{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,10]],"date-time":"2026-06-10T12:04:03Z","timestamp":1781093043661,"version":"3.54.1"},"reference-count":29,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2018,2,1]],"date-time":"2018-02-01T00:00:00Z","timestamp":1517443200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2018,2,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Rationale<\/jats:title>\n                    <jats:p>Rescue\/recovery work at the World Trade Center disaster site (WTC) caused a proximate decline in lung function in Fire Department of the City of New York firefighters. A subset of this cohort experienced an accelerated rate of lung function decline over 15 years of post\u2013September 11, 2001 (9\/11) follow-up.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To determine if early postexposure blood leukocyte concentrations are biomarkers for subsequent FEV1 decline and incident airflow limitation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Individual rates of forced expiratory volume in 1 second (FEV1) change were calculated for 9,434 firefighters using 88,709 spirometric measurements taken between September 11, 2001, and September 10, 2016. We categorized FEV1 change rates into three trajectories: accelerated FEV1 decline (FEV1 loss &amp;gt;64 ml\/yr), expected FEV1 decline (FEV1 loss between 0 and 64 ml\/yr), and improved FEV1 (positive rate of change &amp;gt;0 ml\/yr). Occurrence of FEV1\/FVC less than 0.70 after 9\/11 defined incident airflow limitation. Using regression models, we assessed associations of post-9\/11 blood eosinophil and neutrophil concentrations with subsequent FEV1 decline and airflow limitation, adjusted for age, race, smoking, height, WTC exposure level, weight change, and baseline lung function.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Accelerated FEV1 decline occurred in 12.7% of participants (1,199 of 9,434), whereas post-9\/11 FEV1 improvement occurred in 8.3% (780 of 9,434). Higher blood eosinophil and neutrophil concentrations were each associated with accelerated FEV1 decline after adjustment for covariates (odds ratio [OR], 1.10 per 100 eosinophils\/\u03bcl; 95% confidence interval [CI], 1.05\u20131.15; and OR, 1.10 per 1,000 neutrophils\/\u03bcl; 95% CI, 1.05\u20131.15, respectively). Multivariable-adjusted linear regression models showed that a higher blood neutrophil concentration was associated with a faster rate of FEV1 decline (1.14 ml\/yr decline per 1,000 neutrophils\/\u03bcl; 95% CI, 0.69\u20131.60 ml\/yr; P\u2009&amp;lt;\u20090.001). Higher blood eosinophil concentrations were associated with a faster rate of FEV1 decline in ever-smokers (1.46 ml\/yr decline per 100 eosinophils\/\u03bcl; 95% CI, 0.65\u20132.26 ml\/yr; P\u2009&amp;lt;\u20090.001) but not in never-smokers (P for interaction\u2009=\u20090.004). Higher eosinophil concentrations were also associated with incident airflow limitation (adjusted hazard ratio, 1.10 per 100 eosinophils\/\u03bcl; 95% CI, 1.04\u20131.15). Compared with the expected FEV1 decline group, individuals experiencing accelerated FEV1 decline were more likely to have incident airflow limitation (adjusted OR, 4.12; 95% CI, 3.30\u20135.14).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Higher post-9\/11 blood neutrophil and eosinophil concentrations were associated with subsequent accelerated FEV1 decline in WTC-exposed firefighters. Both higher blood eosinophil concentrations and accelerated FEV1 decline were associated with incident airflow limitation in WTC-exposed firefighters.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1513\/annalsats.201703-276oc","type":"journal-article","created":{"date-parts":[[2017,11,3]],"date-time":"2017-11-03T12:09:35Z","timestamp":1509710975000},"page":"173-183","source":"Crossref","is-referenced-by-count":46,"title":["Blood Leukocyte Concentrations, FEV1 Decline, and Airflow Limitation. A 15-Year Longitudinal Study of World Trade Center\u2013exposed Firefighters"],"prefix":"10.1093","volume":"15","author":[{"given":"Rachel","family":"Zeig-Owens","sequence":"first","affiliation":[{"name":"The Bureau of Health Services and Office of Medical Affairs, Fire Department of the City of New York, Brooklyn, New York"},{"name":"Division of Pulmonary Medicine, Department of Medicine, Montefiore Medical Center and Albert Einstein College of Medicine, Bronx, New