Abstract
Sarcoidosis was revealed by a worker in an initial post-offer examination. This disorder requires careful review prior to workers being in hot or cold environments, using respirators, or traveling internationally. To protect worker health, occupational health nurses must understand the pathophysiology and risks associated with sarcoidosis.
A common autoimmune disorder, sarcoidosis can affect workers globally. King (2015) stated the classic symptom of sarcoidosis is granulomas in various organs. These tiny nodules can coalesce and interfere with organ function. Although the immune system usually protects the body, an autoimmune disorder results in the body attacking itself, and damaging tissues and organs. According to the Foundation for Sarcoidosis Research (2015), the lungs are affected in 90% of individuals with this disorder.
The cause of sarcoidosis is unknown, but the Foundation for Sarcoidosis Research (2015) suggests chemical, bacterial, or viral triggers. A sarcoidosis gene has not been discovered; however, the Foundation notes sarcoidosis may affect multiple members of a family, suggesting a familial history or genetic link that may provoke an inflammatory response.
All races and ages and both genders are affected by sarcoidosis. Sarcoidosis is most common between 20 and 40 years of age, affects African Americans 3 to 4 times more than other ethnicities, and affects women more than men (King, 2015). Extrapulmonary sarcoidosis can be expressed in the heart and eyes of Japanese Americans, as uveitis in African Americans, and as painful skin lumps in Northern Europeans (Foundation for Sarcoidosis Research, 2015).
In addition, the lungs, lymph nodes, skin, eyes, liver, salivary glands, sinuses, kidneys, heart, muscles, bones, brain, testes, and nervous system all can be affected. Symptomology is dependent on the organ involved and the extent of organ damage. As the lungs are affected in 90% of individuals with sarcoidosis, the most common symptoms are shortness of breath and coughing, but other symptoms may include weight loss, fever, fatigue, and weakness (King, 2015). Treatment is based on presenting symptoms. The goal of treatment is to suppress the inflammatory response, improve symptoms, reduce organ damage, increase quality of life, and prevent lung fibrosis.
Occupational health nurses maintain worker safety, especially when workers are exposed to chemicals or dust. They also prepare workers for international travel and educate them about wearing respirators. Nurses can also assist workers in adopting a healthy lifestyle.
Footnotes
Acknowledgements
The author would like to thank the following individuals: Anita I. Zvaigzne, PhD; Jane Gandy; and Irene M. Cheung, MSN, RN.
The author(s) declared no potential conflicts of interest and received no financial support with respect to the research, authorship, and/or publication of this article.
Author Biography
Letha Smith is an occupational health nurse in Irving, Texas, and is a member of the North Texas Association of Occupational Health Nurses.