Pneumonologie

, Volume 153, Issue 1, pp 1–20 | Cite as

Epidemiology of intrathoracic sarcoidosis in the Federal Republic of Germany

Morbidity rates in different regions, community sizes and professions
  • J. Buss
  • H. Dörken
Article

Abstract

From a total group of 782 cases of intrathoracic sarcoidosis, detected in the German Forces (Deutsche Bundeswehr) from 1965–1969 (incidence 28 per 100,000), the 205 youngest cases of about 20 years of age were compared with 1519 unaffected control soldiers of the same age.

The regional distribution did not reveal differences between the North and the South of West Germany. Comparatively low rates of industrialized regions (Nordrhein-Westfalen, Saarland) and big cities (Hamburg, Bremen) can only partly explain the observed regional differences. The highest rate was found for Bayern (49.8 per 100,000), the lowest for Saarland (11.2 per 100,000).

Communities of more than 50,000 inhabitants show about half the incidence of small communities, suggesting a rural factor in the etiology. Low rates in communities of less than 500 inhabitants and peak rates in communities of 10,000 – 20,000 inhabitants in the birthplace and life-time residence studies point to a hypothetical urban triggering influence in the development of the disease.

Farmers show rates twice as high, and cabinetmakers three times as high as the average rate. Farmers seem to be exposed more to a sarcoidosis agent, whereas in the case of cabinetmakers a facilitating action of wood dust most probably has to be considered.

Morbidity rates in the various-sized communities and different professions of another group of patients (92 females and 102 males) of the sanatorium Tönsheide, Schleswig-Holstein, diagnosed from 1955 – 1970, confirmed the results obtained by the Bundeswehr study.

