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Inhaled Steriods Used as Preventive Treatment Post 9/11
Date:10/24/2007

arison group of firefighters who did not participate in the ICS treatment but who were matched for similar exposures and pretreatment pulmonary function.

A total of 2,708 firefighters agreed to participate, but only 158 completed the 4 weeks of treatment (participant totals have been revised since abstract submission). Those who did not complete the treatment cited fear of steroid use and lack of immediate effect. Despite reporting more unprotected hours without a respirator, results showed that the treated group had significantly greater declines in respiratory symptoms and greater quality of life when compared with the untreated firefighters. In addition, revised data analysis showed a small but significant improvement in the lung function of the treated group, as well.

"In situations like the World Trade Center collapse, significant exposure and symptoms are both risk factors for the development of multiple pulmonary disorders," said Dr. Prezant. "The first line of defense must always be respiratory protection, but ICS are a useful adjunct, and we would encourage their use to be considered during emergency conditions where rescues must be made and respiratory protections may be less than adequate, or when early symptoms occur."

"Respiratory illness continues to plague those who were present when the World Trade Center collapsed," said Alvin V. Thomas, MD, FCCP, President of the American College of Chest Physicians. "It is essential that physicians and researchers work to alleviate and eventually cure those ailments caused by this tragedy, as well as any respiratory diseases that may be acquired in other occupational settings."

While researchers are optimistic about the results, they continue to stress that larger studies are required to substantiate these findings. This study was conducted with support from the Investigator-Sponsored Study Program of AstraZeneca, and the use of inhaled corticosteroids may be considered off- label use. The
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SOURCE American College of Chest Physicians
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