granulomatous pulmonary disease in New York City Fire Department rescue workers', Chest, vol. 131, no. 5, pp. 1414-1423. https://doi.org/10.1378/chest.06-2114
Izbicki G, Chavko R, Banauch GI, Weiden MD, Berger KI, Aldrich TK et al. World Trade Center "sarcoid-like" granulomatous pulmonary disease in New York City Fire Department rescue workers. Chest. 2007 May;131(5):1414-1423. https://doi.org/10.1378/chest.06-2114
Izbicki, Gabriel ; Chavko, Robert ; Banauch, Gisela I. ; Weiden, Michael D. ; Berger, Kenneth I. ; Aldrich, Thomas K. ; Hall, Charles B. ; Kelly, Kerry J. ; Prezant, David J. / World Trade Center "sarcoid-like" granulomatous pulmonary disease in New York City Fire Department rescue workers. In: Chest. 2007 ; Vol. 131, No. 5. pp. 1414-1423.
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abstract = "Background: Previous reports suggest that sarcoidosis occurs with abnormally high frequency in firefighters. We sought to determine whether exposure to World Trade Center (WTC) {"}dust{"} during the collapse and rescue/recovery effort increased the incidence of sarcoidosis or {"}sarcoid-like{"} granulomatous pulmonary disease (SLGPD). Methods: During the 5 years after the WTC disaster, enrollees in the Fire Department of New York (FDNY) WTC monitoring and treatment programs who had chest radiograph findings suggestive of sarcoidosis underwent evaluation, including the following: chest CT imaging, pulmonary function, provocative challenge, and biopsy. Annual incidence rates were compared to the 15 years before the WTC disaster. Results: After WTC dust exposure, pathologic evidence consistent with new-onset sarcoidosis was found in 26 patients: all 26 patients had intrathoracic adenopathy, and 6 patients (23{\%}) had extrathoracic disease. Thirteen patients were identified during the first year after WTC dust exposure (incidence rate, 86/100,000), and 13 patients were identified during the next 4 years (average annual incidence rate, 22/100,000; as compared to 15/100,000 during the 15 years before the WTC disaster). Eighteen of 26 patients (69{\%}) had findings consistent with asthma. Eight of 21 patients (38{\%}) agreeing to challenge testing had airway hyperreactivity (AHR), findings not seen in FDNY sarcoidosis patients before the WTC disaster. Conclusion: After the WTC disaster, the incidence of sarcoidosis or SLGPD was increased among FDNY rescue workers. This new information about the early onset of WTC-SLGPD and its association with asthma/AHR has important public health consequences for disease prevention, early detection, and treatment following environmental/occupational exposures.",
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N2 - Background: Previous reports suggest that sarcoidosis occurs with abnormally high frequency in firefighters. We sought to determine whether exposure to World Trade Center (WTC) "dust" during the collapse and rescue/recovery effort increased the incidence of sarcoidosis or "sarcoid-like" granulomatous pulmonary disease (SLGPD). Methods: During the 5 years after the WTC disaster, enrollees in the Fire Department of New York (FDNY) WTC monitoring and treatment programs who had chest radiograph findings suggestive of sarcoidosis underwent evaluation, including the following: chest CT imaging, pulmonary function, provocative challenge, and biopsy. Annual incidence rates were compared to the 15 years before the WTC disaster. Results: After WTC dust exposure, pathologic evidence consistent with new-onset sarcoidosis was found in 26 patients: all 26 patients had intrathoracic adenopathy, and 6 patients (23%) had extrathoracic disease. Thirteen patients were identified during the first year after WTC dust exposure (incidence rate, 86/100,000), and 13 patients were identified during the next 4 years (average annual incidence rate, 22/100,000; as compared to 15/100,000 during the 15 years before the WTC disaster). Eighteen of 26 patients (69%) had findings consistent with asthma. Eight of 21 patients (38%) agreeing to challenge testing had airway hyperreactivity (AHR), findings not seen in FDNY sarcoidosis patients before the WTC disaster. Conclusion: After the WTC disaster, the incidence of sarcoidosis or SLGPD was increased among FDNY rescue workers. This new information about the early onset of WTC-SLGPD and its association with asthma/AHR has important public health consequences for disease prevention, early detection, and treatment following environmental/occupational exposures.

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