Work disability due to inflammatory arthritis greater among lower-paid, manual jobs
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Key takeaways:
- Manual work is impacted by arthritis more than professional work.
- Work impairment and presenteeism improve over the first year following diagnosis.
People who work lower-paid, manual-labor jobs are more likely to discontinue employment in the first 5 years after an early inflammatory arthritis diagnosis, vs. those who work in managerial or professional capacities, according to data.
“Many studies in this field have reported proportions of patients in work vs. not in work, failing to factor in the number of hours worked, nature of employment, and/or flexibility of working arrangements,” Katie Bechman, MD, of King’s College London, and colleagues wrote in Rheumatology. “Data are needed in order to understand the risk factors for poor work outcomes including gender, clinical disease markers and type of employment, and whether successful treatment of inflammatory arthritis improves the ability to work in the short and longer term.”
To investigate the impact of diagnosed inflammatory arthritis on patients’ employment participation, based on gender and occupation type, Bechman and colleagues consulted data from the National Early Inflammatory Arthritis Audit (NEIAA) for 2018 to 2020. According to the researchers, the NEIAA is a large cohort study based in the United Kingdom. Patients aged older than 16 years from England and Wales were eligible for inclusion if they were suspected of having, and later confirmed to have, early inflammatory arthritis.
The researchers collected information on patient demographics, ethnicity, smoking status, comorbidities, how long symptoms of early inflammatory arthritis were present and whether patients worked for 20 hours or more per week at the time of the assessment. Tender and swollen joint counts were taken, and providers completed a global assessment at baseline, 3 months and 6 months. Patients were also asked to complete patient-reported outcome measurement surveys at baseline, 3 months and 6 months.
Baseline occupational status was determined based on whether patients were paid to work for at least 20 hours per week, while work participation was measured using the Work Productivity and Activity Impairment (WPAI) score.
The researchers identified a total of 12,437 patients with diagnosed inflammatory arthritis. Of those patients, 5,999 were in paid employment at baseline. At the time of diagnosis, patients who were working demonstrated “statistically significant lower measures of disease activity” (P < .001), according to the researchers.
A total of 3,694 patients provided occupational data. Among the 793 patients who completed a WPAI evaluation at the time of diagnosis, 7.2% reported occupational cessation, while 12.3% reported changing jobs because of their symptoms. According to the researchers, there was a “high burden” of absenteeism (30%) and presenteeism (40%) in these patients. The researchers additionally reported a higher burden of work disability among patients in manual occupations, compared with those in managerial or professional occupations.
Among patients who completed WPAI evaluations during the follow-up period, 9.4% stopped work and 14.6% changed jobs, with stoppage occurring “almost entirely” in patients performing manual-labor jobs, the researchers wrote.
“Overall, work impairment and presenteeism reduce over the first 12months after diagnosis,” Bechman and colleagues wrote. “People with more routine (manual) occupations are more likely to stop working or change their job because of their diagnosis in the first year and have more difficulties with presenteeism and overall work impairment.”
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