Key words

Sarcoidosis Epidemiology 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Acheson, E. D., Hadfield, E. H., Macbeth, R. G.: Carcinoma of the nasal cavity and accessory sinuses in woodworkers. Lancet1967/1, 311–312CrossRefPubMedGoogle Scholar
  2. 2.
    Alsbirk, P. H.: Epidemiologic studies on sarcoidosis in Denmark. Acta med. Scand. Suppl.425, 106–109 (1964)PubMedGoogle Scholar
  3. 3.
    Atwood, W. G., Nelson, C. T.: Über die Epidemiologie und Ätiologie der Sarkoidose. Fortschr. Med.83, 723–725 (1965)Google Scholar
  4. 4.
    Baer, R. B.: Familial sarcoidosis — epidemiological aspects with notes on a possible relationship to the chewing of pine pitch. Arch. Int. Med.105, 60 (1960)Google Scholar
  5. 5.
    Bailar, J. C., Ederer, F.: Significance factors for the ratio of a Poisson variable to its expectation. Biometrics20, 639–643 (1964)Google Scholar
  6. 6.
    Baldry, P. E., Sutherland, J., Scadding, J. G.: Geographical variations in the incidence of sarcoidosis in Great Britain: a comparative study of four areas. Tubercle (London)50, 211–231 (1969)Google Scholar
  7. 7.
    Barthel, E.: Die Lungensarkoidose aus der Sicht einer Heilstätte. Z. Erkr. Atmungsorgane132, 17–30 (1970)Google Scholar
  8. 8.
    Bauer, H. J., Löfgren, S.: International study of pulmonary sarcoidosis in mass chest radiography. Acta med. Scand. Suppl.425, 103–105 (1964)PubMedGoogle Scholar
  9. 9.
    Bauer, H. J., Wijkström, S.: The prevalence of pulmonary sarcoidosis in Swedish mass radiographic surveys. Acta med. Scand Suppl.425, 112–114 (1964)PubMedGoogle Scholar
  10. 10.
    Baum, G. L., Schwarz, J., Barlow, P. B.: Sarcoidosis and specific etiologic agents: a continuing enigma. Chest63, 488–494 (1973)PubMedGoogle Scholar
  11. 11.
    Becker, F. W., Gallmeier, W. M., Hertenstein, Ch., Kalden, J. R.: Epstein Barr virus antibodies and lymphocytotoxic serum antibodies in patients with sarcoidosis. Klin. Wschr.50, 927–928 (1972)CrossRefPubMedGoogle Scholar
  12. 12.
    Behrendt, H. J.: Discussion note. In: Die Sarcoidose. Wurm, K. (ed.). pp. 175–176. Höchenschwand: K. Wurm 1968Google Scholar
  13. 13.
    Bouhuys, A., Peters, J. M.: Control of environmental lung disease. New Engl. J. Med.283, 573–582 (1970)PubMedGoogle Scholar
  14. 14.
    Bowman, B. U., Daniel, T. M.: Further evidence against the concept of decreased phage neutralizing ability of serum of patients with sarcoidosis. Amer. Rev. Resp. Dis.104, 908–914 (1971)PubMedGoogle Scholar
  15. 15.
    Bowman, B. U., Koehler, R. M., Kubina, G.: On the isolation of infectious agents from granulomas of patients with sarcoidosis. Amer. Rev. Resp. Dis.107, 467–468 (1973)PubMedGoogle Scholar
  16. 16.
    Brackerts, D., Kalden, J. R., Wurm., K.: Tagungsberichte: 6th International Sarcoidosis Conference, Tokio Sept. 1972. Prax. Pneum.27, 314–320 (1973)Google Scholar
  17. 17.
    Brandstetter, E.: Handbuch des Wehrrechts. Köln, Berlin, Bonn, München: Carl Heymanns 1970Google Scholar
  18. 18.
    Brocard, H., Vannier, R.: La sarcoïdose chez les Antillais travaillant à Paris. Soc. méd. Hôp. (Paris)119, 901–905 (1968)Google Scholar
  19. 19.
    Buchmüller, W.: Die Häufigkeit und das Erscheinungsbild des Boeck'schen Sarkoid an Hand des Krankengutes der Universitäts-Hautklinik zu Tübingen. Diss. med., Tübingen 1948Google Scholar
  20. 20.