York"},{"name":"Division of Epidemiology and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ankura","family":"Singh","sequence":"additional","affiliation":[{"name":"The Bureau of Health Services and Office of Medical Affairs, Fire Department of the City of New York, Brooklyn, New York"},{"name":"Division of Pulmonary Medicine, Department of Medicine, Montefiore Medical Center and Albert Einstein College of Medicine, Bronx, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas K.","family":"Aldrich","sequence":"additional","affiliation":[{"name":"Division of Pulmonary Medicine, Department of Medicine, Montefiore Medical Center and Albert Einstein College of Medicine, Bronx, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charles B.","family":"Hall","sequence":"additional","affiliation":[{"name":"Division of Biostatistics, Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Theresa","family":"Schwartz","sequence":"additional","affiliation":[{"name":"The Bureau of Health Services and Office of Medical Affairs, Fire Department of the City of New York, Brooklyn, New York"},{"name":"Division of Pulmonary Medicine, Department of Medicine, Montefiore Medical Center and Albert Einstein College of Medicine, Bronx, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mayris P.","family":"Webber","sequence":"additional","affiliation":[{"name":"The Bureau of Health Services and Office of Medical Affairs, Fire Department of the City of New York, Brooklyn, New York"},{"name":"Division of Epidemiology and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hillel W.","family":"Cohen","sequence":"additional","affiliation":[{"name":"Division of Epidemiology and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kerry J.","family":"Kelly","sequence":"additional","affiliation":[{"name":"The Bureau of Health Services and Office of Medical Affairs, Fire Department of the City of New York, Brooklyn, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Nolan","sequence":"additional","affiliation":[{"name":"The Bureau of Health Services and Office of Medical Affairs, Fire Department of the City of New York, Brooklyn, New York"},{"name":"Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, and"},{"name":"Department of Environmental Medicine, New York University School of Medicine, New York, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David J.","family":"Prezant","sequence":"additional","affiliation":[{"name":"The Bureau of Health Services and Office of Medical Affairs, Fire Department of the City of New York, Brooklyn, New York"},{"name":"Division of Pulmonary Medicine, Department of Medicine, Montefiore Medical Center and Albert Einstein College of Medicine, Bronx, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael D.","family":"Weiden","sequence":"additional","affiliation":[{"name":"The Bureau of Health Services and Office of Medical Affairs, Fire Department of the City of New York, Brooklyn, New York"},{"name":"Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, and"},{"name":"Department of Environmental Medicine, New York University School of Medicine, New York, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2018,2,1]]},"reference":[{"key":"2026020502160369600_bib1","doi-asserted-by":"crossref","first-page":"1263","DOI":"10.1056\/NEJMoa0910087","article-title":"Lung function in rescue workers at the World Trade Center after 7 years","volume":"362","author":"Aldrich","year":"2010","journal-title":"N Engl J Med"},{"key":"2026020502160369600_bib2","doi-asserted-by":"crossref","first-page":"1419","DOI":"10.1016\/j.chest.2015.10.067","article-title":"Lung function trajectories in World Trade Center-exposed New York City firefighters over 13 years: the roles of smoking and smoking cessation","volume":"149","author":"Aldrich","year":"2016","journal-title":"Chest"},{"key":"2026020502160369600_bib3","doi-asserted-by":"crossref","first-page":"1134","DOI":"10.1007\/s10875-013-9913-2","article-title":"Chitotriosidase is a biomarker for the resistance to World Trade Center lung injury in New York City firefighters","volume":"33","author":"Cho","year":"2013","journal-title":"J Clin Immunol"},{"key":"2026020502160369600_bib4","doi-asserted-by":"crossref","first-page":"392","DOI":"10.1164\/rccm.201109-1672OC","article-title":"Metabolic syndrome biomarkers predict lung function impairment: a nested case-control