Contemporary prevalence and incidence of work disability associated with rheumatoid arthritis in the US

Objective. To provide a contemporary estimate of the prevalence and incidence of rheumatoid arthritis (RA) work disability and examine its permanence over time. Methods: Data were collected semiannually from 5,384 subjects with rheumatologist-diagnosed RA. We examined prevalence in subgroups formed by similar to 5-year disease duration intervals using data from subjects age <= 64 years who were employed at disease onset. Annual incidence was examined longitudinally among subjects who supplied data in 2003, 2004, or 2005, were employed at disease onset and in a year's first survey, and were age <= 63 years. For work disability permanence we used longitudinal data from all subjects who became work disabled and observed whether they later returned to work. Results. Mean age of subjects was 52 years, 82% were female, 63% had more than a high school education, mean disease duration was 14 years, and mean Health Assessment Questionnaire score was 1.0. The prevalence of any premature work cessation was 23% in subjects with 1-3 years duration, 35% in those with 10 years, and 51% in those with >= 25 years RA duration. Arthritis-attributed work cessation was 14%, 29%, and 42%, respectively. Annual incidence of any premature work cessation was similar to 10% and arthritis-attributed work cessation incidence was similar to 6%. Thirty-nine, percent of subjects. who stopped working later returned to work. Conclusion. Work disability prevalence in this sample was high (35% within 10 years disease duration), but may represent a decline from the 50% prevalence reported in 1987. Annual incidence of work disability was higher than prior studies, but the return to work rate was also higher.