[Indicators of work incapacity in the first year of chronic polyarthritis]

Already in the early phase of rheumatoid arthritis (RA) sick-leave (SL) frequently indicates a severe handicap with respect to work capacity. However, the significance of demographic, disease and work characteristics for SL are not known in early RA. Therefore, the indicators of SL (defied as the history of SL as certified by a physician) were sought in a cross-sectional multicenter study of early RA (< or = 1 year duration). One-hundred-and-thirty-four employed consecutive outpatients fulfilled > or = 4 of 7 ARA 1987 criteria of RA: 85 females (63%), age 50 years (median), disease duration 7 months (median). At the time of the examination 74 of the 134 patients (55%) were on SL because of RA (dependent dichotomous variable of the analyses). In order to identify the most important indicators of SL all variables with p < or = 0.10 in univariate analyses were entered into a multivariate logistic regression (stepwise forward analysis, p < or = 0.10). Parameters included in two different regression models (somatic variable and depression, job characteristics, respectively) were analyzed together in order to find the final model (p < or = 0.05). The following variables were included in the final logistic regression model of SL (p < or = 0.05): higher values of age, pain, and number of swollen joints, frequent overhead work, frequent pressure of time at work. Other indicators of SL in univariate analyses (p < or = 0.10) were not included in the model: male sex, low functional capacity, walking time, control over the pace and activities of work, occupational qualification, elevated ESR and depression. Significant indicators of SL are work conditions, disease activity, pain and age. Thus interventions focusing on the amelioration of the work capacity and thereby on the reduction of SL should concentrate on both the control of the disease and the improvement of the work conditions.