This article is more than 5 years old. Information may no longer be current.
Physically demanding jobs may impact radiographic progression in patients with AS
Patients with ankylosing spondylitis and physically demanding employment may be more likely to have higher disease activity and display radiographic progression compared to patients with ankylosing spondylitis and more sedentary employment, according to a recently published study.
Researchers studied 184 patients with ankylosing spondylitis (AS) from a cohort of patients in Belgium, France and the Netherlands for 12 years. Patients were 70% men and 83% were HLA-B27-positive. Patients with two radiographs and data on disease activity, occupational activities, smoking status and socioeconomic information were included. None of the patients were treated with anti-tumor necrosis factor-alpha inhibitors at baseline, and 68% were treated with NSAIDs.
Patients were divided by self-reported employment type into blue collar workers who engaged in manual labor and white collar workers who were managers, administrative workers, teachers and engineers. Of the 186 patients, 136 had baseline occupational data available. The modified Stoke Ankylosing Spondylitis Spine Score (mSASSS) and Ankylosing Spondylitis Disease Activity Score (ASDAS) were used in statistical analysis identify associations with employment type and other factors.
Blue collar workers were slightly but significantly more likely to show radiographic progression compared to white collar workers by 2.18 mSASSS units per 2 years compared to 1.82 mSASSS units per 2 years seen in white collar workers. When adjusted for sex, the association was not present.
An association was seen between ASDAS and job type. For every increase in ASDAS unit, an increase of 1.2 mSASSS units per 2 years was seen in blue collar workers compared to 0.2 mSASSS units per 2 years in white collar workers. The association persisted after adjustment for smoking or educational level instead of job type in men but not in women. A trend was seen with increased ASDAS in blue collar workers and smoking but the association did not reach statistical significance. – by Shirley Pulawski
Disclosure: The researchers report no relevant financial disclosures.