    Buck, A. A., Sartwell, P. E.: Epidemiologic investigations of sarcoidosis. Amer. J. Hyg.74, 137–202 (1961)PubMedGoogle Scholar
  21. 21.
    Carr, D. T., Gage, R. P.: The geographic distribution of sarcoidosis. Amer. Rev. Tuberc.70, 899–900 (1954)Google Scholar
  22. 22.
    Chapmann, J. S.: Epidemiology of sarcoidosis in the United States of America. Acta med. Scand. Suppl.425, 146–148 (1964)PubMedGoogle Scholar
  23. 23.
    Chrétiens, J., Saltiel, J. C.: Mémento immunologique de la sarcoïdose. Paris: Masson 1971Google Scholar
  24. 24.
    Comstock, G. W., Keltz, H., Sencer, D. J.: Clay eating and sarcoidosis. A controlled study in the state of Georgia. Amer. Rev. Resp. Dis.84, 130–134 (1961)Google Scholar
  25. 25.
    Cooch, J. W.: Sarcoidosis in the United States Army, 1952 through 1956. Amer. Rev. Resp. Dis.84, 103–108 (1961)Google Scholar
  26. 26.
    da Costa, J. L.: Geographic epidemiology of sarcoidosis in Southeast Asia. Amer. Rev. Resp. Dis.108, 1269–1272 (1973)PubMedGoogle Scholar
  27. 27.
    Mc. Cuiston, C. F., Michael, M. jr., Hudgins, P. C.: Geographic epidemiology of sarcoidosis in Florida. Amer. Rev. Resp. Dis.84, 124–129 (1961)Google Scholar
  28. 28.
    Cummings, M. M., Dunner, E., Schmidt jr., R. H., Barwell, J. B.: Concepts of epidemiology of sarcoidosis: Preliminary report of 1194 cases reviewed with special reference to geographic ecology. Postgrad. Med.19, 437–446 (1956)PubMedGoogle Scholar
  29. 29.
    Cummings, M. M., Dunner, E., Williams, J. A.: Epidemiologic and clinical observations in sarcoidosis. Ann. Int. Med.50, 879–890 (1959)PubMedGoogle Scholar
  30. 30.
    Cummings, M. M.: An evaluation of the possible relationship of pine pollen to sarcoidosis (a critical summary). Acta med. Scand. Suppl.425, 48–50 (1964)PubMedGoogle Scholar
  31. 31.
    Dunner, E., Williams, J. H. jr.: Epidemiology of sarcoidosis in the United States. Amer. Rev. Resp. Dis.84, 163–166 (1961)PubMedGoogle Scholar
  32. 32.
    Femi Pearse, D., Odunjo, E. O.: Sarcoidosis in the Nigerian. A report of five cases. Trop. Geogr. Med.25, 130–138 (1973)PubMedGoogle Scholar
  33. 33.
    Fletcher, G. H.: Sarcoidosis in miners in the republic of Zambia. Central African J. Med.12, 29–30 (1966)Google Scholar
  34. 34.
    Fried, K. H.: Discussion note. Acta med. Scand. Suppl.425, 60 (1964)Google Scholar
  35. 35.
    Fried, K. H.: Vorkommen und Häufigkeit von Sarkoidose in Berlin (West) von 1949 – 62. Acta med. Scand. Suppl.425, 130 (1964)PubMedGoogle Scholar
  36. 36.
    Fruhmann, G., Specht, H.: Byssinose und seltenere Hypersensitivitätspneumonitiden. Internist15, 412–421 (1974)PubMedGoogle Scholar
  37. 37.
    Gentry, J. T., Nitowsky, H. M., Micnael, M. jr.: Studies on the epidemiology of sarcoidosis in the United States: The relationship to soil areas and to urban-rural residence. J. Clin. Invest.34, 1839–1856 (1955)PubMedGoogle Scholar
  38. 38.
    Gross, N. J.: The paradoxical skin response in sarcoidosis. A hypothesis. Amer. Rev. Resp. Dis.107, 798–801 (1973)PubMedGoogle Scholar
  39. 39.
    Gundelfinger, B. F., Britten, S. A.: Sarcoidosis in the United States Navy. Amer. Rev. Resp. Dis.84, 109–115 (1961)PubMedGoogle Scholar
  40. 40.
    Hall, G., Sharma, O. P., Naish, P., Doe, W., James, D. G.: The epidemiology of sarcoidosis. Postgrad. Med. J.45, 241–250 (1969)PubMedGoogle Scholar
  41. 41.
