Employment and work absenteeism in individuals living with a vascular liver disease: a European multicenter study

BACKGROUND & AIMS: Vascular liver diseases (VLDs) are rare conditions affecting adults of working age, yet there are no real-world data on their impact on employment. METHODS: A multicenter cross-sectional study was conducted in France and Spain, using clinical records and self-administered questionnaires. Employment outcomes in patients with a VLD and controls were compared using indirect standardisation with age- and sex-adjusted population norms. Multivariable logistic regression assessed factors associated with health-related inactivity (unable to work due to illness/disability) and health-related absenteeism from work. RESULTS: Of 1136 eligible patients, 595 (52.4%) responded and the data of 432 participants aged 25-64 were analysed. Health-related inactivity (13.0% of patients) and health-related absenteeism over the last year (48.5%) were higher in patients with a VLD than in the general population (Standardised Ratio (SR) = 2.61, 95%CI:1.95-3.42; SR = 1.57, 95%CI:1.33-1.87 respectively). History of gastrointestinal bleeding (adjusted Odds Ratio (aOR) = 2.64, 95%CI:1.17-5.98) and prior interventional procedures (aOR = 2.49, 95%CI:1.06-5.88) were significantly associated with inactivity. Older patients (versus 25-44 years old) and those with a low/moderate educational level (versus high) were more likely to experience inactivity (aOR = 2.23, 95%CI:1.07-4.65; aOR = 3.11, 95%CI:1.53-6.35 respectively). Absenteeism was associated with moderate/severe pain (aOR = 2.45,95%CI:1.10-5.44) and unmet needs for special illness-related leave (aOR = 2.97,95%CI:1.33-6.63). CONCLUSIONS: Patients with VLD face disadvantages in employment participation and absenteeism, driven by disease severity and symptom burden. These effects are most pronounced among low-educated individuals, highlighting socioeconomic disparities in work retention. This underscores the need for targeted workplace accommodations, supportive employment policies, and social care support.