The mental health of asbestos-exposed subjects with pleural abnormalities

Our plain-English summary of The mental health of asbestos-exposed subjects with pleural abnormalities, by P. Franklin, M. Robinson, P. Abaogye-Sarfo, et al (International Archives of Occupational and Environmental Health, 2015).

The study

• Authors: P. Franklin, M. Robinson, P. Abaogye-Sarfo, L. Samuel, N. Olsen, R. Mina, A.W. Musk, A. Reid
• Journal: International Archives of Occupational and Environmental Health
• Published: 2015;88(3):343-50
• Cited by: 5 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

Purpose: To examine the effect of knowledge of radiographic abnormalities on the mental health of asbestos-exposed people with and without pleural abnormalities.

Methods: Subjects were former asbestos mine and mill workers and residents of the mining town who had participated in an annual health review program. Pleural abnormalities (pleural plaques, diffuse pleural thickening and asbestosis) were determined from plain chest X-rays. All Participants completed a questionnaire on mental health status (SF-12) and locus of control (LOC).

Results: There were no significant differences between asbestos-exposed people with and without radiographic abnormalities for either the SF-12 mental health score or LOC. However, the asbestos-exposed cohorts had lower mental health scores compared with a random sample of the local population.

Conclusion: The presence of pleural abnormalities did not further affect the mental health of asbestos-exposed people beyond a decrement associated with exposure per se.

In plain English

In 2007, the authors mailed questionnaires to surviving former workers of the Wittenoom blue asbestos mine and mill in Western Australia and to former residents of the town. They analysed 867 respondents who belonged to a surveillance program and had a chest X-ray within the previous 5 years. The X-rays were classified for pleural plaques, diffuse pleural thickening and asbestosis. Mental health was measured with the SF-12 questionnaire, and sense of personal control with a locus of control scale. Neither measure differed significantly between people with and without these abnormalities. This still held when the analysis was limited to people fully aware of their plaques or thickening, and only about a third were. Compared with a Western Australian population survey, most exposed groups aged 65 and over had significantly lower mental health scores. At ages 30 to 64, only the group without abnormalities scored significantly lower. The authors concluded that pleural abnormalities did not further affect mental health beyond a decrement associated with exposure itself. They cautioned that only aggregated population data were available for that comparison.

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: Postal questionnaire survey of members of an asbestos surveillance program (the Asbestos Review Program), with chest X-ray findings compared within the group and mental and physical health scores compared with a Western Australian population survey
• Who was studied: 867 former workers and former residents of Wittenoom, Western Australia, surveyed in 2007. Of 5,101 people sent questionnaires, 2,538 returned them. The 867 had attended the Asbestos Review Program within 5 years of the questionnaire. Groups: 548 with no abnormality, 65 with pleural plaques only, 184 with diffuse pleural thickening (with or without plaques), and 59 with asbestosis. The comparison group was a 2000 telephone survey of 7,753 Western Australian adults.
• Exposure: Blue asbestos, through work at the Wittenoom mine and mill or through living in the Wittenoom township. Cumulative exposure was estimated in f/ml-years. Median cumulative exposure was 3.5 f/ml-years in the no-abnormality group and 6.6 f/ml-years in the plaques-only group.
• Main results:
  • Within the exposed group, mental health scores were not significantly associated with pleural plaques, diffuse pleural thickening or asbestosis.
  • Median SF-12 mental health scores (interquartile range) were: no abnormality 53.7 (45.2, 57.9); plaques only 51.3 (44.7, 57.3); diffuse pleural thickening 52.2 (42.4, 57.8); asbestosis 54.8 (43.9, 57.9).
  • Total locus of control score (sense of personal control) did not differ between the abnormality groups. The median was 7.0 in every group.
  • Only 59 of 184 people with diffuse pleural thickening (32.1 %) and 19 of 65 with plaques only (printed as 32.2 %) were fully aware of their condition. When the analysis included only the aware people, mental health and locus of control scores still did not differ between those with and without pleural abnormalities.
  • Ages 65 and over: mean mental health scores were lower than the Western Australian population mean of 54.41 for:
• the no-abnormality group: 51.64, p less than 0.001
• the diffuse pleural thickening group: 50.23, p less than 0.001
• the asbestosis group: 51.50, p = 0.034
  The plaques-only group scored 49.68, with p = 0.081.
  • Ages 30 to 64: only the no-abnormality group had a significantly lower mental health score than the Western Australian population (49.79 versus 51.80, p less than 0.001).
  • For physical health, only the diffuse pleural thickening group scored lower than the Western Australian population in both age groups:
• ages 30 to 64: 46.14 versus 49.96, p = 0.017
• ages 65 and over: 39.41 versus 43.35, p less than 0.001
  • Within the exposed group, a more external locus of control (a greater sense of powerlessness) was associated with higher cumulative asbestos exposure (B = 0.132, p = 0.018).
  • Breathlessness was associated with poorer mental health scores and a more external locus of control, independent of physical health score and X-ray abnormalities.
• The authors' conclusion: The authors concluded that the presence of pleural abnormalities did not further affect the mental health of asbestos-exposed people beyond a decrement associated with exposure itself.
• Limitations the authors state:
  • Only aggregated data were available for the Western Australian population, so the comparison could not control for factors such as poor respiratory health.
  • Participants were not always told of their X-ray results, and the authors could not be sure how many truly did not know of their condition. The effect of awareness could therefore not be fully assessed.
  • There was no non-exposed matched control group for the locus of control comparison.
  • Mental health and locus of control were measured at a single time point, so the direction of the relationship with breathlessness could not be assessed.
  • The SF-12 is a brief screening measure and may not have identified some mental health difficulties.

Mines named here

Asbestos mines this study is about. Each mine's page says who ran it, when it worked, and what it produced.

• Wittenoom, Western Australia

All asbestos mines

Topics

The National Library of Medicine indexes this study under subjects our site covers: Pleural plaques and thickening.

Medical terms in this study, explained in our Lexicon: Pleural Plaques, Diffuse Pleural Thickening, Chest X-Ray.

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