    Ten Have, H.: Klinische aspekten van de zietke van Besnier-Boeck-Schaumann. Groningen: Proefschrift, Hoitsema, 1958Google Scholar
  42. 42.
    Heine, F.: Zur Frage der tuberkulösen Ätiologie der Sarkoidose. Prax. Pneum.27, 250–264 (1973)Google Scholar
  43. 43.
    Hennig, W.: Personal communicationGoogle Scholar
  44. 44.
    Hosoda, Y., Chiba, Y., Nobechi, K.: Incidence and prevalence of sarcoidosis in Japan. La Sarcoïdose, Report 4th Conf. Intern. Sarcoidosis. pp. 360–364. Paris: Masson 1967Google Scholar
  45. 45.
    Israel, H. L., Sones, M.: Sarcoidosis. Amer. Pract. Digest Treat.3, 18–21 (1952)Google Scholar
  46. 46.
    Israel, H. L.: Influence of race and geographical origin on sarcoidosis. Arch. Environ. Health20, 608–609 (1970)PubMedGoogle Scholar
  47. 47.
    James, D. G., Brett, G. Z.: Prevalence of intrathoracic sarcoidosis in Britain. Acta med. Scand. Suppl.425, 115–117 (1964)PubMedGoogle Scholar
  48. 48.
    James, D. G., Siltzbach, L. E., Sharma, O. P., Carstairs, L. S.: A tale of two cities: a comparison of sarcoidosis in London and New York. Arch. Int. Med.123, 187–191 (1969)CrossRefGoogle Scholar
  49. 49.
    James, D. G.: Modern concepts of sarcoidosis. Chest64, 675–677 (1973)PubMedGoogle Scholar
  50. 50.
    James, D. G., Walker, A. N., Turiaf, J., Battesti, J. P.: A tale of two cities: a comparison of sarcoidosis in London and Paris. Postgrad. Med. J.49, 86–89 (1973)PubMedGoogle Scholar
  51. 51.
    Jansson, E., Hannuksela, M., Eklund, H., Halme, H., Tuuri, S.: Isolation of a mycoplasma from sarcoid tissue. J. Clin. Path.25, 837–842 (1972)PubMedGoogle Scholar
  52. 52.
    Jörgensen, G.: Untersuchungen zur Genetik der Sarkoidose. Heidelberg: Alfred Hüthig 1965Google Scholar
  53. 53.
    Keller, A. Z., Dunner, E.: Inquiry into the epidemiological aspects of sarcoidosis. La Sarcoïdose. Report 4th Conf. Intern. Sarcoidosis, pp. 319–325. Paris: Masson 1967Google Scholar
  54. 54.
    Keller, A. Z.: Hospital, age, racial, occupational, geographical, clinical and survivorghip characteristics in the epidemiology of sardoidosis. Amer. J. Epidemiol.94, 222–230 (1971)Google Scholar
  55. 55.
    Keller, A. Z.: Anatomic sites, age attributes and rates of sarcoidosis in U.S. veterans. Amer. Rev. Resp. Dis.107, 615–620 (1973)PubMedGoogle Scholar
  56. 56.
    Kendig, E. L. jr., Paecock, R. L., Ryburn, S.: Sarcoidosis — report of three cases in siblings under fifteen years of age. New Engl. J. Med.260, 962–966 (1959)PubMedGoogle Scholar
  57. 57.
    Kent, D. C., Houk, V. N., Elliot, R. C., Sokolowski jr, J. W., Baker, J. H., Sorensen, K.: The definite evaluation of sarcoidosis. Amer. Rev. Resp. Dis.101, 721 (1970)PubMedGoogle Scholar
  58. 58.
    Kitamura, K., Shigematsu, J., Hosoda, Y.: Sarcoidosis in Japan — observation on 700 cases. Amer. Rev. Resp. Dis.96, 952–956 (1967)PubMedGoogle Scholar
  59. 59.
    Kissmeyer, A.: La maladie de Boeck. Sarcoïdes cutanées bénignes multiples. Paris: Masson 1932Google Scholar
  60. 60.
    Lomholt, S.: Discussion sur l'étiologie. Bull. Soc. Franc. derm. syph.:41, 1350–1354 (1934)Google Scholar
  61. 61.
    Longcope, W. T., Pierson, J. W.: Boeck's sarcoid (sarcoidosis). Bull. Johns Hopkins Hosp.60, 223–267 (1937)Google Scholar
  62. 62.
    Lundbäck, H., Löfgren, S.: Attempts at isolation of virus strains from cases of sarcoidosis and malignant lymphoma. — I. Statistical evaluation of results previously reported. Acta med. Scand.143, 98–104 (1952)PubMedGoogle Scholar
