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

Anna Nolan, Bushra Naveed, Ashley L. Comfort, Natalia Ferrier, Charles B. Hall, Sophia Kwon, Kusali J. Kasturiarachchi, Hillel W. Cohen, Rachel Zeig-Owens, Michelle S. Glaser, Mayris P. Webber, Thomas K. Aldrich, William N. Rom, Kerry Kelly, David J. Prezant, Michael D. Weiden

Research output: Contribution to journalArticle

38 Citations (Scopus)

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, FEV 1, 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.

Original languageEnglish (US)
Pages (from-to)412-418
Number of pages7
JournalChest
Volume142
Issue number2
DOIs
StatePublished - Aug 2012

Fingerprint

Chemokine CCL22
Dust
Granulocyte-Macrophage Colony-Stimulating Factor
Biomarkers
Serum
Lung
Chemokine CXCL10
Firefighters
Irritants
Granulocyte Colony-Stimulating Factor
Smoke
Neutrophils
Logistic Models
Inflammation

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Critical Care and Intensive Care Medicine
  • Cardiology and Cardiovascular Medicine

Cite this

Nolan, A., Naveed, B., Comfort, A. L., Ferrier, N., Hall, C. B., Kwon, S., ... Weiden, M. D. (2012). Inflammatory biomarkers predict airflow obstruction after exposure to World Trade Center dust. Chest, 142(2), 412-418. https://doi.org/10.1378/chest.11-1202

Inflammatory biomarkers predict airflow obstruction after exposure to World Trade Center dust. / Nolan, Anna; Naveed, Bushra; Comfort, Ashley L.; Ferrier, Natalia; Hall, Charles B.; Kwon, Sophia; Kasturiarachchi, Kusali J.; Cohen, Hillel W.; Zeig-Owens, Rachel; Glaser, Michelle S.; Webber, Mayris P.; Aldrich, Thomas K.; Rom, William N.; Kelly, Kerry; Prezant, David J.; Weiden, Michael D.

In: Chest, Vol. 142, No. 2, 08.2012, p. 412-418.

Research output: Contribution to journalArticle

Nolan, A, Naveed, B, Comfort, AL, Ferrier, N, Hall, CB, Kwon, S, Kasturiarachchi, KJ, Cohen, HW, Zeig-Owens, R, Glaser, MS, Webber, MP, Aldrich, TK, Rom, WN, Kelly, K, Prezant, DJ & Weiden, MD 2012, 'Inflammatory biomarkers predict airflow obstruction after exposure to World Trade Center dust', Chest, vol. 142, no. 2, pp. 412-418. https://doi.org/10.1378/chest.11-1202
Nolan, Anna ; Naveed, Bushra ; Comfort, Ashley L. ; Ferrier, Natalia ; Hall, Charles B. ; Kwon, Sophia ; Kasturiarachchi, Kusali J. ; Cohen, Hillel W. ; Zeig-Owens, Rachel ; Glaser, Michelle S. ; Webber, Mayris P. ; Aldrich, Thomas K. ; Rom, William N. ; Kelly, Kerry ; Prezant, David J. ; Weiden, Michael D. / Inflammatory biomarkers predict airflow obstruction after exposure to World Trade Center dust. In: Chest. 2012 ; Vol. 142, No. 2. pp. 412-418.
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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, FEV 1, 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.",
author = "Anna Nolan and Bushra Naveed and Comfort, {Ashley L.} and Natalia Ferrier and Hall, {Charles B.} and Sophia Kwon and Kasturiarachchi, {Kusali J.} and Cohen, {Hillel W.} and Rachel Zeig-Owens and Glaser, {Michelle S.} and Webber, {Mayris P.} and Aldrich, {Thomas K.} and Rom, {William N.} and Kerry Kelly and Prezant, {David J.} and Weiden, {Michael D.}",
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AU - Nolan, Anna

AU - Naveed, Bushra

AU - Comfort, Ashley L.

AU - Ferrier, Natalia

AU - Hall, Charles B.

AU - Kwon, Sophia

AU - Kasturiarachchi, Kusali J.

AU - Cohen, Hillel W.

AU - Zeig-Owens, Rachel

AU - Glaser, Michelle S.

AU - Webber, Mayris P.

AU - Aldrich, Thomas K.

AU - Rom, William N.

AU - Kelly, Kerry

AU - Prezant, David J.

AU - Weiden, Michael D.

PY - 2012/8

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N2 - 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, FEV 1, 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.

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