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:
  Cohort Studies Fire Fighters Longitudinal Study Lung Function Metabolic Effects Particulates World Trade Center WTC
• 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
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:b5e57179c24762751b1eb815cd1fe63396214731c736e9e6e2bb90e746224f3c39121fbb4e753b6dc728a9bef613e2fca5fbb4e0d624969bcff101098be66bb4
• Download URL:
  https://stacks.cdc.gov/view/cdc/212754/cdc_212754_DS1.pdf
• File Type:
  [PDF - 360.41 KB ]