Clinical Biomarkers of World Trade Center Airway Hyperreactivity: A 16-Year Longitudinal Study

Details

• Personal Author:
  Clementi E ; Crowley G ; Kwon S ; Liu M ; Nolan A ; Prezant DJ ; Schwartz T ; Zeig-Owens R
• Description:
  RATIONALE: Development of airway hyperreactivity (AHR) related to environmental exposure is a significant global health risk. Similarly, Metabolic Syndrome (MetSyn) is also positively associated with the development of AHR and is a significant contributor to adverse health globally. OBJECTIVES: We propose to investigate if clinical biomarkers including those defining MetSyn are predictors of World Trade Center (WTC)-AHR in the longitudinally followed Fire Department of New York (FDNY) World Trade Center (WTC} exposed cohort. METHODS: A baseline cohort of male firefighters with FEV1 ≥LLN prior to 9/11 that had serum drawn prior to site closure on July 24, 2002(N=7,486) was assessed. Cases of WTC-AHR (N=539) were identified if they had either a positive BO response (FEV 1 increased by ≥12% and ≥200 ml) (N= 236) or had a positive methacholine challenge, defined as a PC20<16mg/mL (N=355). N:52 had both tests positive, WTC-AHR cases were compared to N=6947 subjects that did not develop WTC-AHR. We modeled the ability of MetSyn at the first post-9/11 exam to predict WTCAHR with Cox-proportional hazards regression and adjusted for age and smoking status. We additionally examined leukocyte subsets at the first exam as a comparison of a commonly associated marker of airway hyperreactivity. RESULTS: WTC-AHR cases compared to controls were significantly more likely to be older (40 vs 39), have slightly higher BMI (29 vs 28 kg/m2), have high intensity exposure (23% vs 16%), and have MetSyn compared to controls (20% vs 2%). There was a significant exposure dose response seen in the Cox regression models; the most highly exposed individuals present in the morning of 9/11 had 2.24-fold increased risk of developing WTC-AHR, and 75.9% increased risk if the individual arrived in the afternoon of 9/11 (p<0.001). Having 3 or more criteria of MetSyn increased risk of WTC-AHR by 65.4% (p<0.001). Having at least 5% eosinophilia on first post-9/11 differential independently increased the risk of WTC-AHR by 83.8%(p<0.001). Smoking history was not a significant risk factor in development of WTC·AHR. CONCLUSIONS: We assessed the utility of the clinical biomarkers to predict future AHR development in a population of WTC exposed individuals. These biomarkers are associated with dyslipidemia, insulin resistance, and cardiovascular disease, and suggest that systemic inflammation can contribute to future airway hyperreactivity. Description provided by NIOSH
• Subjects:
  • Cohort Studies
  • Energy Metabolism
  • Firefighters
  • Lung
  • Occupational Health
  • Particulate Matter
  • Respiratory System
  • Safety
  • September 11 Terrorist Attacks
• Keywords:
  • World Trade Center
  • WTC
  • Longitudinal study
  • Fire fighters
  • Cohort studies
  • Metabolic effects
  • Particulates
  • Lung function
• ISSN:
  1073-449X
• Document Type:
  Text
• Funding:
  Cooperative Agreement
• Genre:
  Abstract or Summary
• Place as Subject:
  New York ; OSHA Region 2
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Volume:
  199
• NIOSHTIC Number:
  nn:20066276
• Citation:
  Am J Respir Crit Care Med 2019 May; 199(Abstract Issue):A2492
• Email:
  kwons04@nyumc.org
• Federal Fiscal Year:
  2019
• Performing Organization:
  New York University School of Medicine
• Peer Reviewed:
  False
• Start Date:
  20170701
• Source Full Name:
  American Journal of Respiratory and Critical Care Medicine
• Supplement:
  Abstract Issue
• End Date:
  20260630
• Download URL:
  https://stacks.cdc.gov/view/cdc/212754/cdc_212754_DS1.pdf
• File Type:
  [PDF - 360.41 KB]
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:b5e57179c24762751b1eb815cd1fe63396214731c736e9e6e2bb90e746224f3c39121fbb4e753b6dc728a9bef613e2fca5fbb4e0d624969bcff101098be66bb4