Work dynamics among persons with systemic lupus erythematosus
Work dynamics among persons with systemic lupus erythematosus
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DOI：
10.1002/art.22481
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发表时间：
2007-02-15
期刊：
影响因子：
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通讯作者：
Panopalis, Peter
中科院分区：
文献类型：
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作者：
Yelin, Edward;Trupin, Laura;Panopalis, Peter
Objective.追踪18-64岁系统性红斑狼疮（SLE）患者从诊断到2004年就业的比例变化，估计这段时间内的年工作时间变化，并描述诊断时就业的风险因素。在2002年至2004年期间，对982名SLE患者进行了结构化电话调查。在2002-2003学年入学的900人中，有832人（92%）在2004年接受了重新面试。我们将2004年诊断时、基线访谈时和随访时使用的比例制成表格。在每个时间段雇用的个人中，我们估计了每年的工作时间。然后，我们使用Kaplan-Meier方法估计诊断时雇用的个体的工作损失时间，并使用考克斯比例风险回归来描述这种工作损失的风险因素。在诊断和随访之间，就业比例从74%下降到54%。在同一时期，所有有工作经历的人每年的工作时间减少了32.2%，但在连续就业的人中只减少了1%。在诊断工作的个人中，就业比例在5年和20年后分别下降了15%和63%。人口统计学（年龄，性别和教育）和工作特性（工作的生理和心理要求和控制水平）是工作损失的主要决定因素。SLE患者年工作时间减少的主要原因是完全停止就业，而不是减少就业人员的工作时间。
Objective. To track changes in the proportion of persons ages 18-64 with systemic lupus erythematosus (SLE) who were employed from diagnosis through 2004, to estimate changes in annual work hours during this time, and to describe risk factors for work loss among those employed at diagnosis.Methods. A structured telephone survey was administered to a cohort of 982 persons with SLE, which was assembled between 2002 and 2004. Of the 900 enrolled in 2002-2003, 832 (92%) were re-interviewed in 2004. We tabulated the proportion employed at diagnosis, at baseline interview, and at followup in 2004. Among individuals employed at each time frame, we estimated the hours of work per year. We then used the Kaplan-Meier method to estimate time until work loss among individuals employed at diagnosis and Cox proportional hazards' regression to describe the risk factors for such work loss.Results. Between diagnosis and followup inter-view, the proportion employed declined from 74% to 54%. Over the same period, hours of work per year declined by 32.2% among all individuals with a work history, but by only 1% among those continuously employed. Among individuals working at diagnosis, the proportion employed declined by 15% and 63% after 5 and 20 years, respectively. Demographics (age, sex, and education) and work characteristics (physical and psychological demands of jobs and level of control) were the principal determinants of work loss.Conclusion. Total cessation of employment, rather than reduced hours among employed persons, accounts for most of the decline in annual work hours among persons with SLE.