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Work disability in systemic lupus erythematosus is prevalent and associated with socio-demographic and disease related factors

Meds 2010, School of Medicine, Queen's University, Kingston, Ontario, Canada

J. Pope

The University of Western Ontario, St Joseph's Health Care, London, Ontario, Canada, janet.pope{at}sjhc.london.on.ca

P. Fortin

University of Toronto, University Health Network-Toronto Western Hospital, Toronto, Ontario, Canada

E. Silverman

University of Toronto, Hospital for Sick Children, Toronto, Ontario, Canada

C. Peschken

University of Manitoba, Winnipeg, Manitoba, Canada

1000 Faces of Lupus Investigators and CaNIOS (Canadian Network for Improved Outcomes in SLE)

Our objectives were to examine the prevalence of work disability (WD) and factors associated with job loss in systemic lupus erythematosus (SLE) in a large, multi-centered Canadian sample to determine the current prevalence of WD and identify the contribution of disease activity, damage, and co-morbidities with respect to WD in this cohort. Cross-sectional data on WD status from the 1000 Canadian Faces of Lupus database (a multi-center multi-ethnic cohort of SLE patients) along with clinical measures (number of ACR criteria ever, SLICC Damage Index, SLAM, SLEDAI, SF-36 and Charlson Co-morbidity Index scores), demographic features (age, sex, high school education, household income, marital status, disease duration, employment status) and co-morbidities (including self-reported fibromyalgia, arthralgias, depression and fatigue) were used in bivariate and logistic regression analyses. The 1137 SLE patients had a mean age of 50 years (SE 0.75) and mean disease duration was 18 years (SE 0.70); 19.09% were work disabled and 49.78% were employed. Those with WD were more likely than non-WD SLE patients to have: a higher number of ACR criteria for SLE; not completed high school; older age; single marital status; a lower household income; longer disease duration; higher SLICC Damage Index and SLAM scores; lower SF-36 PCS and SF-36 MCS scores; less vigorous activity per week; and fibromyalgia, arthralgias, fatigue and depression (p < 0.05). This contemporary rate of WD is lower than many past reports. Socio-demographic factors, co-morbidities (fibromyalgia and fatigue) and disease related factors were strongly associated with WD. We cannot determine cause and effect as the study was cross-sectional. Lupus (2009) 18, 1281—1288.

Key Words: 1000 Faces of Lupus • Canadian Network for Improved Outcomes in SLE (CaNIOS) • employment • systemic lupus erythematosus (SLE) • work disability (WD)

This version was published on December 1, 2009

Lupus, Vol. 18, No. 14, 1281-1288 (2009)
DOI: 10.1177/0961203309345784


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