Session Type: Poster Session (Sunday)
Session Time: 9:00AM-11:00AM
Background/Purpose: Withdrawal from the workforce is 3.1 times higher in patients with Ankylosing Spondylitis (AS) compared to the general population [Boonen A, et al. 2001]. Functional disability is the most important predictor of total costs in patients with AS [Ward M. 2002]. Age at onset of AS, less formal education, and having physically demanding jobs were significant risk factors for permanent work disability, which had a prevalence of 13% in one AS cohort [Ward M, et al. 2001].
The purpose of our study was to identify factors associated with work disability, including specific work abilities, in patients with AS. We chose to specifically look at trunk strength, and dynamic flexibility because prior research has shown that bending, twisting, and stretching are the occupational activities associated with greater functional limitations and radiographic damage in patients with longstanding AS [Ward M, et al. 2008].
Methods: We included 1115 patients meeting modified New York Criteria from a prospective AS cohort. We used patients’ current occupation data reported. Occupations were assigned a code from the Occupational Information Network, the US Department of Labor’s job classification database. Each code is associated with a scale ranging from 0-100 that signifies the degree of importance of a particular work ability for that occupation. We used univariable and multivariable logistic regression models to evaluate whether work-related ability that requires trunk strength or dynamic flexibility was associated with self-reported disability.
Results: Our cohort had a mean ± SD age of 45 years, 73.9% were male, 81.0 % were white, and 18.7% reported work disability secondary to AS. In the multivariable model, after controlling for confounders such as demographic characteristics, work activity that required more trunk strength was significantly associated with disability (adjusted OR (aOR) 1.02; 95% CI,1.004-1.03), but no significant association was found between dynamic flexibility and disability (aOR 0.99; 95% CI,0.95-1.02). Older age was also significantly associated with disability (aOR 1.03). Higher education and White race were inversely associated with disability (aOR 0.82 and aOR 0.50, respectively). We did not find any significant effect modification between each variable and trunk strength or dynamic flexibility.
Conclusion: AS patients with occupations requiring higher trunk strength reported significantly higher work disability. Another association included older age. Longer years of education and White race were inversely associated with disability. Disease onset of AS begins when patients are usually in young adulthood; identifying risk factors may identify potential interventions that decrease work disability for AS patients.
To cite this abstract in AMA style:Monga K, Lee M, Ward M, Weisman M, Gensler L, Ishimori M, Tahanan A, Rahbar M, Brown M, Oliver L, Daliri S, Reveille J, Hwang M. Associations of Work-Related Abilities with Disability in Ankylosing Spondylitis [abstract]. Arthritis Rheumatol. 2019; 71 (suppl 10). https://acrabstracts.org/abstract/associations-of-work-related-abilities-with-disability-in-ankylosing-spondylitis/. Accessed November 26, 2020.
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ACR Meeting Abstracts - https://acrabstracts.org/abstract/associations-of-work-related-abilities-with-disability-in-ankylosing-spondylitis/