An FEV 1 one standard deviation above the mean defined resistance to airway injury. The representative sub-cohort defined analyte distribution and a concentration above 75 th percentile defined elevated biomarker expression. Serum was assayed for matrix metalloproteinases (MMP-1,2,3,7,8,9,12 and 13) and tissue inhibitors of metalloproteinases (TIMP-1,2,3,4). We performed a nested case–control study measuring biomarkers in serum drawn before 3/2002 and subsequent forced expiratory volume at one second (FEV 1) on repeat spirometry before 3/2008. We hypothesized that the protease/anti-protease balance in serum soon after exposure predicts subsequent recovery. After, most FDNY workers had persistent lung function decline but some exposed workers recovered.
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