Evaluation of isoniazid as a prophylaxis against progressive massive fibrosis.

Details

• Personal Author:
  Jovanovic M ; Popovic D
• Description:
  Miners pneumoconiosis represents the main problem of occupational pathology in a great part of Yugoslavia, particularly because of the accompanying diseases. Pneumoconioses are complicated with tuberculosis in 15-28% and specially in advanced cases this percentage increases to 65%. Studies conducted in the U.S.A. among persons at risk treated prophylactically with isoniazid at 5 mg. per kg. of body weight per day for a period of one-year reduced the incidence of tuberculosis over a five-year period by about 50% (Amer. Rev. of Resp. Diseases, Vol. 85, No. 6, June 1962; Vol. 88, No. 2, August 1963; Vol. 85, No. 4, April 1962; New England Journal of Medicine, Vol. 265, October 1961, Pp. 713-721). It is believed by many authors that in most cases complicated pneumoconiosis (progressive massive fibrosis (PMF)) is the result of a tuberculous infection. To date controlled experiments on the effect of isoniazid in preventing complicated pneumoconioses have not been reported in the literature. Only some preliminary communications were published. P. Galy, et al treated 19 patients with INH (300-500 mg. per day), and 23 others with Streptomycine, or PAS or Trecator+Viocine. Thirty-five of them had not progressed to PMF, while seven were complicated with tuberculosis. Some attempts were made with BCG vaccine. The role of tuberculin sensitivity in coal miners with pneumoconiosis was studied. We decided to do a study with the objective to determine to what extent the prophylactical administration of isoniazid can prevent complications in a group of men with pneumoconiosis whose X-rays were initially negative for tuberculosis. If it could be proved that isoniazid materially decreased the incidence of complicated pneumoconiosis an important step toward the alleviation of the most disabling aspects of coal dust disease would be possible. Because of a relatively high incidence of tuberculosis among Yugoslav miners there was an opportunity for a study economically not feasible in the United States of America. The data available in Yugoslavia indicate that it might be anticipated that for a group of X-ray category 2 and 3 of pneumoconiosis cases (1958 ILO classification) a great percent would develop complications within a five-year period. If the prophylactical administration of isoniazid for a one-year period is capable of reducing this incidence by as little as 25%, a study of 400 pneumoconiotics over a five-year period, divided at random into two groups, one given isoniazid arid the other a placebo, would produce a statistically significant difference in the incidence of complicated pneumoconiosis. To accommodate dropouts this number was increased to 250 in each of the two groups.
• Subjects:
  Accidents, Occupational Air Movements Coal Coal Mining Mining Occupational Health Respiratory Protective Devices Respiratory System Safety
• Keywords:
  Drug Therapy Miners Pneumoconiosis Prophylaxis Pulmonary Disorders Respiratory Diseases TB Tuberculosis
• Publisher:
  National Institute for Occupational Safety and Health
• Document Type:
  Text
• Funding:
  Grant
• Genre:
  Conference/Symposia Proceedings
• Place as Subject:
  Ohio ; OSHA Region 5
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Pages in Document:
  351-358
• NIOSHTIC Number:
  nn:20057378
• Citation:
  Proceedings of the Special Foreign Currency Program Symposium, October 1970, Dubrovnik, Yugoslavia. Henschel A ed. Cincinnati, OH: U.S. Department of Health, Education, and Welfare, Public Health Service, Health Services and Mental Health Administration, National Institute for Occupational Safety and Health, 1970 Oct; :351-358
• Editor(s):
  Henschel A
• Federal Fiscal Year:
  1971
• Peer Reviewed:
  False
• Source Full Name:
  Proceedings of the Special Foreign Currency Program Symposium, October 1970, Dubrovnik, Yugoslavia
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:73530f37bd776636aa54624e3e886bc2db7a7bc0706c63937104bc6ae9d5ce5fd7a90724535a8e197184268fd1670189522147c4314406f7e303cb43c8eb8a9d
• Download URL:
  https://stacks.cdc.gov/view/cdc/181824/cdc_181824_DS1.pdf
• File Type:
  [PDF - 1.18 MB ]