Work disability in systemic sclerosis

Abstract

Objective: Systemic sclerosis (SSc) is a multisystem disease associated with significant morbidity and increased mortality. Little is known about work disability in SSc. We undertook this study to determine the prevalence and demographic and clinical correlates of work disability in a large cohort of patients with SSc.

Methods: Cross-sectional, multicenter study of patients from the Canadian Scleroderma Research Group Registry. Patients were assessed with detailed clinical histories, medical examinations, and self-administered questionnaires. The primary outcome was self-reported work disability. Multiple logistic regression was used to assess the relationship between selected demographic and clinical variables and work disability.

Results: Of the 643 patients available for this study, 133 (21%) reported that they were work disabled. Work disability in SSc was common, even in people with short disease duration, and increased steadily with increasing disease duration: among those who were <or= 65 years and who reported being either disabled or working, 28.0% and 44.8% of patients with disease duration of < 2 and 10-15 years, respectively, reported that they were work-disabled. The significant correlates of work disability included co-morbidities, disease duration, diffuse disease, disease severity, pain, fatigue, and physical function.

Conclusion: Work disability is prevalent, occurs early, and is associated with markers of disease severity and functional status. Further research is needed to identify other, potentially modifiable, risk factors for work disability in SSc.