title: Inflammatory biomarkers predict airflow obstruction after exposure to World Trade Center dust.
abstract: BACKGROUND
  The World Trade Center (WTC) collapse on September 11, 2001, produced airflow obstruction in a majority of firefighters receiving subspecialty pulmonary evaluation (SPE) within 6.5 years post-September 11, 2001.
  
  
  METHODS
  In a cohort of 801 never smokers with normal pre-September 11, 2001, FEV1, we correlated inflammatory biomarkers and CBC counts at monitoring entry within 6 months of September 11, 2001, with a median FEV(1) at SPE (34 months; interquartile range, 25-57). Cases of airflow obstruction had FEV(1) less than the lower limit of normal (LLN) (100 of 801; 70 of 100 had serum), whereas control subjects had FEV(1) greater than or equal to LLN (153 of 801; 124 of 153 had serum).
  
  
  RESULTS
  From monitoring entry to SPE years later, FEV(1) declined 12% in cases and increased 3% in control subjects. Case subjects had elevated serum macrophage derived chemokine (MDC), granulocyte-macrophage colony-stimulating factor (GM-CSF), granulocyte colony-stimulating factor, and interferon inducible protein-10 levels. Elevated GM-CSF and MDC increased the risk for subsequent FEV(1) less than LLN by 2.5-fold (95% CI, 1.2-5.3) and 3.0-fold (95% CI, 1.4-6.1) in a logistic model adjusted for exposure, BMI, age on September 11, 2001, and polymorphonuclear neutrophils. The model had sensitivity of 38% (95% CI, 27-51) and specificity of 88% (95% CI, 80-93).
  
  
  CONCLUSIONS
  Inflammatory biomarkers can be risk factors for airflow obstruction following dust and smoke exposure. Elevated serum GM-CSF and MDC levels soon after WTC exposure were associated with increased risk of airflow obstruction in subsequent years. Biomarkers of inflammation may help identify pathways producing obstruction after irritant exposure.
authors: Division of Pulmonary, Critical Care, and Sleep Medicine, Department of Medicine, New York University School of Medicine, New York; Bureau of Health Services and Office of Medical Affairs, Fire Department of New York, Brooklyn.
authors: Anna
authors: A
authors: Nolan
authors: Division of Pulmonary, Critical Care, and Sleep Medicine, Department of Medicine, New York University School of Medicine, New York.
authors: Bushra
authors: B
authors: Naveed
authors: Division of Pulmonary, Critical Care, and Sleep Medicine, Department of Medicine, New York University School of Medicine, New York; Bureau of Health Services and Office of Medical Affairs, Fire Department of New York, Brooklyn.
authors: Ashley L
authors: AL
authors: Comfort
authors: Division of Pulmonary, Critical Care, and Sleep Medicine, Department of Medicine, New York University School of Medicine, New York.
authors: Natalia
authors: N
authors: Ferrier
authors: Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY.
authors: Charles B
authors: CB
authors: Hall
authors: Division of Pulmonary, Critical Care, and Sleep Medicine, Department of Medicine, New York University School of Medicine, New York; Touro College of Osteopathic Medicine, New York.
authors: Sophia
authors: S
authors: Kwon
authors: Division of Pulmonary, Critical Care, and Sleep Medicine, Department of Medicine, New York University School of Medicine, New York.
authors: Kusali J
authors: KJ
authors: Kasturiarachchi
authors: Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY.
authors: Hillel W
authors: HW
authors: Cohen
authors: Bureau of Health Services and Office of Medical Affairs, Fire Department of New York, Brooklyn.
authors: Rachel
authors: R
authors: Zeig-Owens
authors: Bureau of Health Services and Office of Medical Affairs, Fire Department of New York, Brooklyn.
authors: Michelle S
authors: MS
authors: Glaser
authors: Bureau of Health Services and Office of Medical Affairs, Fire Department of New York, Brooklyn; Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY.
authors: Mayris P
authors: MP
authors: Webber
authors: Pulmonary Medicine Division, Department of Medicine, Montefiore Medical Center and Albert Einstein College of Medicine, Bronx, NY.
authors: Thomas K
authors: TK
authors: Aldrich
authors: Division of Pulmonary, Critical Care, and Sleep Medicine, Department of Medicine, New York University School of Medicine, New York.
authors: William N
authors: WN
authors: Rom
authors: Bureau of Health Services and Office of Medical Affairs, Fire Department of New York, Brooklyn.
authors: Kerry
authors: K
authors: Kelly
authors: Bureau of Health Services and Office of Medical Affairs, Fire Department of New York, Brooklyn; Pulmonary Medicine Division, Department of Medicine, Montefiore Medical Center and Albert Einstein College of Medicine, Bronx, NY.
authors: David J
authors: DJ
authors: Prezant
authors: Division of Pulmonary, Critical Care, and Sleep Medicine, Department of Medicine, New York University School of Medicine, New York; Bureau of Health Services and Office of Medical Affairs, Fire Department of New York, Brooklyn. Electronic address: michael.weiden@med.nyu.edu.
authors: Michael D
authors: MD
authors: Weiden
mesh_terms: D000328:Adult; D000402:Airway Obstruction / Q000097:blood* / Q000175:diagnosis / Q000209:etiology; D015415:Biomarkers / Q000097:blood; D016022:Case-Control Studies; D015331:Cohort Studies; D016207:Cytokines / Q000097:blood*; D004391:Dust; D061388:Firefighters; D005541:Forced Expiratory Volume; D006801:Humans; D018836:Inflammation Mediators / Q000097:blood*; D008875:Middle Aged; D009519:New York City; D016273:Occupational Exposure / Q000009:adverse effects*; D047851:September 11 Terrorist Attacks; D013997:Time Factors
chemical_list: D015415:Biomarkers; D016207:Cytokines; D004391:Dust; D018836:Inflammation Mediators