Work participation and work disability in Belgian patients with systemic sclerosis

OBJECTIVES: (1) Update data on work participation among patients with SSc followed in a multidisciplinary setting at a Belgian reference centre; (2) Investigate associations between work outcomes, personal, disease-related and contextual factors. METHODS: One hundred and eight adult SSc patients, 84% fulfilling the 2013 ACR/EULAR criteria for SSc, were questioned on their socio-economic status during outpatient visits at Ghent University Hospital (February 2020-March 2021). Employment rate was compared with the general population after adjustment for age and sex. Associations between two work-related outcomes and socio-demographic and clinical variables were explored through binary logistic regression (outcome 1: having a paid job) and negative binomial regression (outcome 2: sick leave). RESULTS: Among 81/108 (75%) participants of working age (18-65 y/o), crude employment rate was 64%, corresponding to a standardized employment ratio of 0.90 (95% CI 0.69-1.17). Work disability was the most common reason for not having a paid job (20%), with patients being older, less well educated and more functionally impaired compared with those with a paid job. Health-related sick leave in the previous year was substantial (79%); the number of days absent from work was significantly associated with internal organ involvement (incidence rate ratio, IRR, 0.3 [95% CI 0.1-0.8]) and working full-time (IRR 0.3 [95% CI 0.1-0.7]). CONCLUSION: Work participation in SSc patients is comparable to the general population, although work disability and sick leave remain substantial. Socio-demographic and job-related factors should be taken into account when assessing work outcomes in SSc, rather than basing work outcomes on disease characteristics alone.