Arthritis and employment research: where are we? Where do we need to go?

Studies of work disability among individuals with arthritis reveal that loss of employment is a common, important, and costly problem. Arthritis and musculoskeletal conditions are the leading cause of longterm work disability in Canada and the US, with an estimated yearly cost of 13.7 billion dollars in Canada. In rheumatoid arthritis, reported rates of work disability are remarkably high, ranging from 32% to 50% 10 years after RA onset, and increasing to 50% to 90% after 30 years. Studies have shown that work disability starts early in the course of RA, emphasizing the need for early intervention. To date, research in the area of arthritis and employment has mostly focused on measuring the extent of the problem and on identifying predictors of work loss. Despite the importance of the problem, there has been little intervention research assessing the effectiveness of medical treatment and few interventions specifically aimed at employment, reducing work loss, or improving ability to work. Research needed includes evaluating the effect of current therapies on employment outcomes, and studying interventions specifically aimed at employment, as well as addressing methodological issues in employment research.