Effects of informing workers of their health risks from exposure to toxic materials

Our plain-English summary of Effects of informing workers of their health risks from exposure to toxic materials, by P.S. Houts, V. McDougall (American Journal of Industrial Medicine, 1988).

The study

• Authors: P.S. Houts, V. McDougall
• Journal: American Journal of Industrial Medicine
• Published: 1988;13(2):271-9
• Cited by: 22 articles, as counted by NIH iCite
• Read it: PubMed · Publisher
• In J-M's library: Johns-Manville's company medical library held a copy (J-M no. 000230).

Abstract

This study compared the mental health, attitudes, and smoking behaviors of 133 workers who had been informed of health risks from exposure to toxic materials on the job with 137 workers who worked in similar conditions but who had not been told that their health was at risk because of exposure to toxic materials. The informed workers reported more health problems than controls, but there were no significant differences between the informed and uninformed groups in mental health, attitudes toward health hazards in or outside of the workplace, or in smoking rates. Ninety percent of all respondents felt that exposed workers definitely should be told of their health risks. These findings indicate little psychological risk from informing workers about their risks because of exposure to toxic substances and a strong desire on the part of workers to be informed.

In plain English

In 1984 the authors surveyed workers by phone on whether being told of toxic-exposure health risks at work affected mental health, attitudes and smoking. The informed group was 133 workers exposed to asbestos between 1964 and 1972 at a glass products factory in north central Pennsylvania. Of these, 22 reported being told they had clinical evidence of asbestosis. The comparison group was 137 workers at another glass products factory, neither exposed to asbestos nor told their health was at risk. Neither informed group differed significantly from the comparison group on a demoralization scale, tranquilizer-type medicine use, or talking to a doctor, minister or counselor about emotional problems. Both informed groups rated their health as poorer and were more aware that asbestos-exposed workers can cut their cancer chances by stopping smoking, but smoking rates did not differ significantly. Ninety percent of all respondents said exposed workers definitely should be told. The authors concluded that informing workers carried little risk of mental distress, and suggested that information alone was not sufficient to change smoking behavior. The study could not assess short-term reactions.

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: Cross-sectional telephone survey comparing informed asbestos-exposed workers (split into those reporting asbestosis and those without) with a control group of uninformed workers in the same industry
• Who was studied: 270 white male hourly workers over age 30, all employed at the time of the 1984 interview. There were 133 informed workers (22 with self-reported asbestosis and 111 without) from one glass products factory in north central Pennsylvania, and 137 control workers from another glass products factory in north central Pennsylvania. Response rates were 90% in the informed group and 91% in the control group.
• Exposure: Informed workers had been exposed to asbestos (fiber type not specified) at a glass products factory between 1964 and 1972. Starting in 1979, a union-company-community committee gave them educational materials, and most were offered free medical examinations. The control workers were not exposed to asbestos but worked in the same industry with similar materials. The comparison of interest was being informed of health risks versus not.
• Main results:
  • Mental health showed no statistically significant differences between either informed group and the control group, after adjusting for age and education. Mean demoralization scores were 72.9 (asbestosis group), 72.0 (without asbestosis) and 72.7 (controls). Use of sleeping pills, tranquilizers or nerve medicine in the past month was 0%, 6% and 5%. Talking to a doctor, minister or counselor about emotional problems in the past year was 0%, 5% and 5%.
  • Both informed groups rated their own health as poorer than the control group did (mean ratings 2.3 and 2.1 versus 1.8, on a scale where 1 is excellent). Both also felt they had a greater chance of becoming ill because of toxic substances at work. These differences were statistically significant at p less than .01.
  • Only the asbestosis group was more likely than controls to say they had symptoms or illnesses they thought were related to their work: 45% in the asbestosis group, 15% in the group without asbestosis and 16% of controls. Fewer than half of the asbestosis group said so.
  • Both informed groups were more aware than controls that asbestos-exposed workers can reduce their chance of cancer by stopping smoking.
  • There were no statistically significant differences in smoking behavior. Current smokers made up 41% of the asbestosis group, 32% of the group without asbestosis and 38% of controls. Cigarettes per day and attempts to quit also did not differ significantly. The authors reported a trend toward lower smoking rates in the informed population.
  • Attitudes toward toxic-substance hazards at work and in the environment showed no statistically significant differences between the informed and control groups.
  • Ninety percent of all respondents felt that workers exposed to cancer-causing substances definitely should be told. The figures were 95% in the asbestosis group, 91% in the group without asbestosis and 90% of controls.
• The authors' conclusion: The authors concluded that there is little risk of mental distress from informing workers of risks from toxic exposures at work, and that workers want to be informed. In their view, this makes a compelling case for providing complete risk information. They also suggested that simply informing workers was not sufficient to change smoking behavior.
• Limitations the authors state:
  • Interviews took place several years after workers were first informed, so the study does not assess the short-term emotional impact of being informed.
  • The authors could not control for actual health status, so poorer self-rated health in the informed groups may reflect perception, reality, or both.
  • The asbestosis group was small (22 workers). The authors noted that the lack of statistically significant demographic differences between this group and the controls could be due to the small numbers.

Topics

The National Library of Medicine indexes this study under subjects our site covers: Asbestosis.

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