Impact of the ankylosing spondylitis on the professional activity.
OBJECTIVE
Ankylosing spondylitis (AS) is a chronic inflammatory disease affecting axial skeleton, occurring in young and active patients and often condition their professional prospects.


OBJECTIVE
To describe the social and occupational characteristics of patients affected by AS, to estimate the impact of the disease on their professional activity and to determine factors exposing to elevated risk of premature withdrawal from the labor force.


METHODS
We had performed a cross-sectional study of 103 patients with AS recruited during 2 years (2005-2007) at the Department of Rheumatology, fulfilling the modified criteria of New York. Demographic, social and professional characteristics were determinated and some disease-specific instruments: BASDAI, BASFI, BASMI, BASG-s, BASRI, as well as an indicator of quality of life: the Short Form Survey-36 (SF-36).


RESULTS
It is about 88 man and 15 women, the average age is 37.6 years+/-11.7 (18-59 years). Seventy percent of patients live in urban zone and 17% have an educational level superior to 13 years. The disease duration is on average of 11.2+/-9.6 years. The mean score of BASFI is 45.5+/-27.5 (7-100), the mean score of BASDAI is 45.9+/-22.4 (9-100), the mean score of BASG-s is 53.8+/-21.2, the mean score of BASMI is of 4.4+/-2.2 (3-10), the mean score of BASRI is 8.4+/-3.5 (2-16). Among these patients 95 (92%) are eligible to a professional activity (aged between 18 and 65 years and having ended their studies or vocational training). The global unemployment rate is 25.3%, that's attributed to the disease is 20.6%. Some factors are associated with high risk of work withdrawal: female gender (p=0.0005), low educational level (p=0.02), living in rural zone (p=0.028), manual labor (p=0.038), cold exposing in work place (p=0.006), high work time a week (p=0.02) and the absence of colleague help (p=0.001). For the specific disease indexes, high risk of withdrawal is correlated with high scores of BASFI (p=0.00002), BASDAI (p=0.044), BAS-Gs (p=0.0005) and BASMI (0.0000). Concerning the SF-36, only the item of physical activity is more significantly altered in patient's having stopped their work.


CONCLUSIONS
Several factors are identified to be associated to a high risk of premature working withdrawal in patients affected by AS. Prevention of this risk needs an early diagnosis and treatment of the disease, a vocational guidance, work preliminary training and eventually professional redeployment.
Montacer Kchir
Mohamed
M
Research unit UR04SP06, Department of Rheumatology, M. Kassab Institut, Kassar Said, Manouba 2010 Tunis, Tunisia.
Mehdi Ghannouchi
Mohamed
M
Hamdi
Wafa
W
Azzouz
Dhouha
D
Kochbati
Samir
S
Saadellaoui
Kawther
K
Daoud
Lilia
L
Hamida
Abdelmajid Ben
AB
Zouari
Mohamed Béchir
MB
D000293:Adolescent; D000328:Adult; D003430:Cross-Sectional Studies; D004185:Disability Evaluation; D004522:Educational Status; D004651:Employment; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009043:Motor Activity / Q000502:physiology; D011788:Quality of Life; D012923:Social Class; D013167:Spondylitis, Ankylosing / Q000503:physiopathology* / Q000523:psychology*; D014416:Tunisia; D014938:Work Capacity Evaluation; D055815:Young Adult