Institute of Occupational, Social and Environmental Medicine, RWTH Aachen University, Aachen, Germany
Institute of Occupational, Social and Environmental Medicine, RWTH Aachen University, Aachen, Germany.
BMJ Open. 2019 Oct 28;9(10):e030094. doi: 10.1136/bmjopen-2019-030094.
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.
Cross-sectional study.
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.
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.
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).
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.
对过去石棉暴露的了解可能导致慢性心理压力。此外，有关癌症风险增加的信息可能会给个人带来心理负担，引发抑郁或焦虑等心理健康症状。这尤其适用于患有非恶性石棉相关疾病（ARD）的个体，例如肺纤维化和胸膜增厚，无论是否伴有肺功能损害。即使在停止暴露多年后，也可能会出现伴有或不伴有肺功能损害的 ARD。因此，本研究的目的是检验我们的研究队列中非恶性 ARD 和肺功能损害是否对心理健康和心理压力有不同的影响。
横断面研究。
共有 612 名男性参与者（平均年龄=66.2 岁，标准差=9.5）参加了德国大学医院研究中心的 ARD 监测计划，该计划于 2008 年 8 月至 2013 年 8 月期间接受了常规检查，包括肺功能测试（24%的人拒绝填写心理问卷）。
使用多元层次回归分析，将 ARD 诊断和肺功能损害用于预测抑郁和焦虑的有效问卷测量的心理健康。心理压力通过侵入性思维和对癌症的特定恐惧来表示。
心理健康的最强预测因子是阻塞性功能障碍（例如，焦虑：β=0.22，p<0.001）。非恶性 ARD 的存在可预测心理压力（例如，侵入性思维：β=0.17，p=0.003）。
心理健康症状与通气障碍有关，而对已经由石棉暴露引起的形态变化的了解主要与心理压力有关。具体来说，受影响的个体更容易出现侵入性思维和对与石棉相关的癌症的特定恐惧。因此，医生应该意识到风险沟通和功能损害可能带来的后果，以消除过度的恐惧或焦虑。
