Mayris P Webber1, Jennifer Yip2, Rachel Zeig-Owens2, William Moir2, Patompong Ungprasert3, Cynthia S Crowson3, Charles B Hall4, Nadia Jaber2, Michael D Weiden5, Eric L Matteson3, David J Prezant2. 1. Montefiore Medical Center, Albert Einstein College of Medicine, Department of Epidemiology and Population Health, Bronx, NY, USA; Fire Department of the City of New York, Bureau of Health Services, 9 Metrotech Center, Brooklyn, NY, USA. Electronic address: Mayris.Webber@fdny.nyc.gov. 2. Fire Department of the City of New York, Bureau of Health Services, 9 Metrotech Center, Brooklyn, NY, USA. 3. Mayo Clinic, Division of Rheumatology, Department of Health Sciences Research, Rochester, MN, USA. 4. Albert Einstein College of Medicine, Department of Epidemiology and Population Health, Bronx, NY, USA. 5. Fire Department of the City of New York, Bureau of Health Services, 9 Metrotech Center, Brooklyn, NY, USA; Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, New York University School of Medicine, New York, NY, USA.
Abstract
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.
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.
Authors: Gabriel Izbicki; Robert Chavko; Gisela I Banauch; Michael D Weiden; Kenneth I Berger; Thomas K Aldrich; Charles Hall; Kerry J Kelly; David J Prezant Journal: Chest Date: 2007-03-30 Impact factor: 9.410
Authors: Jennifer L St Sauver; Brandon R Grossardt; Barbara P Yawn; L Joseph Melton; Joshua J Pankratz; Scott M Brue; Walter A Rocca Journal: Int J Epidemiol Date: 2012-11-18 Impact factor: 7.196
Authors: Hannah T Jordan; Steven D Stellman; David Prezant; Alvin Teirstein; Sukhminder S Osahan; James E Cone Journal: J Occup Environ Med Date: 2011-09 Impact factor: 2.162
Authors: Laura E Crowley; Robin Herbert; Jacqueline M Moline; Sylvan Wallenstein; Gauri Shukla; Clyde Schechter; Gwen S Skloot; Iris Udasin; Benjamin J Luft; Denise Harrison; Moshe Shapiro; Karen Wong; Henry S Sacks; Philip J Landrigan; Alvin S Teirstein Journal: Am J Ind Med Date: 2010-12-22 Impact factor: 2.214
Authors: Barbaros S Erdal; Bradley D Clymer; Vedat O Yildiz; Mark W Julian; Elliott D Crouser Journal: Respir Med Date: 2012-03-13 Impact factor: 3.415
Authors: Mayris P Webber; Jackson Gustave; Roy Lee; Justin K Niles; Kerry Kelly; Hillel W Cohen; David J Prezant Journal: Environ Health Perspect Date: 2009-02-11 Impact factor: 9.031
Authors: Syed H Haider; Arul Veerappan; George Crowley; Erin J Caraher; Dean Ostrofsky; Mena Mikhail; Rachel Lam; Yuyan Wang; Maria Sunseri; Sophia Kwon; David J Prezant; Mengling Liu; Ann Marie Schmidt; Anna Nolan Journal: Am J Respir Cell Mol Biol Date: 2020-08 Impact factor: 6.914
Authors: Kerry M Hena; Jennifer Yip; Nadia Jaber; David Goldfarb; Kelly Fullam; Krystal Cleven; William Moir; Rachel Zeig-Owens; Mayris P Webber; Daniel M Spevack; Marc A Judson; Lisa Maier; Andrew Krumerman; Anthony Aizer; Simon D Spivack; Jessica Berman; Thomas K Aldrich; David J Prezant Journal: Chest Date: 2017-10-21 Impact factor: 9.410
Authors: Hilary L Colbeth; Natalia Genere; Charles B Hall; Nadia Jaber; Juan P Brito; Omar M El Kawkgi; David G Goldfarb; Mayris P Webber; Theresa M Schwartz; David J Prezant; Rachel Zeig-Owens Journal: JAMA Intern Med Date: 2020-06-01 Impact factor: 21.873
Authors: Lisa M Gargano; Kimberly Mantilla; Monique Fairclough; Shengchao Yu; Robert M Brackbill Journal: Int J Environ Res Public Health Date: 2018-02-03 Impact factor: 3.390
Authors: Vasanthi R Sunil; Jared Radbel; Sabiha Hussain; Kinal N Vayas; Jessica Cervelli; Malik Deen; Howard Kipen; Iris Udasin; Robert Laumbach; Jag Sunderram; Jeffrey D Laskin; Debra L Laskin Journal: Int J Environ Res Public Health Date: 2019-03-06 Impact factor: 3.390
Authors: Krystal L Cleven; Kenny Ye; Rachel Zeig-Owens; Kerry M Hena; Cristina Montagna; Jidong Shan; H Dean Hosgood; Nadia Jaber; Michael D Weiden; Hilary L Colbeth; David G Goldfarb; Simon D Spivack; David J Prezant Journal: Int J Environ Res Public Health Date: 2019-05-23 Impact factor: 3.390
Authors: Hilary L Colbeth; Rachel Zeig-Owens; Mayris P Webber; David G Goldfarb; Theresa M Schwartz; Charles B Hall; David J Prezant Journal: Int J Environ Res Public Health Date: 2019-05-16 Impact factor: 3.390
Authors: Jiehui Li; James E Cone; Robert M Brackbill; Ingrid Giesinger; Janette Yung; Mark R Farfel Journal: Int J Environ Res Public Health Date: 2019-03-07 Impact factor: 3.390