Update on work disability in rheumatic diseases.

Two recent studies suggest the prevalence of rheumatic condition-related work disability is considerably lower than was suggested in previous studies. However, the samples in the recent studies did not include older workers and included persons who gained employment after disease onset. In other recent studies, the rate of work disability among persons employed at disease onset is still high; a fair amount of work disability occurs in the early years of disease. There is no clear evidence yet that treatment improvements have altered the rates of work disability. Because work characteristics, like level of physical demand, influence risk for work disability and are potentially amenable, other interventions are needed to reduce rheumatic disease-associated work disability. Accommodation provided to alleviate problems in doing work and outside of work activities is the most promising intervention, followed by job/career change. Assessment tools are just now becoming available to help clinicians identify patients in need of assistance.