Are the knowledge of non-malignant asbestos-related diseases and lung function impairment differentially associated with psychological well-being? A cross-sectional study in formerly asbestos-exposed workers in Germany

Objectives The knowledge of past asbestos exposure may lead to chronic psychological strain. In addition, the information about an increased cancer risk can place a psychological burden on individuals triggering mental health symptoms of depression or anxiety. This applies in particular to individua...

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Main Authors: Jessica Lang, Michael K Felten, Thomas Kraus
Format: Article
Language:English
Published: BMJ Publishing Group 2019-10-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/9/10/e030094.full
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author Jessica Lang
Michael K Felten
Thomas Kraus
author_facet Jessica Lang
Michael K Felten
Thomas Kraus
author_sort Jessica Lang
collection DOAJ
description Objectives The knowledge of past asbestos exposure may lead to chronic psychological strain. In addition, the information about an increased cancer risk can place a psychological burden on individuals triggering mental health symptoms of depression or anxiety. This applies in particular to individuals with non-malignant asbestos-related disease (ARD) such as lung fibrosis and pleural thickening with or without lung function impairment. ARDs with or without lung function impairment may develop even years after exposure cessation. Therefore, the aim of the present study was to test for our cohort whether non-malignant ARD and lung function impairment have differential effects on mental health and psychological strain.Design Cross-sectional study.Participants and setting Overall, 612 male participants (mean age=66.2 years, SD=9.5) attending a surveillance programme for ARDs received routine examinations including lung function testing (24% refused to fill in the psychological questionnaire) at a German university hospital study centre from August 2008 to August 2013.Outcome measures Using multiple hierarchical regression analysis, ARD diagnosis and lung function impairment were used to predict psychological health as measured with validated questionnaires for depression and anxiety. Psychological strain was operationalised by intrusive thoughts and specific fear of cancer.Results The strongest predictor for mental health was obstructive functional impairment (eg, anxiety: β=0.22, p<0.001). Psychological strain was predicted by the presence of a non-malignant ARD (eg, intrusive thoughts: β=0.17, p=0.003).Conclusions The presence of mental health symptoms is associated with ventilation disturbances, whereas the knowledge of an already initiated morphological change—caused by asbestos exposure—is primarily associated with psychological strain. Specifically, the affected individuals are more prone to intrusive thoughts and specific fear of asbestos-related cancer. As an implication, physicians should be sensitised about possible consequences of risk communication and functional impairment to counteract excessive fear or anxiety.
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spelling doaj-art-631821d422ae44f1baa26aebc547e5802024-12-14T06:55:09ZengBMJ Publishing GroupBMJ Open2044-60552019-10-0191010.1136/bmjopen-2019-030094Are the knowledge of non-malignant asbestos-related diseases and lung function impairment differentially associated with psychological well-being? A cross-sectional study in formerly asbestos-exposed workers in GermanyJessica Lang0Michael K Felten1Thomas Kraus2Institute of Occupational, Social and Environmental Medicine, RWTH Aachen University, Aachen, GermanyInstitute of Occupational, Social and Environmental Medicine, RWTH Aachen University, Aachen, GermanyInstitute of Occupational, Social and Environmental Medicine, RWTH Aachen University, Aachen, GermanyObjectives The knowledge of past asbestos exposure may lead to chronic psychological strain. In addition, the information about an increased cancer risk can place a psychological burden on individuals triggering mental health symptoms of depression or anxiety. This applies in particular to individuals with non-malignant asbestos-related disease (ARD) such as lung fibrosis and pleural thickening with or without lung function impairment. ARDs with or without lung function impairment may develop even years after exposure cessation. Therefore, the aim of the present study was to test for our cohort whether non-malignant ARD and lung function impairment have differential effects on mental health and psychological strain.Design Cross-sectional study.Participants and setting Overall, 612 male participants (mean age=66.2 years, SD=9.5) attending a surveillance programme for ARDs received routine examinations including lung function testing (24% refused to fill in the psychological questionnaire) at a German university hospital study centre from August 2008 to August 2013.Outcome measures Using multiple hierarchical regression analysis, ARD diagnosis and lung function impairment were used to predict psychological health as measured with validated questionnaires for depression and anxiety. Psychological strain was operationalised by intrusive thoughts and specific fear of cancer.Results The strongest predictor for mental health was obstructive functional impairment (eg, anxiety: β=0.22, p<0.001). Psychological strain was predicted by the presence of a non-malignant ARD (eg, intrusive thoughts: β=0.17, p=0.003).Conclusions The presence of mental health symptoms is associated with ventilation disturbances, whereas the knowledge of an already initiated morphological change—caused by asbestos exposure—is primarily associated with psychological strain. Specifically, the affected individuals are more prone to intrusive thoughts and specific fear of asbestos-related cancer. As an implication, physicians should be sensitised about possible consequences of risk communication and functional impairment to counteract excessive fear or anxiety.https://bmjopen.bmj.com/content/9/10/e030094.full
spellingShingle Jessica Lang
Michael K Felten
Thomas Kraus
Are the knowledge of non-malignant asbestos-related diseases and lung function impairment differentially associated with psychological well-being? A cross-sectional study in formerly asbestos-exposed workers in Germany
BMJ Open
title Are the knowledge of non-malignant asbestos-related diseases and lung function impairment differentially associated with psychological well-being? A cross-sectional study in formerly asbestos-exposed workers in Germany
title_full Are the knowledge of non-malignant asbestos-related diseases and lung function impairment differentially associated with psychological well-being? A cross-sectional study in formerly asbestos-exposed workers in Germany
title_fullStr Are the knowledge of non-malignant asbestos-related diseases and lung function impairment differentially associated with psychological well-being? A cross-sectional study in formerly asbestos-exposed workers in Germany
title_full_unstemmed Are the knowledge of non-malignant asbestos-related diseases and lung function impairment differentially associated with psychological well-being? A cross-sectional study in formerly asbestos-exposed workers in Germany
title_short Are the knowledge of non-malignant asbestos-related diseases and lung function impairment differentially associated with psychological well-being? A cross-sectional study in formerly asbestos-exposed workers in Germany
title_sort are the knowledge of non malignant asbestos related diseases and lung function impairment differentially associated with psychological well being a cross sectional study in formerly asbestos exposed workers in germany
url https://bmjopen.bmj.com/content/9/10/e030094.full
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