title: Labor market participation following onset of seizures and early epilepsy: Findings from a UK cohort.
abstract: OBJECTIVE
  Previous studies have reported a considerable employment disadvantage among people with epilepsy. In a cohort of men and women who had experienced a single seizure or had early epilepsy at study entry we explored employment status and social mobility over 4 years and investigated whether employment outcomes were more disadvantageous for certain social groups.
  
  
  METHODS
  Analyses were based on 350 individuals of working age identified via the UK Multicentre Study of Early Epilepsy and Single Seizures. Employment rates were calculated for the cohort and general population. Employment trajectories over 4 years were explored according to occupational social class. The relative risk of employment was calculated by clinical features of seizures and social class.
  
  
  RESULTS
  Individuals with single seizures or early epilepsy had significantly lower employment rates than the general population at study entry, and 2- and 4-year follow-up. Employment rates of men and women in the cohort did not differ significantly. Although little social class mobility occurred during follow-up, there was evidence of some downward mobility between first seizure(s) and study entry. In the fully adjusted model, nonemployment was predicted at all time points by having fair/poor self-rated health and experiencing four or more seizures. We observed that some individuals continued to work in hazardous occupations or drive professionally within a year of experiencing seizure(s).
  
  
  CONCLUSIONS
  People who have recently experienced a single seizure or who have early epilepsy are exposed to substantial employment disadvantage. Greater efforts are necessary to help these people return to work and stay employed.
authors.affiliation: Division of Public Health, University of Liverpool, Liverpool, United Kingdom. p.j.holland@lancaster.ac.uk
authors.forename: Paula
authors.initials: P
authors.lastname: Holland
authors.forename: Steven
authors.initials: S
authors.lastname: Lane
authors.forename: Margaret
authors.initials: M
authors.lastname: Whitehead
authors.forename: Anthony G
authors.initials: AG
authors.lastname: Marson
authors.forename: Ann
authors.initials: A
authors.lastname: Jacoby
mesh_terms: D000293:Adolescent; D000328:Adult; D001334:Automobile Driving / Q000706:statistics & numerical data; D015331:Cohort Studies; D004651:Employment / Q000706:statistics & numerical data; D004827:Epilepsy / Q000191:economics* / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012306:Risk; D012640:Seizures / Q000191:economics* / Q000453:epidemiology; D012937:Social Mobility; D011795:Surveys and Questionnaires; D013997:Time Factors; D006113:United Kingdom / Q000453:epidemiology; D055815:Young Adult