Trial of prophylactic inhaled steroids to prevent or reduce pulmonary function decline, pulmonary symptoms, and airway hyperreactivity in firefighters at the world trade center site

Gisela I. Banauch, Gabriel Izbicki, Vasilios Christodoulou, Michael D. Weiden, Mayris P. Webber, Hillel Cohen, Jackson Gustave, Robert Chavko, Thomas K. Aldrich, Kerry J. Kelly, David J. Prezant

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Background: Inhaled corticosteroids (ICS) are the most effective anti-inflammatory treatment for asthmatics. This trial evaluated the effects of prophylactic ICS in firefighters exposed to the World Trade Center disaster. Methods: Inhaled budesonide via a dry powder inhaler (Pulmicort Turbuhaler, AstraZeneca, Wilmington, DE) was offered on-site to New York City firefighters between September 18 and 25, 2001. One to 2 years later, firefighters (n -64) who completed 4 weeks of daily ICS treatment were evaluated and compared with an age- and exposure-matched comparison group (n-72) who did not use ICS. Results: When spirometry results at the final visit were compared with those from the weeks following the 9/11 disaster, the treatment group had a greater increase in forced vital capacity (P-.009) and possibly a slower decline in forced expiratory volume at 1 second (P-.11), as well as a greater improvement in perceived well-being as assessed by the St George's Respiratory Questionnaire (P <.01). There was no difference in airway hyperreactivity and no evidence of adverse effects from ICS. Conclusions: Because the potential for hazardous exposures is great at many disasters, disease prevention programs based on environmental controls and respiratory protection are warranted immediately. Our results suggest that, pending further study with a larger sample, prophylactic ICS should be considered, along with respiratory protection, to minimize possible lung insult. (Disaster Med Public Health Preparedness. 2008;2:33-39).

Original languageEnglish (US)
Pages (from-to)33-39
Number of pages7
JournalDisaster Medicine and Public Health Preparedness
Volume2
Issue number1
DOIs
StatePublished - Mar 2008

Fingerprint

Firefighters
Adrenal Cortex Hormones
Steroids
Disasters
Lung
Budesonide
Dry Powder Inhalers
Spirometry
Vital Capacity
Forced Expiratory Volume
Anti-Inflammatory Agents
Research Design
Therapeutics
Public Health

Keywords

  • Firefighters
  • Inhaled corticosteroid
  • Preventive medicine
  • Pulmonary disease
  • World trade center

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health

Cite this

Trial of prophylactic inhaled steroids to prevent or reduce pulmonary function decline, pulmonary symptoms, and airway hyperreactivity in firefighters at the world trade center site. / Banauch, Gisela I.; Izbicki, Gabriel; Christodoulou, Vasilios; Weiden, Michael D.; Webber, Mayris P.; Cohen, Hillel; Gustave, Jackson; Chavko, Robert; Aldrich, Thomas K.; Kelly, Kerry J.; Prezant, David J.

In: Disaster Medicine and Public Health Preparedness, Vol. 2, No. 1, 03.2008, p. 33-39.

Research output: Contribution to journalArticle

Banauch, Gisela I. ; Izbicki, Gabriel ; Christodoulou, Vasilios ; Weiden, Michael D. ; Webber, Mayris P. ; Cohen, Hillel ; Gustave, Jackson ; Chavko, Robert ; Aldrich, Thomas K. ; Kelly, Kerry J. ; Prezant, David J. / Trial of prophylactic inhaled steroids to prevent or reduce pulmonary function decline, pulmonary symptoms, and airway hyperreactivity in firefighters at the world trade center site. In: Disaster Medicine and Public Health Preparedness. 2008 ; Vol. 2, No. 1. pp. 33-39.
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AU - Christodoulou, Vasilios

AU - Weiden, Michael D.

AU - Webber, Mayris P.

AU - Cohen, Hillel

AU - Gustave, Jackson

AU - Chavko, Robert

AU - Aldrich, Thomas K.

AU - Kelly, Kerry J.

AU - Prezant, David J.

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N2 - Background: Inhaled corticosteroids (ICS) are the most effective anti-inflammatory treatment for asthmatics. This trial evaluated the effects of prophylactic ICS in firefighters exposed to the World Trade Center disaster. Methods: Inhaled budesonide via a dry powder inhaler (Pulmicort Turbuhaler, AstraZeneca, Wilmington, DE) was offered on-site to New York City firefighters between September 18 and 25, 2001. One to 2 years later, firefighters (n -64) who completed 4 weeks of daily ICS treatment were evaluated and compared with an age- and exposure-matched comparison group (n-72) who did not use ICS. Results: When spirometry results at the final visit were compared with those from the weeks following the 9/11 disaster, the treatment group had a greater increase in forced vital capacity (P-.009) and possibly a slower decline in forced expiratory volume at 1 second (P-.11), as well as a greater improvement in perceived well-being as assessed by the St George's Respiratory Questionnaire (P <.01). There was no difference in airway hyperreactivity and no evidence of adverse effects from ICS. Conclusions: Because the potential for hazardous exposures is great at many disasters, disease prevention programs based on environmental controls and respiratory protection are warranted immediately. Our results suggest that, pending further study with a larger sample, prophylactic ICS should be considered, along with respiratory protection, to minimize possible lung insult. (Disaster Med Public Health Preparedness. 2008;2:33-39).

AB - Background: Inhaled corticosteroids (ICS) are the most effective anti-inflammatory treatment for asthmatics. This trial evaluated the effects of prophylactic ICS in firefighters exposed to the World Trade Center disaster. Methods: Inhaled budesonide via a dry powder inhaler (Pulmicort Turbuhaler, AstraZeneca, Wilmington, DE) was offered on-site to New York City firefighters between September 18 and 25, 2001. One to 2 years later, firefighters (n -64) who completed 4 weeks of daily ICS treatment were evaluated and compared with an age- and exposure-matched comparison group (n-72) who did not use ICS. Results: When spirometry results at the final visit were compared with those from the weeks following the 9/11 disaster, the treatment group had a greater increase in forced vital capacity (P-.009) and possibly a slower decline in forced expiratory volume at 1 second (P-.11), as well as a greater improvement in perceived well-being as assessed by the St George's Respiratory Questionnaire (P <.01). There was no difference in airway hyperreactivity and no evidence of adverse effects from ICS. Conclusions: Because the potential for hazardous exposures is great at many disasters, disease prevention programs based on environmental controls and respiratory protection are warranted immediately. Our results suggest that, pending further study with a larger sample, prophylactic ICS should be considered, along with respiratory protection, to minimize possible lung insult. (Disaster Med Public Health Preparedness. 2008;2:33-39).

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