Home Health & Education Racial disparities, environmental factors influence sarcoidosis risk in U.S. population

Racial disparities, environmental factors influence sarcoidosis risk in U.S. population

Bernie Mac

New research published in the Annals of the American Thoracic Society reveals significant racial disparities in sarcoidosis incidence in the United States. Based on data from the Optum health care database covering 15% of U.S. residents over three years (2010–13), the study sheds light on the impact of environmental exposures on sarcoidosis risk, mainly focusing on the variations among ethnic groups.

This revelation comes more than 15 years after the disease gained attention because of the untimely death of actor-comedian Bernie Mac, who battled sarcoidosis for 25 years before dying in 2008 at the age of 50.

While Mac’s publicist attributed his death to pneumonia, not sarcoidosis, medical experts claim the interconnectedness of the two conditions cannot be ignored. They argue that individuals with sarcoidosis are predisposed to pneumonia, which places emphasis on the significance of understanding and addressing this complex disease.

The latest study utilized the Optum health care database covering three years from 2010 to 2013 and identified 29,372 adult patients with sarcoidosis. Notably, 55% of these patients were over 55 years old at the time of diagnosis, challenging previous assumptions about the peak age of the disease.

Among the key findings, the incidence and prevalence rates of sarcoidosis were notably higher in African Americans compared to other ethnic groups. African Americans exhibited an incidence rate of 17.8 and a prevalence rate of 141.4 per 100,000, while White individuals had rates of 8.1 and 49.8, Hispanics at 4.3 and 21.7, and Asians at 3.2 and 18.9, respectively.

The data provides a comprehensive snapshot of sarcoidosis in the United States, challenging prior estimates of 150,000 to 200,000 cases. The study’s findings underscored the need for heightened awareness, early detection, and tailored treatment strategies for different ethnic and demographic groups.

The research also explored the impact of environmental exposures on sarcoidosis risk. Exposure to mold, musty odors, various metals, and farm animals increased the odds of sarcoidosis, with African Americans showing stronger associations between environmental factors and the disease compared to European Americans.

The study emphasizes the need for a more thorough understanding of the etiology of the disease, even though granulomas form and grow during sarcoidosis without known pathogens. The data challenges prior estimates of sarcoidosis cases in the U.S. and highlights the importance of considering environmental factors and racial disparities in future research and healthcare initiatives related to sarcoidosis prevention and treatment.

“The present study adds further support to multiple exposures as risk factors for sarcoidosis identified in the National Library of Medicine’s ‘A Case Control Etiologic Sarcoidosis Study,’ including protective effects of tobacco exposure and risk-increasing effects of metals and insecticides,” Albert M. Levin, Ph.D, director of the Center for Bioinformatics at Henry Ford Health, and colleagues wrote.

 “In trying to understand the underlying causes of exposure effects that differ by race, one cannot overlook the potential of racial bias in the diagnostic workup of sarcoidosis cases and even in the exposure assessment that could lead to spurious results,” Levin and colleagues wrote.

“Reports of disparate disease outcomes for low-income African Americans support this possibility, and future studies should be appropriately designed to minimize or eliminate such biases and explore measures of structural racism as potential contributory exposures to the differences in risk of sarcoidosis between African Americans and European Americans.”

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