Disease characteristics as determinants of the labour market position of adolescents and young adults with chronic digestive disorders.
BACKGROUND
Job prospects can be problematic for young patients with chronic digestive disorders.


OBJECTIVE
To compare the employment status and disease burden in young adult patients with several chronic digestive disorders with healthy controls, and to determine whether labour participation depends on disease characteristics, such as type of diagnosis and burden of disease.


METHODS
In total 622 patients categorized into five diagnostic groups--inflammatory bowel disease (IBD) (n=274), chronic liver diseases (n=78), congenital digestive disorders (n=104), food allergy (n=77), celiac disease (n=89)--and a population-based control group (n=248), age 15-24 years.


METHODS
Labour participation and burden of disease (i.e. consequences of the disease in daily life) were assessed by a postal questionnaire. Multivariate statistics were computed to investigate the relationship between disease characteristics and labour participation.


RESULTS
Patients with IBD or chronic liver diseases were found to have limited job prospects. Patients with chronic liver diseases, IBD and food allergy reported more disease burden regarding several indicators compared with controls. Logistic regression analyses including background characteristics revealed socio-economic status (educational level of parents) and nocturnal toilet use as important determinants of employment. In addition, gender and medication intake were found to be most determinative for a full-time position.


CONCLUSIONS
The possible impact of IBD and chronic liver diseases on the labour participation of young adults should be recognized and deserves extra attention from gastroenterologists so that young patients can be supported to increase their job opportunities.
Calsbeek
Hiske
H
Netherlands Institute for Health Services Research (NIVEL), Utrecht, The Netherlands. h.calsbeek@nivel.nl
Rijken
Mieke
M
Dekker
Joost
J
van Berge Henegouwen
Gerard P
GP
D000293:Adolescent; D000328:Adult; D002446:Celiac Disease / Q000534:rehabilitation; D002908:Chronic Disease; D017281:Cost of Illness; D004066:Digestive System Diseases / Q000151:congenital / Q000534:rehabilitation*; D004651:Employment / Q000706:statistics & numerical data*; D004812:Epidemiologic Methods; D005260:Female; D005512:Food Hypersensitivity / Q000534:rehabilitation; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000534:rehabilitation; D008107:Liver Diseases / Q000534:rehabilitation; D008297:Male; D012923:Social Class