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Chest. 2012 Aug;142(2):412-418. doi: 10.1378/chest.11-1202.

Inflammatory biomarkers predict airflow obstruction after exposure to World Trade Center dust.

Author information

1
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.
2
Division of Pulmonary, Critical Care, and Sleep Medicine, Department of Medicine, New York University School of Medicine, New York.
3
Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY.
4
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.
5
Bureau of Health Services and Office of Medical Affairs, Fire Department of New York, Brooklyn.
6
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.
7
Pulmonary Medicine Division, Department of Medicine, Montefiore Medical Center and Albert Einstein College of Medicine, Bronx, NY.
8
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.
9
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.

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.

PMID:
21998260
PMCID:
PMC3425337
DOI:
10.1378/chest.11-1202
[Indexed for MEDLINE]
Free PMC Article

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