CHEST: Steroids Prevented Lung Damage After 9/11
April 25th, 2007 Posted by: Dr. Cox
David Prezant, M.D.
Montefiore Medical Center
CHICAGO, Oct. 25 — A prophylactic course of inhaled corticosteroids may protect the lungs of disaster workers inadvertently exposed to airborne dust particles, a researcher said here.
Firefighters in New York who took inhaled budesonide starting two weeks after the World Trade Center attacks had better lung function and quality of life a year and a half later than did those who did not take the drug, according to David Prezant, M.D., of the New York fire department and Montefiore Medical Center. Action Points
Explain to interested patients that many New York disaster workers were exposed to particulate matter after Sept. 11, 2001, resulting in respiratory after-effects.
Note that this study suggests that a four-week course of inhaled corticosteroids may have helped firefighters recover from the exposure.
Note, too, that this study was published as an abstract and presented orally at a conference. These data and conclusions should be considered to be preliminary until published in a peer-reviewed publication.
The differences were both “clinically and statistically significant,” Dr. Prezant said at CHEST 2007, the annual meeting of the American College of Chest Physicians.
But he cautioned that the study is “preliminary and hypothesis-generating” because many of the approximately 2,700 firefighters who originally signed up for the study dropped out almost immediately.
Reasons for dropping out included fear of steroid side effects and lack of immediate benefit, Dr. Prezant said.
“We had hoped we would be following these 2,700 firefighters,” Dr. Prezant said, but most only took the medication for a few days. Only 158 were treated for the full four weeks that was suggested, he added.
Dr. Prezant and colleagues have been studying the cough that affected disaster workers in the wake of the 2001 attacks on the World Trade Center.
For this analysis, he said, 64 of those who completed treatment were matched for age and exposure to World Trade Center dust with firefighters who did not sign up for the study in the first place.
Between a year and 18 months after treatment, Dr. Prezant said, firefighters who took the steroid had:
A greater increase in forced vital capacity than untreated controls — 220 milliliters compared with 20 milliliters, a change that was significant at P
Primary source: CHEST
Source reference:
Banauch GI, et al “The use of prophylactic inhaled steroids (budesonide) to prevent or reduce pulmonary symptoms, airway hyperreactivity, and pulmonary function declines after exposure to World Trade Center dust” CHEST Meeting Abstracts 2007; 132: 598b-599b.
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