Background Rheumatoid arthritis (RA) is recognised as one of the most disabling rheumatic diseases. Work disability and social impairment are frequently overlooked consequences of RA.

Objectives (1) to evaluate the prevalence of work disability; (2) to evaluate the impact of the disease on the social network in patients with rheumatoid arthritis (RA).

Methods We submitted a self-report questionnaire concerning RA impact on employment status and social support network to a cohort of 229 patients with RA, fulfilling the 1987 ACR criteria, followed in a hospital-based outpatient rheumatology clinic. 146 patients (63.8%) returned the completed questionnaire (female = 88.4%, male = 11.6%; mean age = 56 years; mean disease duration = 13.4 ± 8.1 years; RF positive = 73.8%; mean Larsen score = 50.6; ACR functional class I ? 20.4%, II ? 26.0%, III ? 30.3%, IV ? 12.7%).

Results 83.9% of the patients had less than 7 years of formal education. 70.2% had a monthly income of less than 500 euros. 58.7% of the patients were retired and 2.9% unemployed. From these patients, 84.5% had stopped working due to RA. From the employed patients, 5.8% were currently on leave. From all patients, 83.1% had to take a leave at least once due to RA. The mean total time on leave was 587 days per patient. 86.3% of the patients reported that RA compromised their capability to earn money. 81.4% of the patients were married, 7.9% single, 2.9% divorced or separated and 7.9% widowed. All the divorced or separated patients related their status to RA. 88.4% of the patients live with spouse or first grade relatives. Only 2.7% reported to live alone. 72.8% of the patients depend on escort for physician visits, in most of the cases (92.4%) by the spouse. A minority of patients may rely on institutional social support: 7.2% live in a old age residence, 11.2% have access to a day-care centre, 13.3% to a social worker, 12.3% to a religious association and 8.2% to voluntary workers. 89.6% of the patients reported that RA jeopardised the ability to engage in their previous leisure activities.

Conclusion There was a high prevalence of permanent and temporary work disability related to RA in this cohort. This may be related to the high disease duration of this group. Most patients rely on social support from the family. The impact of RA on marital status was limited, but much more extensive on leisure activities.