Your browser doesn't support javascript.
loading
Show: 20 | 50 | 100
Results 1 - 4 de 4
Filter
1.
BMC Public Health ; 10: 647, 2010 Oct 26.
Article in English | MEDLINE | ID: mdl-20977751

ABSTRACT

BACKGROUND: The aim of this study was to assess the psychological consequences of HRCT scan screening in retired asbestos-exposed workers. METHODS: A HRCT-scan screening program for asbestos-related diseases was carried out in four regions of France. At baseline (T1), subjects filled in self-administered occupational questionnaires. In two of the regions, subjects also received a validated psychological scale, namely the psychological consequences questionnaire (PCQ). The physician was required to provide the subject with the results of the HRCT scan at a final visit. A second assessment of psychological consequences was performed 6 months after the HRCT-scan examination (T2). PCQ scores were compared quantitatively (t-test, general linear model) and qualitatively (chi²-test, logistic regression) to screening results. Multivariate analyses were adjusted for gender, age, smoking, asbestos exposure and counseling. RESULTS: Among the 832 subjects included in this psychological impact study, HRCT-scan screening was associated with a significant increase of the psychological score 6 months after the examination relative to baseline values (8.31 to 10.08, p < 0.0001, t-test). This increase concerned patients with an abnormal HRCT-scan result, regardless of the abnormalities, but also patients with normal HRCT-scans after adjustment for age, gender, smoking status, asbestos exposure and counseling visit. The greatest increase was observed for pleural plaques (+3.60; 95%CI [+2.15;+5.06]), which are benign lesions. Detection of isolated pulmonary nodules was also associated with a less marked but nevertheless significant increase of distress (+1.88; 95%CI [+0.34;+3.42]). However, analyses based on logistic regressions only showed a close to significant increase of the proportion of subjects with abnormal PCQ scores at T2 for patients with asbestosis (OR = 1.92; 95%CI [0.97-3.81]) or with two or more diseases (OR = 2.04; 95%CI [0.95-4.37]). CONCLUSION: This study suggests that HRCT-scan screening may be associated with increased distress in asbestos-exposed subjects. If confirmed, these results may have consequences for HRCT-scan screening recommendations.


Subject(s)
Asbestos , Mass Screening/psychology , Occupational Exposure , Patients/psychology , Tomography, X-Ray Computed/psychology , Adult , Aged , Aged, 80 and over , Female , France , Humans , Male , Middle Aged , Stress, Psychological , Surveys and Questionnaires
2.
Am J Respir Crit Care Med ; 182(4): 526-30, 2010 Aug 15.
Article in English | MEDLINE | ID: mdl-20442438

ABSTRACT

RATIONALE: Whether occupational exposure to asbestos causes airway obstruction remains controversial. OBJECTIVES: This study evaluated lung function in relation to cumulative exposure to asbestos in a large cohort of retired or unemployed workers exposed to asbestos. METHODS: The study population consisted of 3,660 volunteer subjects. An individual cumulative exposure index to asbestos was calculated for each subject, and information was obtained on smoking status. Pulmonary function tests were performed in all subjects; high-resolution chest computed tomography was also performed in 3,335 subjects. MEASUREMENTS AND MAIN RESULTS: Values of FEV(1)/FVC and FEF(25-75%) did not differ between five classes (quintiles) of cumulative exposure to asbestos, and no significant correlation was observed between cumulative exposure to asbestos and pulmonary function parameters, after adjustment for sex, tobacco consumption, emphysema, and body mass index. Furthermore, the proportion of abnormal pulmonary function tests did not differ between the five classes of cumulative exposure to asbestos. CONCLUSIONS: The results do not support a causal relationship between asbestos exposure alone and airway obstruction. However, the study sample may not be representative of all people occupationally exposed to asbestos, because a fraction of subjects with previously diagnosed asbestosis probably did not participate in this screening program.


