title: Arthritis-related work transitions: a prospective analysis of reported productivity losses, work changes, and leaving the labor force.
abstract: OBJECTIVE
  To prospectively examine arthritis-related productivity losses, work changes, and leaving employment, the relationships among these work transitions, and the factors associated with them.
  
  
  METHODS
  Participants with inflammatory arthritis or osteoarthritis were interviewed at 4 time points, 18 months apart, using a structured questionnaire. At baseline (T1), all participants (n = 490; 381 women, 109 men) were employed. At T2, T3, and T4, the sample decreased to 413, 372, and 349 participants, respectively. Respondents were recruited using community advertising and from rheumatology and rehabilitation clinics. Work transitions considered were productivity losses (absenteeism, job disruptions), work changes (reduced hours, changing jobs), and leaving employment. Also measured were demographic, illness, work context, and psychological variables. Generalized estimation equations modeled predictors of work transitions over time.
  
  
  RESULTS
  Although 63.1% of respondents remained employed throughout the study, work transitions were common (reported by 76.5% of participants). Productivity losses, especially job disruptions such as being unable to take on extra work, were the most frequently reported. Work transitions were related to subsequently making other work transitions, including leaving employment. Age, sex, education, activity limitations, control, depression, and arthritis-work spillover were also associated with work transitions.
  
  
  CONCLUSIONS
  This study sheds light on a process of diverse employment changes that may occur in the lives of many individuals with arthritis. It emphasizes the interrelationships among work transitions, as well as other factors in predicting work transitions, and it provides insight into work changes that may signal impending difficulties with remaining employed.
authors.affiliation: Arthritis Community Research & Evaluation Unit and University of Toronto, Ontario, Canada. gignac@uhnres.utoronto.ca
authors.forename: Monique A M
authors.initials: MA
authors.lastname: Gignac
authors.forename: Xingshan
authors.initials: X
authors.lastname: Cao
authors.forename: Diane
authors.initials: D
authors.lastname: Lacaille
authors.forename: Aslam H
authors.initials: AH
authors.lastname: Anis
authors.forename: Elizabeth M
authors.initials: EM
authors.lastname: Badley
mesh_terms: D000041:Absenteeism; D001168:Arthritis / Q000191:economics*; D004526:Efficiency; D004651:Employment; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009790:Occupations; D010003:Osteoarthritis / Q000191:economics; D011446:Prospective Studies; D014937:Work; D014940:Work Schedule Tolerance