title: Employment in French young adult survivors of childhood leukemia: an LEA study (for Leucemies de l'Enfant et de l'Adolescent-childhood and adolescent leukemia).
abstract: Our principal aim was to assess the occupational outcomes of French survivors of childhood leukemia, compared to national population. The secondary objective was to identify determinants linked with employment stability after childhood leukemia.
  
  
  
  All survivors aged 15 and over enrolled in the French LEA Cohort (Childhood and Adolescent Leukemia) were included. Occupational data were self-reported. The occupational distributions expected in the cohort for each age range were established based on the distribution in France as reference, and comparisons between observed and expected distributions were performed. Logistic regression model was used to explore determinants of stability of survivors' employment.
  
  
  
  The questionnaire was completed by 845 eligible survivors (response rate 87.8 %), with a mean age of 22.3 ± 5.4 years and a mean follow-up duration of 14.3 ± 6.3 years. Among the 361 survivors currently in the labor market, 36 (10.0 %) were seeking a job, which is significantly lower than expected (19.3 %) compared to French population. Conversely, among those currently employed, the number of survivors in unstable employment (43.9 %) was significantly higher than expected (33.5 %). Younger age and higher number of late effects were risk factors for unstable employment.
  
  
  
  While the employment rate of the young French adult population of childhood leukemia survivors seems rather positive, access to a steady job appears to be compromised for some survivors.
  
  
  
  A strategy to better identify particular subgroups of survivors at greatest risk for difficulties in their professional achievement will help ensure the development of specific intervention strategies and support procedures.
authors.affiliation: EA 3279 - Public Health, Chronic Diseases and Quality of Life - Research Unit, Aix-Marseille University, Marseille, 13284, France. Julie.Berbis@ap-hm.fr.
authors.forename: Julie
authors.initials: J
authors.lastname: Berbis
authors.affiliation: Occupational Medicine and Health Department, APHM, Groupe Hospitalier Timone, 13385, Marseille, France.
authors.forename: Céline
authors.initials: C
authors.lastname: Reggio
authors.affiliation: EA 3279 - Public Health, Chronic Diseases and Quality of Life - Research Unit, Aix-Marseille University, Marseille, 13284, France.|Department of Pediatric Hematology and Oncology, Timone Enfants Hospital and Aix-Marseille University, Marseille, France.
authors.forename: Gérard
authors.initials: G
authors.lastname: Michel
authors.affiliation: Department of Pediatric Onco-Haematology, Hôpital d'Enfants de Brabois, Vandoeuvre Les Nancy, France.
authors.forename: Pascal
authors.initials: P
authors.lastname: Chastagner
authors.affiliation: Department of Pediatric Hematology and Oncology, University Hospital of Lyon, Lyon, France.
authors.forename: Yves
authors.initials: Y
authors.lastname: Bertrand
authors.affiliation: Department of Pediatric Hematology and Oncology, CIC Inserm 501, University Hospital of Clermont-Ferrand, Clermont-Ferrand, France.
authors.forename: Justyna
authors.initials: J
authors.lastname: Kanold
authors.affiliation: Pediatric Hematology and Oncology Department, University Hospital, Montpellier, France.
authors.forename: Nicolas
authors.initials: N
authors.lastname: Sirvent
authors.affiliation: Department of Pediatric Hematology-Oncology, University Hospital of Grenoble, Grenoble, France.
authors.forename: Dominique
authors.initials: D
authors.lastname: Plantaz
authors.affiliation: Department of Paediatric Onco-haematology, APHP, Saint Louis Hospital, Paris, France.
authors.forename: André
authors.initials: A
authors.lastname: Baruchel
authors.affiliation: Department of Paediatric Onco-haematology, APHP, GHUEP, Armand Trousseau Hospital, Paris, 75012, France.
authors.forename: Marie-Dominique
authors.initials: MD
authors.lastname: Tabone
authors.affiliation: EA 3279 - Public Health, Chronic Diseases and Quality of Life - Research Unit, Aix-Marseille University, Marseille, 13284, France.
authors.forename: Floriane
authors.initials: F
authors.lastname: Garnier
authors.affiliation: EA 3279 - Public Health, Chronic Diseases and Quality of Life - Research Unit, Aix-Marseille University, Marseille, 13284, France.|Occupational Medicine and Health Department, APHM, Groupe Hospitalier Timone, 13385, Marseille, France.
authors.forename: Marie-Pascale
authors.initials: MP
authors.lastname: Lehucher-Michel
authors.affiliation: EA 3279 - Public Health, Chronic Diseases and Quality of Life - Research Unit, Aix-Marseille University, Marseille, 13284, France.
authors.forename: Pascal
authors.initials: P
authors.lastname: Auquier
mesh_terms: D000293:Adolescent; D000328:Adult; D004651:Employment / Q000639:trends*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007938:Leukemia / Q000401:mortality / Q000534:rehabilitation*; D008297:Male; D012307:Risk Factors; D017741:Survivors; D055815:Young Adult
keywords: Adult survivors; Childhood leukemia survivors; Employment; Late effects; Stability of work contract