11

Sarcoidosis (ICD-9 Code 135)Sarcoidosis (ICD-9 code 135) is a multi-system disease of unknown etiology with a marked predilection for the luorgan system or tissue can be involved, including the heart, skin, eyes, nervous system, liver, kidneys, etc. The halthe histological finding of non-caseating granulomas in the affected tissue. The condition is diagnosed by excludinstates that can present with similar histological findings, such as mycobacterial and fungal infections, hypersensitivlung, and chronic beryllium disease [Newman et al. 1997]. In fact, some of these other conditions may at times be sarcoidosis. Such misclassifications might increase the apparent incidence of sarcoidosis and influence its geograpInfectious agents have been etiologically implicated, but never confirmed as causative, in sarcoidosis. It is well knracial and ethnic groups have higher incidence of the disease; there is a three-fold higher incidence for blacks comUnited States [Rybicki et al. 1997]. In addition, incidence rates vary substantially by country, including a high incin Scandinavia, suggesting either an ethnic or environmental component to the cause of the disease. Sarcoidosis ochest x-ray findings of bilateral hilar adenopathy with or without parenchymal/interstitial markings. In many of theand the chest x-ray findings resolve over time, even without treatment. In a small percentage of patients, the diseamedical therapy. Death from sarcoidosis usually results from pulmonary and/or cardiac involvement. ReferencesNewman LS, Rose CS, Maier LA [1997]. Sarcoidosis. N Engl J Med 336:1224-1234.Rybicki BA, Major M, Popovich J Jr, Maliarik MJ, Iannuzzi MC [1997]. Racial differences in sarcoidosis incidence: a 5-year study in organization. Am J Epidemiol 145:234-241.
6DUFRLGRVLV

$JH$GMXVWHG 'HDWK 5DWHV E\ +6$

86 5HVLGHQWV  <HDUV RI $JH DQG 2OGHU 

,&' &RGH 

'RXEOHKDWFK PDUNV LQGLFDWH   GHDWKV
6DUFRLGRVLV

'HDWK 5DWHV RI (DFK +6$ &RPSDUHG ZLWK 86 5DWH

86 5HVLGHQWV  <HDUV RI $JH DQG 2OGHU 

,&' &RGH 

'RXEOHKDWFK PDUNV LQGLFDWH   GHDWKV
/XQJ &DQFHU

$JH$GMXVWHG 'HDWK 5DWHV E\ +6$

86 5HVLGHQWV  <HDUV RI $JH DQG 2OGHU 

,&' &RGH 
/XQJ &DQFHU

'HDWK 5DWHV RI (DFK +6$ &RPSDUHG ZLWK 86 5DWH

86 5HVLGHQWV  <HDUV RI $JH DQG 2OGHU 

,&' &RGH 
16

Lung Cancer (ICD-9 Code 162)Malignant neoplasms of trachea, bronchus, and lung (ICD-9 code 162) are caused primarily by cigarette smoking, occupational and environmental exposures also represent well known causes. Occupational carcinogens causing larsenic, asbestos, chloromethyl ethers, chromium, polycyclic aromatic hydrocarbons, ionizing radiation, nickel, anand Fraumeni 1996]. Silica was recently designated as a human carcinogen [IARC 1997], and occupational exposindustrial exposures, including acrylonitrile and beryllium, have also been associated with lung cancer excess. Radreported to increase the risk of lung cancer among underground miners, with risk quantitatively related to the inhadaughter products [Samet 1989]. It has been estimated that, in the United States in 1985, cigarette smoking accoof lung cancer in males and nearly 80 percent in females [Surgeon General 1989]. Several studies have observed tamong males, lung cancer is inversely related to socioeconomic status as measured by income or education level [1996]. For example, British mortality data have revealed a two-fold difference in mortality between low and high General 1978].The estimated population attributable risk of lung cancer due to occupation was 9.2 percent based on hospital datmetropolitan areas [Morabia et al. 1992]. In another study, the estimated population attributable risk due to occuwas between 4.6 percent and 9.2 percent after adjustment for smoking [Vineis and Simonato 1991].ReferencesBlot WJ, Fraumeni JF, Jr. [1996]. Cancers of the lung and pleura. In: Schottenfeld D, Fraumeni JF, Jr., eds. Cancer epidemiology anOxford: Oxford University Press, pp. 637-665.IARC (International Agency for Research on Cancer) [1997]. IARC monographs on the evaluation of carcinogenic risks to humans: sdust and para-armid fibrils. 68:41-242.Morabia A, Markowitz S, Garibaldi K, Wynder EL [1992]. Lung cancer and occupation: results of a multicenter case-control study. BRegistrar General [1978]. Occupational mortality. Decennial supplement for England and Wales, 1970-1972. London: HMSO.Samet JM [1989]. Radon and lung cancer. J Natl Cancer Inst 81:745-757.USDHHS (U.S. Department of Health and Human Services) [1989]. Reducing the health consequences of smoking: 25 years of progre(CDC) 89-8411, pp. 121-188.Vineis P, Simonato L [1991]. Proportion of lung and bladder cancers in males resulting from occupation: a systematic approach. Arch