study","volume":"185","author":"Naveed","year":"2012","journal-title":"Am J Respir Crit Care Med"},{"key":"2026020502160369600_bib5","doi-asserted-by":"crossref","first-page":"412","DOI":"10.1378\/chest.11-1202","article-title":"Inflammatory biomarkers predict airflow obstruction after exposure to World Trade Center dust","volume":"142","author":"Nolan","year":"2012","journal-title":"Chest"},{"key":"2026020502160369600_bib6","doi-asserted-by":"crossref","first-page":"1023","DOI":"10.1183\/09031936.00077012","article-title":"Cardiovascular biomarkers predict susceptibility to lung injury in World Trade Center dust-exposed firefighters","volume":"41","author":"Weiden","year":"2013","journal-title":"Eur Respir J"},{"key":"2026020502160369600_bib7","doi-asserted-by":"crossref","first-page":"1128","DOI":"10.1056\/NEJMoa0909883","article-title":"Susceptibility to exacerbation in chronic obstructive pulmonary disease","volume":"363","author":"Hurst","year":"2010","journal-title":"N Engl J Med"},{"key":"2026020502160369600_bib8","doi-asserted-by":"crossref","first-page":"390","DOI":"10.1016\/S2213-2600(16)00100-4","article-title":"Blood eosinophil count and exacerbations in severe chronic obstructive pulmonary disease after withdrawal of inhaled corticosteroids: a post-hoc analysis of the WISDOM trial","volume":"4","author":"Watz","year":"2016","journal-title":"Lancet Respir Med"},{"key":"2026020502160369600_bib9","doi-asserted-by":"crossref","first-page":"1564","DOI":"10.1289\/ehp.7233","article-title":"Induced sputum assessment in New York City firefighters exposed to World Trade Center dust","volume":"112","author":"Fireman","year":"2004","journal-title":"Environ Health Perspect"},{"key":"2026020502160369600_bib10","doi-asserted-by":"crossref","first-page":"25","DOI":"10.3109\/02770903.2012.743149","article-title":"Elevated peripheral eosinophils are associated with new-onset and persistent wheeze and airflow obstruction in World Trade Center-exposed individuals","volume":"50","author":"Kazeros","year":"2013","journal-title":"J Asthma"},{"key":"2026020502160369600_bib11","doi-asserted-by":"crossref","first-page":"1253","DOI":"10.1513\/AnnalsATS.201511-742OC","article-title":"Blood eosinophils and World Trade Center exposure predict surgery in chronic rhinosinusitis: a 13.5-year longitudinal study","volume":"13","author":"Kwon","year":"2016","journal-title":"Ann Am Thorac Soc"},{"key":"2026020502160369600_bib12","article-title":"Predictors of accelerated FEV1 decline in WTC-exposed firefighters: a 15-year longitudinal study","author":"Zeig-Owens"},{"key":"2026020502160369600_bib13","first-page":"A4650","article-title":"Predictors of accelerated FEV1 decline in World Trade Center-exposed firefighters: a 15-year longitudinal study [abstract]","volume":"195","author":"Weiden","year":"2017","journal-title":"Am J Respir Crit Care Med"},{"key":"2026020502160369600_bib14","article-title":"Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease","author":"Global Initiative for Chronic Obstructive Lung Disease (GOLD)"},{"key":"2026020502160369600_bib15","doi-asserted-by":"crossref","first-page":"179","DOI":"10.1164\/ajrccm.159.1.9712108","article-title":"Spirometric reference values from a sample of the general U.S. population","volume":"159","author":"Hankinson","year":"1999","journal-title":"Am J Respir Crit Care Med"},{"key":"2026020502160369600_bib16","doi-asserted-by":"crossref","first-page":"515","DOI":"10.1093\/biomet\/81.3.515","article-title":"Proportional hazards tests and diagnostics based on weighted residuals","volume":"81","author":"Grambsch","year":"1994","journal-title":"Biometrika"},{"key":"2026020502160369600_bib17","doi-asserted-by":"crossref","first-page":"e40016","DOI":"10.1371\/journal.pone.0040016","article-title":"Comparison of WTC dust size on macrophage inflammatory cytokine release in vivo and in vitro","volume":"7","author":"Weiden","year":"2012","journal-title":"PLoS One"},{"key":"2026020502160369600_bib18","doi-asserted-by":"crossref","first-page":"572","DOI":"10.1164\/rccm.200807-1097OC","article-title":"Rapid DNA methylation changes after exposure to traffic particles","volume":"179","author":"Baccarelli","year":"2009","journal-title":"Am J Respir Crit Care Med"},{"key":"2026020502160369600_bib19","doi-asserted-by":"crossref","first-page":"e003218","DOI":"10.1161\/JAHA.116.003218","article-title":"Effects of air pollution and blood mitochondrial