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

• Main Authors: Kerry M. Hena, Scarlett Murphy, Yian Zhang, Yongzhao Shao, Angeliki Kazeros, Joan Reibman
• Format: Article
• Language: English
• Published: MDPI AG 2019-04-01
• Series: International Journal of Environmental Research and Public Health
• Subjects: sarcoidosis; World Trade Center (WTC); Scadding stage; lung function; severe lung disease; extrathoracic sarcoidosis; cardiac sarcoidosis
• Online Access: https://www.mdpi.com/1660-4601/16/7/1291

<i>Background</i>: 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. <i>Methods</i>: 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. <i>Results</i>: 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 &#8805; 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. <i>Conclusions</i>: 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.