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

Details

• Personal Author:
  Aldrich TK ; Banauch GI ; Chavko R ; Christodoulou V ; Cohen H ; Gustave J ; Izbicki G ; Kelly KJ ; Prezant DJ ; Webber MP ; Weiden MD
• Description:
  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. [Description provided by NIOSH]
• Subjects:
  Asthma Asthma, Occupational Emergency Responders Environmental Monitoring Firefighters Lung Lung Diseases Occupational Health Personal Protective Equipment Preventive Medicine Respiratory Function Tests Respiratory Protective Devices Respiratory System Respiratory Tract Diseases Risk Assessment Risk Factors Safety September 11 Terrorist Attacks Steroids Surveys And Questionnaires

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• Keywords:
  Author Keywords: World Trade Center Bronchial-asthma Emergency-responders Environmental-control Exposure-levels Fire-fighters Firefighters Hazards Inhaled Corticosteroid Preventive-medicine Preventive Medicine Pulmonary-disorders Pulmonary-function Pulmonary-system Pulmonary-system-disorders Pulmonary Disease Questionnaires Rescue-workers Respiratory-protection Respiratory-system-disorders Risk-factors Spirometry

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• ISSN:
  1935-7893
• Document Type:
  Text
• Funding:
  Cooperative Agreement
• Genre:
  Journal Article
• Place as Subject:
  New York ; OSHA Region 2
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Pages in Document:
  33-39
• Volume:
  2
• Issue:
  1
• NIOSHTIC Number:
  nn:20046200
• Citation:
  Disaster Med Public Health Prep 2008 Mar; 2(1):33-39
• Contact Point Address:
  David J. Prezant, MD, FCCP, New York City Fire Department, Office of Medical Affairs (Room 4w-1), Brooklyn, NY 11201
• Email:
  prezand@fdny.nyc.gov
• Federal Fiscal Year:
  2008
• Performing Organization:
  New York City Fire Department
• Peer Reviewed:
  True
• Start Date:
  20040701
• Source Full Name:
  Disaster Medicine and Public Health Preparedness
• End Date:
  20110630
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:04fcf8eceb40d821921646c4ba8b80a278193f3568c11b456371e0b7aa433ffe2362d0d3eb73c633f60d68745900fd9ba7e4816cbea8c9dbbbad800453f8561c
• Download URL:
  https://stacks.cdc.gov/view/cdc/201325/cdc_201325_DS1.pdf
• File Type:
  [PDF - 261.57 KB ]