title: Work factors are associated with workplace activity limitations in systemic lupus erythematosus.
abstract: OBJECTIVE
  The objective of this study was to examine the extent of workplace activity limitations among persons with lupus and to identify factors associated with activity limitations among those employed.
  
  
  METHODS
  We conducted a cross-sectional study using a mailed survey and clinical data of persons with lupus who attended a large lupus outpatient clinic. Data were collected on demographics, health, work factors and psychosocial measures. The workplace activity limitations scale (WALS) was used to measure difficulty related to different activities at work. Multivariable analysis examined the association of health, work context, psychosocial and demographic variables with workplace activity limitations.
  
  
  RESULTS
  We received 362 responses from 604 (60%) mailed surveys. Among those not employed, 52% reported not working because of lupus. A range of physical and mental tasks were reported as difficult. Each of the physical, cognitive and energy work activities was cited as difficult by more than one-third of participants. Among employed participants, 40% had medium to high WALS difficulty scores. In the multivariable analysis, factors significantly associated with workplace activity limitations were older age, greater disease activity, fatigue, poorer health status measured by the 36-item Short Form Health Survey, lower job control, greater job strain and working more than 40 h/week.
  
  
  CONCLUSIONS
  People with lupus experience limitations and difficulty at work. Determinants of workplace activity limitations are mainly those related to workplace and health factors.
authors.affiliation: Department of Medicine, College of Medicine and Health Science, UAE University, Al Ain, United Arab Emirates, Division of Health Care & Outcomes Research, Toronto Western Research Institute, University Health Network, Institute for Work and Health, Dalla Lana School of Public Health, University of Toronto, Mobility Program Clinical Research Unit, Li Ka Shing Knowledge Institute of St Michael's Hospital, Institute for Health Policy, Management & Evaluation, University of Toronto, Centre for Prognostic Studies in the Rheumatic Diseases, Division of Rheumatology, Department of Medicine, University Health Network, Toronto, Centre de recherche du CHU de Québec, Division de Rhumatologie, Département de Médicine and Département de Médecine, Université Laval, Québec, Canada.
authors.forename: Ali M
authors.initials: AM
authors.lastname: Al Dhanhani
authors.affiliation: Department of Medicine, College of Medicine and Health Science, UAE University, Al Ain, United Arab Emirates, Division of Health Care & Outcomes Research, Toronto Western Research Institute, University Health Network, Institute for Work and Health, Dalla Lana School of Public Health, University of Toronto, Mobility Program Clinical Research Unit, Li Ka Shing Knowledge Institute of St Michael's Hospital, Institute for Health Policy, Management & Evaluation, University of Toronto, Centre for Prognostic Studies in the Rheumatic Diseases, Division of Rheumatology, Department of Medicine, University Health Network, Toronto, Centre de recherche du CHU de Québec, Division de Rhumatologie, Département de Médicine and Département de Médecine, Université Laval, Québec, Canada Department of Medicine, College of Medicine and Health Science, UAE University, Al Ain, United Arab Emirates, Division of Health Care & Outcomes Research, Toronto Western Research Institute, University Health Network, Institute for Work and Health, Dalla Lana School of Public Health, University of Toronto, Mobility Program Clinical Research Unit, Li Ka Shing Knowledge Institute of St Michael's Hospital, Institute for Health Policy, Management & Evaluation, University of Toronto, Centre for Prognostic Studies in the Rheumatic Diseases, Division of Rheumatology, Department of Medicine, University Health Network, Toronto, Centre de recherche du CHU de Québec, Division de Rhumatologie, Département de Médicine and Département de Médecine, Université Laval, Québec, Canada Department of Medicine, College of Medicine and Health Science, UAE University, Al Ain, United Arab Emirates, Division of Health Care & Outcomes Research, Toronto Western Research Institute, University Health Network, Institute for Work and Health, Dalla Lana School of Public Health, University of Toronto, Mobility Program Clinical Research Unit, Li Ka Shing Knowledge Institute of St Michael's Hospital, Institute for Health Poli
authors.forename: Monique A M
authors.initials: MA
authors.lastname: Gignac
