In 1974, a 21-year-old black enlisted man had sarcoidosis diagnosed based on a chest radiograph indicating bilateral hilar adenopathy without parenchymal disease; noncaseating granulomata were present on lymph node biopsy. He had a history of shortness of breath, cough, and chest and joint pain, which he related to his work of grinding antiskid materials from aircraft carrier decks during the preceding 2 years. He received a medical discharge for sarcoidosis in 1975. In 1987, physicians at the U.S. Department of Veterans Affairs diagnosed pneumoconiosis in this patient after mineral-dust deposits were identified in a lung biopsy; the mineral-dust deposits were attributed to the same work exposures aboard the aircraft carrier. In October 1992, the patient asked the USN to request NIOSH to investigate whether his sarcoidosis diagnosis and other cases diagnosed in persons with whom he had served in the USN may have been associated with environmental exposures during their USN service. Because of the possibility of an association between risk for sarcoidosis-like illnesses and environmental exposures during service in the USN and because the underlying cause(s) of sarcoidosis is unknown, in December 1992 the USN requested that NIOSH evaluate the potential relation between sarcoidosis and the USN work environment.
Apr 15, 2018
Sarcoidosis Among U.S. Navy Enlisted Men, 1965-1993
Sarcoidosis is a multisystem granulomatous disease of unknown etiology with highest incidence among young and middle-aged adults. In the United States, the risk for sarcoidosis is substantially higher among blacks than among other races (1,2); however, the reasons for this association are unknown. In response to the occurrence of a case of sarcoidosis in a U.S. Navy (USN) enlisted man, CDC's National Institute for Occupational Safety and Health (NIOSH) analyzed USN data on cases of sarcoidosis diagnosed among active-duty enlisted personnel during 1965-1993. This report summarizes the findings of this analysis, which indicate that the incidence of sarcoidosis declined among USN enlisted men during 1965-1993, particularly among blacks, and that the risk for sarcoidosis was statistically associated with the assignment of USN enlisted men to aircraft carriers.
NIOSH obtained records from the U.S. Naval Health Research Center (NHRC) for all incident cases of sarcoidosis (defined as diagnosis of "sarcoidosis" by a USN health-care provider) identified among white and black enlisted men while on active duty at any time from 1965 through 1993 * (n=1121). Incidence rates were calculated using age-specific total denominator data for white and black enlisted men on active duty from 1971 through 1993 (denominator data were unavailable for the years before 1971). Numbers for other races were too small for meaningful analysis (no more than three incident cases of sarcoidosis were diagnosed among persons in any other racial category); women were excluded because none had been assigned to aircraft carriers -- an exposure of particular a priori interest -- during 1965-1993.
