[2009] [FRI0314-AHP] EMPLOYMENT STATUS AND RISK FACTORS FOR WORK DISABILITY IN SYSTEMIC SCLEROSIS (SSC)

G. Sandqvist, R. Hesselstrand, A. Scheja Dept of Rheumatology, Lund University Hospital, Lund, Sweden

Background: The balance of activities of daily life is markedly influenced by employment status. Long periods of absence from work are often accompanied by loss of life roles and have negative consequences for the individual and society. Working ability is a multifactorial phenomenon, depending on individual resources and demands of work.
Objectives: To investigate employment status in SSc and to identify risk factors, individual and work related, for work disability.
Methods: Fifty-seven (of 76 invited consecutive) patients (53 female/4 male) with SSc (47 lcSSc/10 dcSSc), age median 58 (IQ-range 47 – 62) years and disease duration 14 (9 – 19) years were included in the study. The patients were assessed regarding sociodemographic characteristics (age, education, marital status, children at home, employment status), disease manifestations [skin score, DLCO, perceived symptoms as Raynuad's, shortness of breath, fatigue, stiffness, pain, ulcers/scars, hand function (VAS)] work ability [Work ability index (WAI)], empowerment in a workplace (Psychological empowerment instrument), study specific questions about social support at home, adaptations at the workplace, and access to helpful colleagues, ADL capacity and satisfaction [the scleroderma Functional Score (FS), Satisfaction with Daily Occupations (SDO)].
Results: Sixteen (28.1%) patients worked without any sickness benefit, 20 (35.1%) were partial on sick leave and partial working Twenty-one (36.8%) were on full-time sick leave or disability pension since median 8 (5.5 – 16.5) years after disease onset. The patients with full-time sickness benefit were significantly older at the disease onset (p<0.05) than patients without, or with partial sickness benefit. No other significant difference concerning sociodemographic or objective disease manifestations was found. Six patients had received disability pension more than10 years before the study and are excluded in the analysis of risk factors for work disability. The professions were; office clerks, teachers, various forms of nursing, child care workers, shop assistants, cleaners and mechanics. The WAI was median 31.5 out of 49 points, 13 patients (26.5%) had good or excellent WAI (> 36), 15 (30.6%) had less good (28-36), and 21 (42.9%) had bad WAI(<28). Working ability was correlated to fatigue, pain, stiffness, hand function, social support, empowerment competence, ADL-capacity and satisfaction with daily activities (p<0.001). No correlation between WAI and sociodemographic variables or objective measures of organ manifestations was found. Significant differences between the groups were found in: fatigue, pain, hand function, empowerment competence and satisfaction with daily activities (p<0.001), and ulcers, stiffness, empowerment impact, and possibility to adapt the work (p<0.01). No differences were found concerning sociodemographic variables or objective measures of organ manifestations.
Conclusion: Work disability is major problem in SSc. Impaired hand function, pain, fatigue, insufficient confidence to possess the skills and inadequate adaptation of work tasks are prominent risk factors.
Disclosure of Interest: None declared

Ann Rheum Dis 2009;68(Suppl3):460

Scleroderma, myositis and related syndromes