Psychological impact of computed tomography screening for lung cancer and occupational pulmonary disease among asbestos-exposed workers.

The objective of this study was to investigate the psychological impact of screening for lung cancer and occupational pulmonary disease among asbestos-exposed workers. Altogether, 633 workers were screened with chest computed tomography (627 men, 6 women, mean age 64.5 years). Participants' views on the necessity of screening,awareness of asbestos-exposure risks, their perceived lung cancer risk, trial adherence intention, health anxiety,and worry about lung cancer were assessed. Health anxiety was reduced significantly after screening (P < 0.001). After 1 year, no significant long-term psychological differences were found between those who immediately received clear results and those who were submitted to additional examinations because of positive findings. In conclusion,computed tomography screening of pulmonary disease was well accepted and did not produce excessive long-term anxiety or other negative psychological effects,which could prevent the participation in the future screening programs.

Return-to-work policies in Finnish occupational health services.

AIM: To describe return-to-work services for employees on sick leave offered by Finnish occupational health services (OHS). METHODS: Finnish OHS are surveyed every 3 years. Respondents are asked if they offer services to facilitate return to work (RTW), and if so, to describe them. The description was qualitatively analysed using the Atlas-ti programme to find the themes that best describe the services. We also studied characteristics of OHS predicting a return-to-work policy. RESULTS: Of the total sample of 969 occupational health units, 95% responded to the survey. Forty-one per cent reported offering services for facilitating RTW after sick leave. The service usually consisted of occupational physician examination of employees on sick leave for approximately 6 weeks. This was followed by a joint discussion between employee, physician and supervisor, which could result in work accommodation or a work trial period. There was a substantial variation, with only 10% mentioning a joint meeting and 13% mentioning a work trial period or work accommodation. Return-to-work policies were more frequently found in the OHS that served only a few employers, provided more group activities and collaborated more with employers and research institutes. CONCLUSION: Less than half of Finnish OHS offer return-to-work services of which the contents show wide variation that is not in line with current scientific evidence. A guideline project for return-to-work practices is needed to fill the gap. More research is needed to best define monitoring and screening practices for workers on sick leave.