authors.affiliation: Department of Medicine, College of Medicine and Health Science, UAE University, Al Ain, United Arab Emirates, Division of Health Care & Outcomes Research, Toronto Western Research Institute, University Health Network, Institute for Work and Health, Dalla Lana School of Public Health, University of Toronto, Mobility Program Clinical Research Unit, Li Ka Shing Knowledge Institute of St Michael's Hospital, Institute for Health Policy, Management & Evaluation, University of Toronto, Centre for Prognostic Studies in the Rheumatic Diseases, Division of Rheumatology, Department of Medicine, University Health Network, Toronto, Centre de recherche du CHU de Québec, Division de Rhumatologie, Département de Médicine and Département de Médecine, Université Laval, Québec, Canada Department of Medicine, College of Medicine and Health Science, UAE University, Al Ain, United Arab Emirates, Division of Health Care & Outcomes Research, Toronto Western Research Institute, University Health Network, Institute for Work and Health, Dalla Lana School of Public Health, University of Toronto, Mobility Program Clinical Research Unit, Li Ka Shing Knowledge Institute of St Michael's Hospital, Institute for Health Policy, Management & Evaluation, University of Toronto, Centre for Prognostic Studies in the Rheumatic Diseases, Division of Rheumatology, Department of Medicine, University Health Network, Toronto, Centre de recherche du CHU de Québec, Division de Rhumatologie, Département de Médicine and Département de Médecine, Université Laval, Québec, Canada.
authors.forename: Dorcas E
authors.initials: DE
authors.lastname: Beaton
authors.affiliation: Department of Medicine, College of Medicine and Health Science, UAE University, Al Ain, United Arab Emirates, Division of Health Care & Outcomes Research, Toronto Western Research Institute, University Health Network, Institute for Work and Health, Dalla Lana School of Public Health, University of Toronto, Mobility Program Clinical Research Unit, Li Ka Shing Knowledge Institute of St Michael's Hospital, Institute for Health Policy, Management & Evaluation, University of Toronto, Centre for Prognostic Studies in the Rheumatic Diseases, Division of Rheumatology, Department of Medicine, University Health Network, Toronto, Centre de recherche du CHU de Québec, Division de Rhumatologie, Département de Médicine and Département de Médecine, Université Laval, Québec, Canada.
authors.forename: Jiandong
authors.initials: J
authors.lastname: Su
authors.affiliation: Department of Medicine, College of Medicine and Health Science, UAE University, Al Ain, United Arab Emirates, Division of Health Care & Outcomes Research, Toronto Western Research Institute, University Health Network, Institute for Work and Health, Dalla Lana School of Public Health, University of Toronto, Mobility Program Clinical Research Unit, Li Ka Shing Knowledge Institute of St Michael's Hospital, Institute for Health Policy, Management & Evaluation, University of Toronto, Centre for Prognostic Studies in the Rheumatic Diseases, Division of Rheumatology, Department of Medicine, University Health Network, Toronto, Centre de recherche du CHU de Québec, Division de Rhumatologie, Département de Médicine and Département de Médecine, Université Laval, Québec, Canada Department of Medicine, College of Medicine and Health Science, UAE University, Al Ain, United Arab Emirates, Division of Health Care & Outcomes Research, Toronto Western Research Institute, University Health Network, Institute for Work and Health, Dalla Lana School of Public Health, University of Toronto, Mobility Program Clinical Research Unit, Li Ka Shing Knowledge Institute of St Michael's Hospital, Institute for Health Policy, Management & Evaluation, University of Toronto, Centre for Prognostic Studies in the Rheumatic Diseases, Division of Rheumatology, Department of Medicine, University Health Network, Toronto, Centre de recherche du CHU de Québec, Division de Rhumatologie, Département de Médicine and Département de Médecine, Université Laval, Québec, Canada Department of Medicine, College of Medicine and Health Science, UAE University, Al Ain, United Arab Emirates, Division of Health Care & Outcomes Research, Toronto Western Research Institute, University Health Network, Institute for Work and Health, Dalla Lana School of Public Health, University of Toronto, Mobility Program Clinical Research Unit, Li Ka Shing Knowledge Institute of St Michael's Hospital, Institute for Health Poli
authors.forename: Paul R
authors.initials: PR
authors.lastname: Fortin
mesh_terms: D000203:Activities of Daily Living; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D004185:Disability Evaluation; D005221:Fatigue / Q000453:epidemiology / Q000209:etiology* / Q000523:psychology; D005260:Female; D006306:Health Surveys; D006801:Humans; D015994:Incidence; D008180:Lupus Erythematosus, Systemic / Q000150:complications / Q000534:rehabilitation*; D008297:Male; D008875:Middle Aged; D011792:Quebec / Q000453:epidemiology; D012720:Severity of Illness Index; D014937:Work / Q000502:physiology*; D017132:Workplace; D055815:Young Adult
keywords: SLE; disability; lupus; work; work difficulties; work limitations; workplace