  63. 63.
    Mankiewicz, E.: The relationship of sarcoidosis to anonymous bacteria. Acta med. Scand. Suppl.425, 68–73 (1964)PubMedGoogle Scholar
  64. 64.
    Meissner, G.: Nachweis von Tuberkelbakterien bei Fällen von Morbus Boeck. In: Sarkoidose, pp. 23–28. Jensen, E. (ed.). Bremen: Schünemann 1972Google Scholar
  65. 65.
    Meyer-Rohn, J.: Untersuchungen zur Ätiologie des Morbus Boeck. Arch. klin. exp. Derm.213, 509 (1961)CrossRefGoogle Scholar
  66. 66.
    Michael, M. jr., Cole, R. M., Beeson, P. B., Olson, B. J.: Sarcoidosis — preliminary report on a study of 350 cases with special reference to epidemiology. Amer. Rev. Tuberc.62, 403–407 (1950)Google Scholar
  67. 67.
    Milham, S., Hesser, J. E.: Hodgkin's disease in woodworkers. Lancet1967/2, 136–137CrossRefPubMedGoogle Scholar
  68. 68.
    Milliken, T. G.: Sarcoidosis in Northern Ireland. Acta med. Scand. Suppl.425, 123–125 (1964)PubMedGoogle Scholar
  69. 69.
    Münzner, Chr.: Einige Daten bei 1152 Hamburger Bürgern — Ergebnisse einer Fragebogenerhebung. Diss. med., Hamburg 1968Google Scholar
  70. 70.
    Neumann, C.: Sarkoidose in Deutschland. Prax. Pheum.23, 130–132 (1969)Google Scholar
  71. 71.
    Neumann, C.: Zur Epidemiologie der Sarkoidose in der Bundesrepublik. Pneumonologie143, 299–330 (1970)Google Scholar
  72. 72.
    Neumann, C.: Zur Epidemiologie der Sarkoidose. Pneumonologie149, 229–236 (1973)PubMedGoogle Scholar
  73. 73.
    Nitter, L.: Changes in the chest roentgenogram in Boeck's sarcoid of the lungs. Acta radiologica Suppl.105 (1953)Google Scholar
  74. 74.
    Nottebart, H. C., Mc Ghee, R. F., Utz, J. P.: Cryptococcosis complicating sarcoidosis. Amer. Rev. Resp. Dis.107, 1060–1063 (1973)PubMedGoogle Scholar
  75. 75.
    Orie, M. B. M., ter Brugge, R.: Prevalence of pulmonary sarcoidosis in the Netherlands. Acta med. Scand. Suppl.425, 137 (1964)PubMedGoogle Scholar
  76. 76.
    Present, D. H., Siltzbach, L. E.: Sarcoidosis among the Chinese and a review of the worldwide epidemiology of sarcoidosis. Amer. Rev. Resp. Dis.95, 285–292 (1967)PubMedGoogle Scholar
  77. 77.
    Putkonen, T., Hannuksela, M., Mustakallio, K. K.: Cold season prevalence of the clinical onset of sarcoidosis. Arch. Environ. Health 12, 564–568 (1966)PubMedGoogle Scholar
  78. 78.
    Rabinowitz, J. G., Ulreich, S., Soriano, C.: The usual unusual manifestations of sarcoidosis and "hilar haze" — a new diagnostic aid. Amer. J. Roentgenol.120, 821–831 (1974)PubMedGoogle Scholar
  79. 79.
    Ramirez, E. A.: Observations on the geographic distribution of sarcoidosis in Puerto Rico. La Sarcoïdose, Report 4th Conf. Intern. Sarcoidosis, pp. 403–406. Paris: Masson 1967Google Scholar
  80. 80.
    Refvem, O.: II. Boeck's disease and occurrence of minute mineral particles (preliminary report). Acta pathol. microbiol. Scand.25, 111–121 (1948)Google Scholar
  81. 81.
    Ritter, G.: Die neue Krankenblattdokumentation in den Bundeswehrlazaretten mit ausgewählten Ergebnissen. Wehrmed. Mschr.14, 2–9 (1970)Google Scholar
  82. 82.
    Sartwell, P. E.: Epidemiology of sarcoidosis in the US Navy. Amer. J. Epidemiol.99, 250–257 (1974)Google Scholar
  83. 83.
    Scadding, J. G.: Sarcoidosis. London: Eyre & Spottiswood 1967Google Scholar
  84. 84.
    Schaumann, J.: Étude sur le lupus pernio et ses rapports avec les sarcoïdes cutanées. Ann. Derm. Syph. (Paris)6, 357–373 (1916–1917)Google Scholar
