OCM3 Sarcoidosis in the armed services: What can we learn about prevention? (Occupational & Environmental Medicine).

OCM3 SARCOIDOSIS IN THE ARMED SERVICES: WHAT CAN WE LEARN ABOUT PREVENTION? Roscoe C. Young, Jr., MD, MSPH, and Dee McLeod, BA. Meharry Medical College, Nashville, Tenn.

A survey of epidemiologic reports of sarcoidosis from the Department of Veterans Affairs, the US Armed Forces, and those of three other countries was conducted. Antigenic stimuli that initiate the immunologic cascade leading to a hyperactive immune response and granuloma formation in organ systems characteristic of sarcoidosis may be due to various low-level exposures superimposed against a fertile background of hereditary predisposition. In the Armed Forces of the United States, subtle secular trends suggest a decrease in cases and decrease in the high black/white ratio of the disease, since exposures are identified that cause sarcoid-like illness. Ethnic/racial equality is eliminating prejudicial duty assignments and decreasing racial disparity in the disease. We urge continued legislative controls on environmental emissions, pollution, and good public health practices afloat, aloft, and in field environments, to further decrease sarcoidosis and similar illnesses that undermine the global readiness of our armed forces.