DNA methylation on markers of heart rate variability","volume":"5","author":"Byun","year":"2016","journal-title":"J Am Heart Assoc"},{"key":"2026020502160369600_bib20","doi-asserted-by":"crossref","first-page":"474","DOI":"10.1378\/chest.14-2309","article-title":"Cigarette smoke-induced hypermethylation of the GCLC gene is associated With COPD","volume":"149","author":"Cheng","year":"2016","journal-title":"Chest"},{"key":"2026020502160369600_bib21","doi-asserted-by":"crossref","first-page":"1074","DOI":"10.1016\/j.envpol.2016.08.059","article-title":"Differential responses of healthy and chronic obstructive pulmonary diseased human bronchial epithelial cells repeatedly exposed to air pollution-derived PM4","volume":"218","author":"Leclercq","year":"2016","journal-title":"Environ Pollut"},{"key":"2026020502160369600_bib22","doi-asserted-by":"crossref","first-page":"912","DOI":"10.1165\/rcmb.2013-0304OC","article-title":"DNA methylation is globally disrupted and associated with expression changes in chronic obstructive pulmonary disease small airways","volume":"50","author":"Vucic","year":"2014","journal-title":"Am J Respir Cell Mol Biol"},{"key":"2026020502160369600_bib23","doi-asserted-by":"crossref","first-page":"3073","DOI":"10.1093\/hmg\/dds135","article-title":"Cigarette smoking behaviors and time since quitting are associated with differential DNA methylation across the human genome","volume":"21","author":"Wan","year":"2012","journal-title":"Hum Mol Genet"},{"key":"2026020502160369600_bib24","doi-asserted-by":"crossref","first-page":"662","DOI":"10.1164\/rccm.201104-0597OC","article-title":"Acute exacerbations of chronic obstructive pulmonary disease: identification of biologic clusters and their biomarkers","volume":"184","author":"Bafadhel","year":"2011","journal-title":"Am J Respir Crit Care Med"},{"key":"2026020502160369600_bib25","doi-asserted-by":"crossref","first-page":"965","DOI":"10.1164\/rccm.201509-1869OC","article-title":"Blood eosinophils and exacerbations in chronic obstructive pulmonary disease: the Copenhagen General Population Study","volume":"193","author":"Vedel-Krogh","year":"2016","journal-title":"Am J Respir Crit Care Med"},{"key":"2026020502160369600_bib26","doi-asserted-by":"crossref","first-page":"747","DOI":"10.1016\/S2213-2600(17)30217-5","article-title":"Eosinophils in COPD: just another biomarker?","volume":"5","author":"Bafadhel","year":"2017","journal-title":"Lancet Respir Med"},{"key":"2026020502160369600_bib27","doi-asserted-by":"crossref","first-page":"214","DOI":"10.1016\/S2213-2600(14)70002-5","article-title":"Risk loci for chronic obstructive pulmonary disease: a genome-wide association study and meta-analysis","volume":"2","author":"Cho","year":"2014","journal-title":"Lancet Respir Med"},{"key":"2026020502160369600_bib28","doi-asserted-by":"crossref","first-page":"45","DOI":"10.1038\/ng.500","article-title":"Meta-analyses of genome-wide association studies identify multiple loci associated with pulmonary function","volume":"42","author":"Hancock","year":"2010","journal-title":"Nat Genet"},{"key":"2026020502160369600_bib29","doi-asserted-by":"crossref","first-page":"533","DOI":"10.1016\/j.jaci.2016.06.062","article-title":"Genome-wide association study on the FEV1\/FVC ratio in never-smokers identifies HHIP and FAM13A","volume":"139","author":"van der Plaat","year":"2017","journal-title":"J Allergy Clin Immunol"}],"container-title":["Annals of the American Thoracic Society"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/annalsats\/article-pdf\/15\/2\/173\/66733247\/annalsats_15_2_173.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/annalsats\/article-pdf\/15\/2\/173\/66733247\/annalsats_15_2_173.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,5]],"date-time":"2026-02-05T07:16:12Z","timestamp":1770275772000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/annalsats\/article\/15\/2\/173\/8456858"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,2,1]]},"references-count":29,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2018,2,1]]},"published-print":{"date-parts":[[2018,2,1]]}},"URL":"https:\/\/doi.org\/10.1513\/annalsats.201703-276oc","relation":{},"ISSN":["2329-6933","2325-6621"],"issn-type":[{"value":"2329-6933","type":"print"},{"value":"2325-6621","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2018,2]]},"published":{"date-parts":[[2018,2,1]]}}}