Pos1334 work participation and work disability in belgian patients with systemic sclerosis

Background Systemic sclerosis (SSc) is an immune-mediated connective tissue disease that potentially affects multiple organ systems. Besides health-related complications, patients often describe work-related difficulties (e.g. productivity loss, sick leave, work disability) that may result in a major individual burden and the rise of indirect costs for society. Objectives Despite the rheumatology community’s growing interest, work participation and its influencing factors is still an underrecognized and underexplored field of research in SSc patients. This study therefore aims to provide up-to-date data about work status and its determinants in SSc patients. Methods Adult SSc patients were questioned on their socio-economic status at the occasion of an outpatient visit at the rheumatology clinic of Ghent University Hospital, a tertiary hospital in the Flemish region (February 2020 to March 2021). All patients were included in a SSc clinical care path (Belgian Systemic Sclerosis Cohort) and fulfilled the LeRoy and Medsger’s classification criteria. Employment rate was compared with general Flemish population after adjustment for age and sex. Comparative data on the average duration of working life in Belgium were derived from Eurostat (reference year 2020). Results Among the 108 participants, 81 (75%) belonged to the working age category (18-65 y/o). The crude employment rate in SSc patients of work-productive age was 64%, resulting in a standardized employment ratio of 0.90 (95%CI 0.69-1.17). About half of these patients worked full time (53%), with a mean±SD of 41.7±8.7 weekly working hours. The median duration of labor force participation in SSc patients was 40.0 years, while the average career duration in the Belgian population amounted 33.4 years. Long term work disability was reported as the most common reason for leaving the labor market (20%). Patients on work disability were significantly older, less highly educated, more functionally disabled and reported a lower quality of life than patients having a paid job. Job characteristics did not differ significantly between patients with and without a paid job (Table 1). Conclusion Our data refute the common perception that SSc patients show a significantly lower work participation grade compared to the general population. Socio-demographic but not job-related characteristics are associated with work disability in this population. Quality of life is remarkably better in patients who perform a paid job, reinforcing the importance to support active labor force participation. Table 1 : Patients characteristics according to working status. SSc patients with a paid job N= 52 SSc patients with work disability N=16 P-value Male 13 (26%) 3 (13%) 0.74 Age, y 46.8 ± 10.1 54.8 ± 8.2 0.004 Post-secondary education 25 (49%) 2 (13%) 0.009 Disease duration, years 3.0 (1.0-7.0) 4.0 (1.0-12.5) 0.49 Subtype 0.14 - DcSSc 6 (12%) 5 (31%) - LcSSc 31 (61%) 6 (38%) - LSSc 14 (27%) 5 (31%) Internal organ involvement 19 (37%) 7 (44%) 0.64 Cutaneous manifestations 42 (82%) 13 (69%) 0.29 Peripheral vasculopathy 51 (100%) 15 (93.8%) 0.23 SHAQ 0.4 (0.0-1.1) 1.1 (0.4-2.0) 0.04 EQ-5D-5L 0.8 (0.8-0.9) 0.5 (0.2-0.8) <0.001 EQ-VAS 73 (65-81) 55 (40-70) <0.001 Blue collar work 32 (65%) 11 (69%) 0.80 Full-time work 27 (54%) 9 (56%) 0.87 Laborer 17 (33%) 9 (56%) 0.10 SHAQ, Scleroderma specific Health Assessment Questionnaire; EQ-5D-5L, EuroQoL-5D; VAS, visual analogue scale. Figure 1 : Retention time on the labor market since start of patient’s professional career. Acknowledgements I have no acknowledgementThe Ghent University Hospital is member of the Flemish Network on rare connective tissue diseases and of the European Reference Network on Rare and Complex Connective Tissue and Musculoskeletal Diseases (ERN ReCONNET).s to declare. Disclosure of Interests None Declared.