Although we found the incidence of sarcoidosis to be increased in firefighters, functional impact was minimal. Only two firefighters (#5,19) had cardiopulmonary symptoms (dyspnea or chest pain) that were severe enough to limit work activities (Table 1). One firefighter (#5) had moderate reductions in pulmonary function (Table 2). Exercise testing was not available to us […]

The increased incidence of sarcoidosis in FDNY firefighters is not unexpected. Environmental factors (infections, allergens, and toxins) have long been suspected in the development of sarcoidosis. Few occupations are at higher risk for toxic exposures than firefighters. Although self-contained breathing apparatus and relatively impermeable uniforms are worn by all FDNY firefighters, it is common to […]

As an occupational study, several additional issues deserve comment. First, with the possible exception of two firefighters, we believe this group developed sarcoidosis only after employment as FDNY firefighters. Prior to 1995, sarcoidosis disallowed employment as an FDNY firefighter; complete medical evaluations (including history, examination, and chest radiograph) were obtained in all candidates, and records […]

Recently, the United States Navy and the National Institute for Occupational Safety and Health reported the incidence of sarcoidosis in United States Navy enlisted men from 1971 to 1993. Mandatory chest radiographs were required for all recruits; for incumbents with symptoms; or at change of assignment, release, or discharge. Most of the diagnoses were biopsy […]

This is in sharp contrast to our control group of EMS HCWs, for whom the annual incidence proportion was zero and the point prevalence on July 1, 1998 was 35/100,000. Interestingly, no new cases were found in EMS HCWs despite the following: (1) greater nonwhite representation (42%) than FDNY firefighter (6%); and (2) previous reports […]

After completing the diagnostic evaluation, 22 firefighters immediately returned to full firefighter duties, Given the absence of symptoms, no demonstrable airway hyperreactivity, and the paucity of pulmonary function findings at rest and during exercise, we lacked a medical justification for an alternative duty status decision. Three firefighters were treated with oral steroids by their personal […]

Exercise performance is shown in Tables 3 and 4. Of the 17 firefighters tested, 3 did not achieve a HR > 85% of predicted maximum (#6,10) or an RER > 1.12 (#15). ECGs at rest and during exercise were normal in all tested. Peak V02 was normal in 10 firefighters (59%), and anaerobic threshold was […]