title: Work Disability in Early Systemic Sclerosis: A Longitudinal Population-based Cohort Study.
abstract: OBJECTIVE
  To study work disability (WD) with reference to levels of sick leave and disability pension in early systemic sclerosis (SSc).
  
  
  METHODS
  Patients with SSc living in the southern part of Sweden with onset of their first non-Raynaud symptom between 2003 and 2009 and with a followup of 36 months were included in a longitudinal study. Thirty-two patients (26 women, 24 with limited SSc) with a median age of 47.5 years (interquartile range 43-53) were identified. WD was calculated in 30-day intervals from 12 months prior to disease onset until 36 months after, presented as the prevalence of WD per year (0-3) and as the period prevalence of mean net days per month (± SD). Comparisons were made between patients with different disease severity and sociodemographic characteristics, and between patients and a reference group (RG) from the general population.
  
  
  RESULTS
  Seventy-eight percent had no WD 1 year prior to disease onset, which decreased to 47% after 3 years. The relative risk for WD in patients with SSc compared with RG was 0.95 (95% CI 0.39-2.33) at diagnosis, and increased to 2.41 (1.28-4.55) after 3 years. There were no significant correlations between WD and disease severity, but between WD and years at workplace (rs = -0.72; p = 0.002), education (rs = -0.51; p = 0.004), and sickness absence the month before disease onset (rs = 0.58; p = 0.001), respectively.
  
  
  CONCLUSIONS
  Considerable increase in WD was noted 3 years after disease onset. Limited education, fewer years at workplace, and sickness absence before disease onset may be risk factors for sustained WD.
authors.affiliation: From the Department of Clinical Sciences, Section of Rheumatology, and Orthopedics, Department of Clinical Sciences, Lund University; Epidemiology and Register Centre South, Skåne University Hospital, Lund, Sweden; Musculoskeletal Statistics Unit, The Parker Institute, Department of Rheumatology, Copenhagen University Hospital, Bispebjerg and Frederiksberg, Denmark.G. Sandqvist, RegOT, PhD, Department of Clinical Sciences, Section of Rheumatology, Lund University; R. Hesselstrand, MD, PhD, Department of Clinical Sciences, Section of Rheumatology, Lund University; I.F. Petersson, MD, PhD, Orthopedics, Department of Clinical Sciences, Lund University, and Epidemiology and Register Centre South, Skåne University Hospital; L.E. Kristensen, MD, PhD, Department of Clinical Sciences, Section of Rheumatology, Lund University, and Musculoskeletal Statistics Unit, The Parker Institute, Department of Rheumatology, Copenhagen University Hospital. gunnel.sandqvist@med.lu.se.
authors.forename: Gunnel
authors.initials: G
authors.lastname: Sandqvist
authors.affiliation: From the Department of Clinical Sciences, Section of Rheumatology, and Orthopedics, Department of Clinical Sciences, Lund University; Epidemiology and Register Centre South, Skåne University Hospital, Lund, Sweden; Musculoskeletal Statistics Unit, The Parker Institute, Department of Rheumatology, Copenhagen University Hospital, Bispebjerg and Frederiksberg, Denmark.G. Sandqvist, RegOT, PhD, Department of Clinical Sciences, Section of Rheumatology, Lund University; R. Hesselstrand, MD, PhD, Department of Clinical Sciences, Section of Rheumatology, Lund University; I.F. Petersson, MD, PhD, Orthopedics, Department of Clinical Sciences, Lund University, and Epidemiology and Register Centre South, Skåne University Hospital; L.E. Kristensen, MD, PhD, Department of Clinical Sciences, Section of Rheumatology, Lund University, and Musculoskeletal Statistics Unit, The Parker Institute, Department of Rheumatology, Copenhagen University Hospital.
authors.forename: Roger
authors.initials: R
authors.lastname: Hesselstrand
authors.affiliation: From the Department of Clinical Sciences, Section of Rheumatology, and Orthopedics, Department of Clinical Sciences, Lund University; Epidemiology and Register Centre South, Skåne University Hospital, Lund, Sweden; Musculoskeletal Statistics Unit, The Parker Institute, Department of Rheumatology, Copenhagen University Hospital, Bispebjerg and Frederiksberg, Denmark.G. Sandqvist, RegOT, PhD, Department of Clinical Sciences, Section of Rheumatology, Lund University; R. Hesselstrand, MD, PhD, Department of Clinical Sciences, Section of Rheumatology, Lund University; I.F. Petersson, MD, PhD, Orthopedics, Department of Clinical Sciences, Lund University, and Epidemiology and Register Centre South, Skåne University Hospital; L.E. Kristensen, MD, PhD, Department of Clinical Sciences, Section of Rheumatology, Lund University, and Musculoskeletal Statistics Unit, The Parker Institute, Department of Rheumatology, Copenhagen University Hospital.
authors.forename: Ingemar F
authors.initials: IF
authors.lastname: Petersson
authors.affiliation: From the Department of Clinical Sciences, Section of Rheumatology, and Orthopedics, Department of Clinical Sciences, Lund University; Epidemiology and Register Centre South, Skåne University Hospital, Lund, Sweden; Musculoskeletal Statistics Unit, The Parker Institute, Department of Rheumatology, Copenhagen University Hospital, Bispebjerg and Frederiksberg, Denmark.G. Sandqvist, RegOT, PhD, Department of Clinical Sciences, Section of Rheumatology, Lund University; R. Hesselstrand, MD, PhD, Department of Clinical Sciences, Section of Rheumatology, Lund University; I.F. Petersson, MD, PhD, Orthopedics, Department of Clinical Sciences, Lund University, and Epidemiology and Register Centre South, Skåne University Hospital; L.E. Kristensen, MD, PhD, Department of Clinical Sciences, Section of Rheumatology, Lund University, and Musculoskeletal Statistics Unit, The Parker Institute, Department of Rheumatology, Copenhagen University Hospital.
authors.forename: Lars Erik
authors.initials: LE
authors.lastname: Kristensen
mesh_terms: D000328:Adult; D000367:Age Factors; D015331:Cohort Studies; D016001:Confidence Intervals; D042241:Early Diagnosis; D004651:Employment / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D018570:Risk Assessment; D012595:Scleroderma, Systemic / Q000175:diagnosis* / Q000453:epidemiology / Q000534:rehabilitation*; D012720:Severity of Illness Index; D012737:Sex Factors; D018582:Sick Leave / Q000706:statistics & numerical data; D018709:Statistics, Nonparametric; D013548:Sweden / Q000453:epidemiology; D014938:Work Capacity Evaluation; D014942:Workers' Compensation / Q000706:statistics & numerical data*
keywords: DISABILITY; LONGITUDINAL STUDIES; OCCUPATIONAL THERAPY; SYSTEMIC SCLEROSIS; WORK