Serum Th-2 cytokines and FEV1 decline in WTC-exposed firefighters: A 19-year longitudinal study

Michael D. Weiden, Ankura Singh, David G. Goldfarb, Barbara Putman, Rachel Zeig-Owens, Theresa Schwartz, Hillel W. Cohen, David J. Prezant

Research output: Contribution to journalArticlepeer-review

4 Scopus citations


Background: Accelerated-FEV1-decline, defined as rate of decline in FEV1 > 64 ml/year, is a risk factor for asthma and chronic obstructive pulmonary disease in World Trade Center (WTC)-exposed firefighters. Accelerated-FEV1-decline in this cohort is associated with elevated blood eosinophil concentrations, a mediator of Th-2 response. We hypothesized that an association exists between Th-2 biomarkers and FEV1 decline rate in those with accelerated-FEV1-decline. Methods: Serum was drawn from Fire Department of the City of New York (FDNY) firefighters 1–6 months (early) (N = 816) and 12–13 years (late) (N = 983) after 9/11/2001. Th-2 biomarkers IL-4, IL-13, and IL-5 were assayed by multiplex Luminex. Individual FEV1 decline rates were calculated using spirometric measurements taken: (1) between 9/11/2001 and 9/10/2020 for the early biomarker group and (2) between late measurement date and 9/10/2020 for the late biomarker group. Associations of early and late Th-2 biomarkers with subsequent FEV1 decline rates were analyzed using multivariable linear regression controlling for demographics, smoking status, and other potential confounders. Results: In WTC-exposed firefighters with accelerated-FEV1-decline, IL-4, IL-13, and IL-5 measured 1–6 months post-9/11/2001 were associated with greater FEV1 decline ml/year between 9/11/2001 and 9/10/2020 (−2.9 ± 1.4 ml/year per IL-4 doubling; −8.4 ± 1.2 ml/year per IL-13 doubling; −7.9 ± 1.3 ml/year per IL-5 doubling). Among late measured Th-2 biomarkers, only IL-4 was associated with subsequent FEV1 decline rate (−4.0 ± 1.6 ml/year per IL-4 doubling). Conclusions: In WTC-exposed firefighters with accelerated-FEV1-decline, elevated serum IL-4 measured both 1–6 months and 12–13 years after 9/11 is associated with greater FEV1 decline/year. Drugs targeting the IL-4 pathway may improve lung function in this high-risk subgroup.

Original languageEnglish (US)
Pages (from-to)845-852
Number of pages8
JournalAmerican Journal of Industrial Medicine
Issue number10
StatePublished - Oct 2021


  • FEV slope
  • Th-2 biomarkers
  • World Trade Center
  • cohort studies
  • firefighting

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health


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