Psychological strain due to the knowledge of hazardous substance exposure

Introduction
Workers who have been exposed to hazardous substances like asbestos or polychlorinated biphenyls (PCBs) on the job have an increased probability for developing substance dependent health impairments or illnesses. The knowledge about the potential health threat may also affect an individual’s psychological well-being. However, past research studying the relationship between a hazardous substance exposure and psychological strain has led to inconclusive findings (e.g., Kovalchick et al., 2002). Thus, the aim of the present study was to systematically analyse the psychological impact of objectively assessed hazardous substance exposures in two separate samples.

Methods
The first sample comprised 330 male, formerly asbestos exposed workers. The second sample comprised 180 predominantly male individuals who had been exposed to PCBS. Both samples were enrolled in substance specific surveillance programs. In addition to the medical screening process, participants filled out a standardized survey assessing psychological strain outcomes like stress, depression and anxiety (e.g., DASS; Lovibond & Lovibond 1995, PHQ 9; Kroenke et al, 2001).

Results
Formerly asbestos exposed workers who have been diagnosed with asbestos-related benign tissue changes reported significantly higher stress- (F = 6.97, p< 0.01) and anxiety levels (F = 15.11, p < 0.01) than workers without manifest asbestos-related changes. In addition, these individuals were also suffering more from intrusive thoughts (F = 12.59, p< 0.01). Similar results were reported from participants whose PCB levels exceeded the concentrations from the general population. Within these participants psychological strain was significantly increased.

Discussion
Findings from the present study show that the knowledge of having been exposed to a hazardous substance does in fact influence individuals’ psychological well-being. Psychological strain outcomes were highest among objectively exposed individuals. These findings imply physicians to be sensitive also to the psychological needs of individuals participating in surveillance programs.