Assessing quality of life when planning and evaluating worker notification programs: two case examples

Our plain-English summary of Assessing quality of life when planning and evaluating worker notification programs: two case examples, by B.E. Meyerowitz (American Journal of Industrial Medicine, 1993).

The study

• Author: B.E. Meyerowitz
• Journal: American Journal of Industrial Medicine
• Published: 1993;23(1):221-7
• Cited by: 4 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

Notifying workers that they have been placed at risk for serious medical problems may affect their lives in unexpected ways. Although very little evidence supports the fear of notification causing grave psychological problems, more subtle disruptions in quality of life may result. In addition, psychological reactions to notification, such as anxiety or denial, may impede or enhance workers' abilities to process, remember, or act upon the information presented. Measuring how different notification strategies affect quality of life is crucial; this process can enable us to design and select effective strategies that improve, rather than disrupt, the lives of workers and their families. Two preliminary efforts to include consideration of quality of life in planning and evaluating notification programs are described.

In plain English

This short paper described two preliminary efforts, carried out with the United Paperworkers International Union, to take workers' quality of life into account when notifying them of health risks. The first case summarized an earlier project by the author and colleagues, published in 1989. Notification letters went to three hundred eighty workers who had worked several years before in departments with high asbestos exposure at an acoustical tile and wallboard plant, and seventy-two percent of them (272 workers) attended a union-sponsored screening. Most questionnaire respondents (74.4%) reported at least some distress on first learning of their risk. Fewer than 20% were surprised, and 60% reported taking some direct action. Signs of minimizing the risk were reported by 34.7% of nonattenders and 15.8% of attenders. The second case was a questionnaire about workplace carcinogens in general, returned by 369 paper industry workers. Over two-thirds wanted more information. The author concluded that the first notification program appeared successful without serious undesirable consequences for most workers. The author cautioned that the study design could not clearly link notification to the reactions, and that both examples were very preliminary.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: Descriptive paper presenting two preliminary case examples. The first is a summary of an earlier published questionnaire study of workers notified of asbestos exposure (Meyerowitz et al., 1989). The second is a preliminary questionnaire survey of union members' attitudes toward workplace carcinogens.
• Who was studied: Case one: three hundred eighty workers from an acoustical tile and wallboard plant who received notification letters. Seventy-two percent of them (272 workers) attended a union-sponsored screening. Questionnaires were returned anonymously by 90.8% of attenders and 51% of nonattenders. Case two: 369 United Paperworkers International Union members from 67 locals, who had worked in the paper industry for an average of 18 years.
• Exposure: Case one: past work, several years earlier, in departments with high levels of asbestos exposure at an acoustical tile and wallboard plant. No fiber type is named. Case two: workplace carcinogens in general, not asbestos specifically.
• Main results:
  • Case one: most asbestos-exposed workers (74.4%) reported at least some distress when first learning of their risk for asbestos-related illness.
  • Case one: fewer than 20% of workers were surprised to learn of their asbestos exposure.
  • Case one: denial or minimization of risk was indicated by 34.7% of nonattenders versus 15.8% of screening attenders.
  • Case one: the most common reasons for not attending the screening were logistic, reported by 30.6% of nonattenders. A small group (16.3%) did not attend because they did not want to know if they had health problems.
  • Case one: 60% of workers reported taking some form of direct action on learning of their exposure, such as seeking information or taking on-the-job precautions.
  • Case one: workers who first learned through the notification program did not differ in psychological distress or use of denial from those who had learned earlier through less formal means.
  • Case one: 84.3% of attenders and 48.9% of nonattenders said they appreciated the availability of the screening program.
  • Case one: among screening attenders, 37% reported negative feelings and 72% reported positive feelings while awaiting screening.
  • Case two: over half of paper workers (57.3% scoring above the midpoint) thought it likely they had been or would be exposed to cancer-causing agents on the job. Two-thirds would not know where to find information about workplace carcinogenic exposure.
  • Case two: 67.7% of paper workers believed they needed to be suspicious about almost every chemical, and 37.9% believed they could trust OSHA standards.
  • Case two: over two-thirds of paper workers (72.1%) were interested in obtaining more information about job-related carcinogens.
• The authors' conclusion: The author concluded that, from a quality-of-life perspective, the asbestos notification program appeared to have been successful, without serious undesirable consequences for the large majority of workers. Formal notification was not associated with increased difficulties. The author described both examples as very preliminary demonstrations of the potential usefulness of worker-oriented quality-of-life assessments.
• Limitations the authors state:
  • Case one: the study design does not allow clear links to be drawn between notification and the reactions described.
  • Case one: workers were in a strong union, had a screening program available, and were exposed many years before notification. Reactions might differ in other circumstances.
  • Case two: a response rate could not be calculated (estimated around 50%). Respondents were probably those most interested in health and safety, so the results should not be assumed to be generalizable.
  • The author stated that research in this area is insufficient and that much of it, including these examples, is methodologically flawed.

Topics

Medical terms in this study, explained in our Lexicon: Quality of Life.

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