Background Work is a major component of daily life for most adults. People work to make a living, but work also creates routines and structure in everyday life. Studies to date indicate that the prevalence of work disability is high in early and late systemic sclerosis (SSc) (1-4). Therefore, in order to identify patients with needs for early interventions, e.g. medical treatment and rehabilitation, more knowledge about patterns of work disability and its relationship to disease activity in early disease is needed.
Objectives To study work disability with reference to levels of sick leave and disability pension in early SSc.
Methods SSc patients living in the southern part of Sweden with onset of their first non-Raynaud symptom between 2003 and 2009 and with a follow-up of 36 months were included in a longitudinal study. Thirty-two patients (26 female, 24 with limited SSc), median age 47.5 years (IQR 43-53), were identified. Work disability was calculated in 30-day-intervals from 12 months prior disease onset until 36 months after, presented as the prevalence of work disability per year (0–3) and as period prevalence of mean net days per month (±SD). Comparisons were made between patients with different disease severity and sociodemographic characteristics, and between patients and a reference group from the general population.
Results Seventy-eight percent had no work disability one year prior disease onset, which decreased to 47% after 3 years. The relative risk for work disability in SSc patients compared to reference group was 0.95 (95% CI 0.39–2.33) at diagnosis, and increased to 2.41 (1.28–4.55) after 3 years. There were no significant correlations between work disability and disease severity, but between work disability and years at workplace rs=-.72 (p=0.002), education rs=-.51 (p=0.004), and sickness absence the month before disease onset rs=.58 respectively (p=0.001).
Conclusions Considerable increase in work disability was noted 3 years after disease onset. Short education, fewer years at workplace, and sickness absence before disease onset may be risk factors for sustained work disability and these patients should be selected for early rehabilitation intervention.
Quimet JM, Pope JE, Gutmanis I, Koval J. Work disability in scleroderma is greater than in rheumatoid arthritis and is predicted by high HAQ scores. The open Rheumatology Journal 2008; 2:44-52.
Sandqvist G, Scheja A, Eklund M. Working ability in relation to disease severity,everyday occupations and wellbeing in women with limited systemic sclerosis. Rheumatology (Oxford) 2008; 47:1708-11.
Hudson M, Steel R, Lu Y, Thombs BD;Canadian scleroderma research group, Baron M. Work disability in systemic sclerosis. J Rhuematol 2009;36:2481-6.
Sharif R, Mayes MD, Nicassio PM, Gonzales EB, Estrada-Y-Martin RM, Nair DK, Reveille JD, Arnett FC, Assassi S, for the GENISOS Study Group. Determinants of work disability in patients with systemic sclerosis: A longitudinal study of the GENISOS cohort. Semin Arthritis Rheum 2011;41:38-47.
Disclosure of Interest None declared