Yelin E, Henke C, Epstein W
Arthritis Rheum. 1987 May;30(5):507-12. doi: 10.1002/art.1780300504.
This paper traces the work history of patients with rheumatoid arthritis (RA) from the year of diagnosis to 1985. The paper also describes the risk factors for work loss among patients with RA. It uses data from a panel of 698 RA patients, observed for 4 years, from the practices of a random sample of northern California rheumatologists. Of these 698, 353 had worked for pay at some point in their lives. Three hundred six of the 353 had worked when diagnosed as having RA. Of these 306, 157 (51%) were no longer working in 1985. Forty-seven individuals started working after the onset of illness, but of these, approximately one-third had stopped working by 1985. In all, 50% of RA patients with some work experience stopped working within a decade of diagnosis, 60% within 15 years, and 90% within 30 years. We found that the probability of work loss is lessened among persons in jobs that have few physical requirements, among those with high levels of discretion over the pace and activities of work, and among those who were able to stay on the job held when the diagnosis was made. The probability of work loss is increased among service workers. The findings of this longitudinal study, showing that work characteristics profoundly alter the probability of work loss among persons with RA, are consistent with the findings of our earlier cross-sectional studies of work outcome and RA.
本文追溯了类风湿关节炎（RA）患者从确诊年份到1985年的工作经历。本文还描述了RA患者工作丧失的风险因素。它使用了来自698名RA患者的数据，这些患者在北加利福尼亚州随机抽取的风湿病学家的诊所中接受了4年的观察。在这698名患者中，有353人在其生命中的某个时候有过有偿工作经历。在这353名患者中，有306人在被诊断患有RA时仍在工作。在这306人中，有157人（51%）在1985年时已不再工作。有47人在患病后开始工作，但其中约三分之一的人到1985年时已停止工作。总体而言，有一定工作经历的RA患者中，50%在确诊后的十年内停止工作，60%在15年内停止工作，90%在30年内停止工作。我们发现，对于身体要求较低的工作岗位上的人、对工作节奏和活动有高度自主权的人以及能够继续从事确诊时所从事工作的人来说，工作丧失的可能性会降低。服务业工人的工作丧失可能性会增加。这项纵向研究的结果表明，工作特征会深刻改变RA患者工作丧失的可能性，这与我们早期关于工作结果和RA的横断面研究结果一致。
