Occupation as a gendered-role and outcome in systemic sclerosis

Area of Science:

• Rheumatology and Immunology
• Sociomedical Sciences
• Occupational Health

Background:

• Sex differences are recognized in systemic sclerosis (SSc) pathogenesis and progression.
• Limited data exists on the impact of gender, distinct from biological sex, on SSc.
• Occupation is explored as a proxy for gender-related roles and their influence on SSc.

Purpose of the Study:

• To investigate the association between occupation scores and SSc outcomes.
• To determine if occupation, as a gender-related factor, independently predicts SSc disease characteristics and patient experience.

Main Methods:

• An occupation score was developed based on the National Occupational Classification 2016, differentiating male- and female-dominated professions.
• 1104 SSc patients from the Canadian Scleroderma Research Group registry were assigned scores based on self-reported occupation.
• Multivariate models adjusted for sex, age, smoking, and education analyzed the effect of occupation score on SSc outcomes.

Main Results:

• Significant differences in disease duration, diffuse disease prevalence, interstitial lung disease, and pulmonary hypertension were observed between sexes.
• Median occupation scores significantly differed between females and males, with a weak correlation between sex and occupation score.
• Adjusted analyses revealed no independent predictive effect of occupation score on SSc subset, interstitial lung disease, pulmonary hypertension, pain, treatment response, or mortality.

Conclusions:

• No independent association was found between occupation score (as a proxy for gender) and systemic sclerosis outcomes.
• Occupation may be an inadequate measure of gender, necessitating caution in interpreting these findings.
• Future studies require validated gender measures to robustly assess gender's role in systemic sclerosis.