  85. 85.
    Schmidt, M.: Immunologische Befunde bei Sarkoidose. Internist10, 373–376 (1969)PubMedGoogle Scholar
  86. 86.
    Schönholzer, G.: Morbus Besnier-Boeck-Schaumann und Armeedurchleuchtung. Schweiz. Med. Wschr.77, 585–588 (1947)Google Scholar
  87. 87.
    Seiler, E.: Über die Epidemiologie der Sarkoidose (Morbus Boeck) in der Schweiz. Schweiz. Z. Tuberk.17, 205–228 (1960)PubMedGoogle Scholar
  88. 88.
    Sichermann, H. J., Andersen, H. A., De Remee, R. A.: Sarcoidosis or fungal disease? Chest64, 36–38 (1973)PubMedGoogle Scholar
  89. 89.
    Siltzbach, L.: An international Kveim test study 1960–66. La Sarcoidose, Report 4th Conf. Intern. Sarcoidosis, pp. 201–213. Paris: Masson 1967Google Scholar
  90. 90.
    Siltzbach, L.: Geographic aspects of sarcoïdosis. Trans. N. Y. Acad. Sci.29, 364–374 (1967)PubMedGoogle Scholar
  91. 91.
    Terris, M., Chaves, A. D.: Comparative epidemiologic study of sarcoidosis and tuberculosis in New York City. La Sarcoïdose, Report 4th Conf. Intern. Sarcoïdosis, pp. 336–346. Paris: Masson 1967Google Scholar
  92. 92.
    Törnell, E.: Is sarcoidosis a fungoid disease? Acta tuberc. Scand.20, 212 (1946)Google Scholar
  93. 93.
    Törnell, E.: Lymphogranulomatose bénigne et tuberculose. Poumon5, 109–121 (1949)Google Scholar
  94. 94.
    Trübestein, G. K., Ferlinz, R., Stadeler, H. J.: Das Aspergillom der Lunge bei Sarkoidose. Med. Welt23, 1689–1691 (1972)PubMedGoogle Scholar
  95. 95.
    Turiaf, J., Brun, J., Meyer, A.: Epidemiologic investigation on sarcoidosis in France. Acta med. Scand. Suppl.425, 129 (1964)PubMedGoogle Scholar
  96. 96.
    Turiaf, J., Battesti, J. P., Lehner, J. P.: La sarcoïdose de l'enfant. Nouv. Presse méd.3, 1351–1354 (1974)Google Scholar
  97. 97.
    Uehlinger, E. A.: Epidemiology of sarcoidosis in Switzerland. Amer. Res. Resp. Dis.84, 153–154 (1961)Google Scholar
  98. 98.
    Valesky, A., Wolfart, W., Seith, U.: Die Bedeutung der histologischen Sicherung der Diagnose Sarkoidose (Morbus Boeck). Dtsch. Med. Wschr.96, 1833–1836 (1971)PubMedGoogle Scholar
  99. 99.
    Wurm, K.: Sarkoidose (Morbus Boeck). Med. Klinik66, 415–418 (1971)Google Scholar
  100. 100.
    Wurm, K., Reindell, H., Heilmeyer, L.: Der Lungenboeck im Röntgenbild. Stuttgart: Georg Thieme 1958Google Scholar
  101. 101.
    Young, R. C. jr., Titus Dillon, P. Y., Schneider, M. L., Shelton, T. G.: Sarcoidosis in Washington D. C. Arch. Int. Med.125, 102–105 (1970)CrossRefGoogle Scholar
  102. 102.
    Statistisches Reichsamt: Amtliches Gemeindeverzeichnis für das Deutsche Reich auf Grund der Volkszählung 1939. Statistik des Deutschen Reiches, 2nd ed. Berlin 1940, Vol. 550Google Scholar
  103. 103.
    Statistisches Bundesamt: Amtliches Gemeindeverzeichnis für die Bundesrepublik Deutschland, Bevölkerungs- und Gebietsstand 6. Juni 1961. Stuttgart, Mainz: Kohlhammer 1961Google Scholar
  104. 104.
    Statistisches Bundesamt: Erwerbspersonen in beruflicher Gliederung. Heft 13 der Fachserie A "Bevölkerung und Kultur" nach der Volks- und Berufszählung vom 6. Juni 1961. Stuttgart, Mainz: Kohlhammer 1968Google Scholar

Copyright information

© Springer-Verlag 1975

Authors and Affiliations

  • J. Buss
    • 1
  • H. Dörken
    • 1
  1. 1.I. Medizinische Universitätsklinik Hamburg-EppendorfGermany

Personalised recommendations