Subject(s)
Airway Obstruction/epidemiology , Asbestos/adverse effects , Occupational Exposure/statistics & numerical data , Adult , Aged , Aged, 80 and over , Airway Obstruction/etiology , Causality , Cohort Studies , Comorbidity , Cross-Sectional Studies , Female , Forced Expiratory Flow Rates , Forced Expiratory Volume , France , Humans , Lung/diagnostic imaging , Male , Middle Aged , Occupational Exposure/adverse effects , Respiratory Function Tests/methods , Respiratory Function Tests/statistics & numerical data , Smoking/epidemiology , Tomography, X-Ray Computed/methods , Tomography, X-Ray Computed/statistics & numerical data , Vital Capacity
3.
Lung Cancer ; 67(2): 144-50, 2010 Feb.
Article in English | MEDLINE | ID: mdl-19464070

ABSTRACT

INTRODUCTION: Clinical characteristics and risk factors of nonsmoker patients with lung cancer are still debated. AIM AND METHODS: The aim of this work is to describe the characteristics of never smoker patients with lung cancer, focusing on occupational and environmental exposures, Data collected were: age, gender, histological types, methods of diagnosis, TNM staging, smoking, and occupational data. Statistical analysis included descriptive analyses, Pearson's chi-square or nonparametric tests, and logistic regressions. RESULTS: All lung cancers diagnosed between January 1, 1997 and December 31, 2006, representing 1493 cases were included. Lung adenocarcinoma (ADC) [Odds Ratio (OR)=2.5 (1.5-4.3), p<0.0001] as well as clinical stage I cases at diagnosis [OR=2.4 (1.3-4.3)] were most frequent in nonsmokers relative to ever smokers. Comparison of clinical features among male and female nonsmoker patients did not reveal significant differences. Conversely, strong differences appeared when comparing environmental tobacco smoke (ETS) and occupational exposures in nonsmoker women vs men: ETS exposure (78.6% nonsmoker women vs 21.4% nonsmoker men, p<0.0001), occupational exposure (9.4% vs 48.6%, p<0.0005). Noteworthy, a sizeable number of nonsmoker male (40.0%), and nonsmoker female (31.2%) patients had no known exposure to major lung carcinogens. CONCLUSIONS: Main risk factors (ETS and occupational exposure) may only explain some cases.


Subject(s)
Environmental Exposure/adverse effects , Lung Neoplasms/etiology , Occupational Exposure/adverse effects , Adult , Aged , Aged, 80 and over , Female , Humans , Lung Neoplasms/pathology , Male , Middle Aged , Neoplasm Staging , Risk Factors , Smoking/adverse effects , Tobacco Smoke Pollution/adverse effects
4.
Am J Ind Med ; 52(4): 288-96, 2009 Apr.
Article in English | MEDLINE | ID: mdl-19152347

ABSTRACT

OBJECTIVES: CT-scan screening programs for lung cancer detection have been proposed in high-risk subjects, and more recently in former asbestos-exposed subjects. However, to date no data are available on psychological impact of such programs. The aim of this study is to examine the risk factors of psychological distress at baseline of a CT-scan screening program among asbestos-exposed subjects. METHODS: The Asbestos Post-Exposure Survey (APEXS) was carried out in France between October 2003 and December 2005 in order to screen asbestos-related diseases by CT-scan. Volunteers underwent self-administered questionnaires including an asbestos exposure assessment and, for a large sub-sample, a validated psychological distress scale. Non-exposed subjects were used as reference group. RESULTS: At baseline, a significant higher level of distress was observed in exposed subjects (n = 3,122) relative to the reference group (n = 486) after adjustment on age, sex, and tobacco status. This distress is associated independently with the self-perception of (i) intensity of asbestos exposure and (ii) the risk of current or future disease related to the asbestos exposure. The perception of the cancer risk related to asbestos seems to play a fundamental role in this psychological distress. CONCLUSION: In this study, asbestos-exposed subjects experienced a higher significant cancer distress than previously described in literature. These findings may be of potential public health importance. First, the impact of such occupational exposures on quality of life of patients who suffer from cancer related to these exposures has to be appraised. Secondly, the assessment of psychological impact of CT-scan screening programs among asbestos-exposed subjects is also required.


Subject(s)
Lung Neoplasms/psychology , Mesothelioma/psychology , Tomography, X-Ray Computed/psychology , Female , France , Humans , Logistic Models , Lung Neoplasms/diagnostic imaging , Male , Mesothelioma/diagnostic imaging , Middle Aged , Risk Factors , Surveys and Questionnaires
SELECTION OF CITATIONS
SEARCH DETAIL
...