0
Original Research |

Inflammatory Biomarkers Predict Airflow Obstruction After Exposure to World Trade Center DustBiomarkers After World Trade Center Exposure

Anna Nolan, MD, FCCP; Bushra Naveed, MD; Ashley L. Comfort, BS; Natalia Ferrier, MD; Charles B. Hall, PhD; Sophia Kwon, MPH; Kusali J. Kasturiarachchi, BA; Hillel W. Cohen, DrPH; Rachel Zeig-Owens, MPH; Michelle S. Glaser, MPH; Mayris P. Webber, DrPH; Thomas K. Aldrich, MD, FCCP; William N. Rom, MD, FCCP; Kerry Kelly, MD; David J. Prezant, MD, FCCP; Michael D. Weiden, MD
Author and Funding Information

From the Division of Pulmonary, Critical Care, and Sleep Medicine (Drs Nolan, Naveed, Ferrier, Rom, and Weiden and Mss Comfort, Kwon, and Kasturiarachchi), Department of Medicine, New York University School of Medicine, New York; the Bureau of Health Services and Office of Medical Affairs (Drs Nolan, Webber, Kelly, Prezant, and Weiden and Mss Comfort, Zeig-Owens, and Glaser), Fire Department of New York, Brooklyn; the Department of Epidemiology and Population Health (Drs Hall, Cohen, and Webber), Albert Einstein College of Medicine, Bronx; the Touro College of Osteopathic Medicine (Ms Kwon), New York; and the Pulmonary Medicine Division (Drs Aldrich and Prezant), Department of Medicine, Montefiore Medical Center and Albert Einstein College of Medicine, Bronx, NY.

Correspondence to: Michael D. Weiden, MD, NYU School of Medicine, 550 1st Ave, New York, NY 10016; e-mail: michael.weiden@med.nyu.edu


For editorial comment see page 278

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians. See online for more details.

Funding/Support: This work was supported by the National Institutes of Health [Grants K23HL084191 (Dr Nolan), K24A1080298 (Dr Weiden), UL1 RR029893, T32-ES007267 (Drs Naveed and Ferrier), U01CA008617, RO1HL090316 (Dr Rom), and 1UL1RR029893 (New York University, Clinical and Translational Science Institute)] and the National Institute for Occupational Safety and Health [Grants U10-OH008243, U10-OH008242 (Dr Prezant)].


Chest. 2012;142(2):412-418. doi:10.1378/chest.11-1202
Text Size: A A A
Published online

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 FEV1 at SPE (34 months; interquartile range, 25-57). Cases of airflow obstruction had FEV1 less than the lower limit of normal (LLN) (100 of 801; 70 of 100 had serum), whereas control subjects had FEV1 greater than or equal to LLN (153 of 801; 124 of 153 had serum).

Results:  From monitoring entry to SPE years later, FEV1 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 FEV1 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.

Figures in this Article

Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Figures

Tables

References

NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).

Some tools below are only available to our subscribers or users with an online account.

Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Related Content

Customize your page view by dragging & repositioning the boxes below.

CHEST Journal Articles
PubMed Articles
  • CHEST Journal
    Print ISSN: 0012-3692
    Online ISSN: 1931-3543