The impact of systemic lupus erythematosus on employment.

OBJECTIVE: Our primary objective was to examine work status (e.g., job loss, changes in amount worked) and predictors of job loss in patients with systemic lupus erythematosus (SLE).
METHODS: Recently diagnosed SLE patients were enrolled in the Carolina Lupus Study between 1997 and 1999; an age-, sex-, and state-matched control group selected through driver's license registries for the 60-county study area was also enrolled. In 2001, a followup study of both groups was conducted (median 4 yrs since diagnosis). Work history data were obtained in an in-person interview at enrollment and a telephone interview at followup.
RESULTS: Fifty-one patients (26%) and 26 controls (9%) (p < 0.0001) who were working the year before diagnosis (or for controls, a corresponding reference year) were no longer working at followup; 92% of patients compared with 40% of controls who were no longer working indicated that they had stopped working because of their health (p < 0.0001). College graduates were less likely to quit their jobs due to health compared to non-college graduates (adjusted OR = 0.27, 95% CI 0.09, 0.84). SLE patients with arthritis were 3 times more likely to have left their jobs due to health reasons compared to those who didn't have arthritis (adjusted OR = 3.3, 95% CI 1.2, 8.8); an association was also seen with pleuritis (adjusted OR 2.3, 95% CI 1.1, 4.6).
CONCLUSION: The burden expressed as work cessation due to health, especially among lesser educated patients and those with arthritis or pleuritis, is significant even early in the disease process.