Effect of Osteoarthritis on Work Participation and Loss of Working Life-years

Objective. To examine to what extent disabling osteoarthritis (OA), leading to a prolonged sickness absence (SA), interferes with work participation and shortens working life-years. Methods. A total of 4704 wage earners aged 30 to 59 years, whose SA due to OA started in 2006, were followed until October 31, 2014. Kaplan-Meier analysis was used to plot sustained (at least 28 consecutive days) return-to-work curves. The associations of potential determinants with early exit from paid employment were examined applying Cox proportional hazards regression analysis. Years expected to be spent in different work participation statuses until statutory retirement age were estimated based on daily work participation statuses using adapted Sullivan method. Results. Persons with knee OA showed the fastest, and persons with hip OA the slowest, sustained return to work. Although most participants typically were at work during the first year of followup, a considerable proportion was permanently retired. Male sex, older age, low education, long initial SA, and having not returned to work sustainably, as well as receiving vocational rehabilitation, predicted early exit from paid employment during the followup. Overall, only 45-53% of potential working life-years were estimated to be spent at work, being highest for the oldest age group. Conclusion. Our study showed a considerable effect of OA on work participation and working life duration. Clinicians should avoid prescription of long SA or temporary work disability due to OA without a clear treatment or return-to-work plan.