Study on accident related smoke inhalation shows most effected to be non-smokers

New research at Rhode Island Hospital studied the chronic effects of smoke inhalation by examining the lungs of 21 survivors of The Station fire (February 20, 2003).

While the overall results of the study showed variability in the chronic effects, the study noted that the most severely impacted were non-smokers. This finding may have useful implications for future victims of smoke inhalation as early treatment efforts could be tailored according to their cigarette smoking history. The study is the first to see the variability of the chronic impact of smoke inhalation between smokers and non-smokers.

The study, led by Gerald Abbott, MD, director of chest radiology at Rhode Island Hospital, used volumetric high resolution computed tomography (HRCT) performed 35 to 48 months after the fire on a group of 21 survivors as well as a control group of ten healthy non-survivors to provide a basis of comparison between the two groups. The study showed variability in the chronic effects, ranging from no detectable effects to a significant increase in air-trapping, an abnormal retention of air in the lungs following expiration.

Air-trapping was graded according to the percentage of lung area involved and results fell within three grades, with one being the least severe and three being the most severe. Healthy, non-survivors in the study showed primarily grade one and occasionally grade two air-trapping , a familiar finding in normal individuals. Abnormal degrees of air trapping suggest the presence of a constrictive bronchiolitis involving the small airways of the lung. The study showed that the most severely affected survivors (Grade 3) were non-cigarette smokers.

"This research tells us that physicians treating patients for smoke inhalation should be aware that one of the chronic effects of smoke inhalation, air-trapping, seems to be more severe in non-smokers," says Abbott.

The study was funded by a research grant from the Rhode Island Medical Imaging Foundation awarded to Abbott, along with the research team of Terrence T. Healey, MD, chief resident of diagnostic imaging, and two pulmonologists, Sidney Braman, MD, and Michael Stanchina, MD, of the department of pulmonary and critical care medicine at Rhode Island Hospital.

Healey presented the study's findings at the recent meeting of The Society of Thoracic Radiology in Las Vegas and was the inaugural recipient of the prestigious Jack Wescott Award for outstanding research presented by a resident. The award included a $1,000 honorarium. Healey has been accepted for a year of fellowship training in thoracic radiology at Massachusetts General Hospital at the completion of his residency in July, 2008, and intends to return to Rhode Island Hospital to pursue a career in chest imaging.