SARS-CoV-2 and Asbestos Exposure: Can Our Experience With Mesothelioma Patients Help Us Understand the Psychological Consequences of COVID-19 and Develop Interventions?

Our plain-English summary of SARS-CoV-2 and Asbestos Exposure: Can Our Experience With Mesothelioma Patients Help Us Understand the Psychological Consequences of COVID-19 and Develop Interventions?, by A. Granieri, M. Bonafede, A. Marinaccio, et al (Frontiers in Psychology, 2020).

The study

• Authors: A. Granieri, M. Bonafede, A. Marinaccio, I. Iavarone, D. Marsili, I.G. Franzoi
• Journal: Frontiers in Psychology
• Published: 2020;11:584320
• Type of article: Review
• Cited by: 10 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

Abstract

Since its emergence, the novel coronavirus disease of 2019 (COVID-19) has had enormous physical, social, and psychological impacts worldwide. The aim of this article was to identify elements of our knowledge on asbestos exposure and malignant mesothelioma (MM) that can provide insight into the psychological impact of the COVID-19 pandemic and be used to develop adequate interventions. Although the etiology of Covid-19 and MM differs, their psychological impacts have common characteristics: in both diseases, there is a feeling of being exposed through aerial contagion to an "invisible killer" without boundaries that can strike even the strongest individuals. In both cases, affected persons can experience personality dysfunction, anxiety, depression, and posttraumatic symptoms; helplessness, hopelessness, and projection of destructive thoughts onto external forces often emerge, while defense mechanisms such as denial, splitting, repression, and reduced emotional expression are used by individuals to contain their overwhelming anxieties. We believe that in both diseases, an integrated multidimensional intervention offered by hospitals and other public health services is the most effective approach to alleviating patients' and caregivers' psychological distress. In particular, we emphasize that in the context of both MM and COVID-19, Brief Psychoanalytic Group therapy can help patients and caregivers attribute meaning to the significant changes in their lives related to the experience of the disease and identify adaptive strategies and more realistic relational modalities to deal with what has happened to them. We also highlight the importance of developing a surveillance system that includes individual anamnestic evaluation of occupational risk factors for COVID-19 disease.

Copyright © 2020 Granieri, Bonafede, Marinaccio, Iavarone, Marsili and Franzoi.

In plain English

This article is a conceptual analysis, not a study that collected new data. The authors, who work in Italy and have worked with communities exposed to asbestos in Casale Monferrato, asked whether their experience with malignant mesothelioma (MM) patients and their caregivers could help explain the psychological effects of COVID-19. Using published research, they compared the two diseases. MM is not contagious and appears on average 40 or more years after asbestos exposure. COVID-19 is an infection that appears within days to two weeks. Even so, the authors argued that both can create a feeling of being exposed to an invisible threat, along with anxiety, depression, guilt and isolation. They also described similar defense mechanisms in both groups, such as denial and splitting. They described Brief Psychoanalytic Group therapy: 12 weekly one-hour group sessions for MM patients and caregivers, so far used only in Casale Monferrato. The authors concluded that this model can be adapted to COVID-19 patients and caregivers. They also called for a surveillance system that records occupational risk factors for COVID-19. They did not report testing the therapy with COVID-19 patients.

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: Conceptual analysis (an argument drawing on published literature and the authors' clinical experience; no new data collected)
• Who was studied: No study participants. The authors drew on their own decade of work with MM patients and caregivers at contaminated sites, mainly the National Priority Contaminated Site of Casale Monferrato, Italy, and on published studies of MM and COVID-19.
• Exposure: Occupational and environmental asbestos exposure, including exposure from the Eternit asbestos-processing factory in Casale Monferrato (no specific fiber types are analyzed), compared with exposure to the SARS-CoV-2 virus
• Main results:
  • The authors argued that, despite different causes, MM and COVID-19 may have a similar psychological impact on individuals.
  • The authors identified the main difference as contagion: MM is not contagious and is linked to environmental or, more often, occupational asbestos exposure.
  • The authors stated that the time from asbestos exposure to MM symptoms averages 40 years or more, while COVID-19 appears within a few days to 2 weeks.
  • The authors proposed that, as in residents of asbestos-contaminated sites, people in the pandemic rely on defense mechanisms such as denial, splitting, repression and reduced emotional expression.
  • The authors stated that the strict restrictions needed for MM patients during the pandemic can magnify the isolation they already experience.
  • The authors described Brief Psychoanalytic Group therapy as 12 weekly one-hour group sessions led by two psychotherapists. They stated it has been used so far only in Casale Monferrato.
• The authors' conclusion: The authors concluded that the group therapy model developed for MM patients and caregivers can be adapted to COVID-19 patients and caregivers. They also concluded that a surveillance system including individual evaluation of occupational risk factors for COVID-19 is needed.

Topics

Medical terms in this study, explained in our Lexicon: Asbestos Exposure, Mesothelioma, Malignant Mesothelioma, Etiology.

Related studies

• Commentary: SARS-CoV-2 and Asbestos Exposure: Can Our Experience With Mesothelioma Patients Help Us Understand the Psychological Consequences of COVID-19 and Develop Interventions? — D. Di Basilio, J. Shigemura, et al. (2021)
• Psychological Distress after a Diagnosis of Malignant Mesothelioma in a Group of Patients and Caregivers at the National Priority Contaminated Site of Casale Monferrato — M. Bonafede, A. Granieri, et al. (2020)
• Preliminary validation of a questionnaire assessing psychological distress in caregivers of patients with malignant mesothelioma: Mesothelioma Psychological Distress Tool-Caregivers — M. Bonafede, C. Chiorri, et al. (2022)
• Preliminary validation of a brief PROM assessing psychological distress in patients with malignant mesothelioma: The mesothelioma psychological distress tool-Patients — F. Guglielmucci, M. Bonafede, et al. (2022)
• The psychological distress and care needs of mesothelioma patients and asbestos-exposed subjects: A systematic review of published studies — M. Bonafede, M. Ghelli, et al. (2018)
• Psychological Distress in Patients With Asbestos-Related Diseases and Their Families: A Systematic Literature Review — I.G. Franzoi, M.D. Sauta, et al. (2025)

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