Risk factors associated with loss of productivity at work
in patients with Systemic Lupus Erytheamus
Systemic lupus erythematosus; disability evaluation; disabled persons.
INTRODUCTION: Systemic Lupus Erythematosus (SLE) is a chronic autoimmune
disease involving multiple organs. Prevalence of work disability (WD) respectively
within 5 years after diagnosis ranges from 15% to 40%, increasing to 36% and 51% at
10 and 15 years. Several risk factors for work dysfunction have been reported in several
SLE patients, including sociodemographic, environmental and disease-related issues.
Although several studies have public consequences for productivity in SLE, none has
evaluated the Brazilian targets. OBJECTIVES: To determine the prevalence and risk
factors associated with WD in patients with SLE. METHOD: cross-sectional study
carried out at the SLE Outpatient Clinic of the Rheumatology Service of the University
Hospital of Alagoas, Brazil. The sampling was non-probabilistic for convenience,
consisting of 110 patients in outpatient care. Data collection was based on the
application of the Sociodemographic and Occupational Questionnaire, ABEP's Brazilian
Economic Classification Criteria, MAT (Measurement of Adherence to Treatment), SF-
12 (The 12-item Short Form Survey), SLICC (The Systemic Lupus International
Collaborating Clinics/ American College of Rheumatology – Damage Index), SLEDAI
(The Systemic Lupus Erythematosus Disease Activity Index), in its 2K modified
version, and analysis of medical records. As for the statistical analysis, the Shapiro-
Wilk test evaluated the normality of the distribution of continuous variables, which
were compared using the Mann-Whitney test. Chi-square, Chi-square with continuity
correction or Fisher's exact tests were performed to compare categorical variables. The
association between sociodemographic, occupational and clinical factors with work
disability was assessed using logistic regression. RESULTS: The sample consisted of
98.1% female participants, with a median age of 38.5 (IQR 18) years, 78.1% non-
Caucasians, with more than 10 years of schooling in 62.7% of participants, with 74.5%
of the sample framed in social vulnerability status, with an average income of up to
R$1,100.00, equivalent to US$212.76. As for occupational profile, 83.6% were inactive
at the time of the research, while 64.55% had an active current income and 47.2%
received social security benefit due to a temporary or permanent poor health condition.
75.4% came to work in jobs that required high physical demand life habits. As for life
habits, 3.6% of the participants said they were alcoholics, 1.8% said they were smokers,
24.5% said they practiced regular physical exercise. The prevalence of WD due to SLE
in our sample was 76.3%. In the univariate analysis, the significant predictors of labor
dysfunction were older age, less than 10 years of education, married marital status,
occupational position with high physical demand and not practing physical exercise. In
the multivariate analysis, an association was found between WD and less than 10 years
of education (p=0.028). Clinical characteristics were not significant predictors of work-
related dysfunction. Participants with less than 10 years of education were 5.33 times
more likely to have work disability. CONCLUSION: More than half of the sample
(76.3% of the participants) presented loss of productivity at work. Less than 10 years of
education was a predictor of work disability in this population.