Contemporary prevalence and incidence of work disability associated with rheumatoid arthritis in the US

Abstract

Objective: To provide a contemporary estimate of the prevalence and incidence of rheumatoid arthritis (RA) work disability and examine its permanence over time.

Methods: Data were collected semiannually from 5,384 subjects with rheumatologist-diagnosed RA. We examined prevalence in subgroups formed by approximately 5-year disease duration intervals using data from subjects age < or =64 years who were employed at disease onset. Annual incidence was examined longitudinally among subjects who supplied data in 2003, 2004, or 2005, were employed at disease onset and in a year's first survey, and were age < or =63 years. For work disability permanence we used longitudinal data from all subjects who became work disabled and observed whether they later returned to work.

Results: Mean age of subjects was 52 years, 82% were female, 63% had more than a high school education, mean disease duration was 14 years, and mean Health Assessment Questionnaire score was 1.0. The prevalence of any premature work cessation was 23% in subjects with 1-3 years duration, 35% in those with 10 years, and 51% in those with > or =25 years RA duration. Arthritis-attributed work cessation was 14%, 29%, and 42%, respectively. Annual incidence of any premature work cessation was approximately 10% and arthritis-attributed work cessation incidence was approximately 6%. Thirty-nine percent of subjects who stopped working later returned to work.

Conclusion: Work disability prevalence in this sample was high (35% within 10 years disease duration), but may represent a decline from the 50% prevalence reported in 1987. Annual incidence of work disability was higher than prior studies, but the return to work rate was also higher.

Figure 1

Derivation of the full data set and the samples used to assess work disability prevalence, incidence, and permanence. RA = rheumatoid arthritis.

Figure 2

Work disability prevalence by ~5-year intervals of disease duration. All subjects were employed at disease onset. Solid columns represent all subjects age ≤64 years who were no longer employed. Shaded columns represent subjects ≤64 years of age who were no longer employed and attributed this to arthritis. N = subjects with data at a disease time period.