Working Conditions Correlate With Health in Young Adults With Rheumatic Disease

Researchers noted the association of job insecurity and workplace activity limitations with rheumatic disease symptoms in young adulthood.

Workplace limitations and job insecurity correlate with symptom trajectories in young adults with rheumatic diseases, according to study findings published in Arthritis Care & Research (Hoboken).

Researchers conducted a longitudinal cohort study that included Canadian young adults aged 18 to 35 years diagnosed with rheumatic diseases. The researchers conducted the baseline survey on December 1, 2019, with subsequent surveys occurring every 9 months. The participants completed at least 2 surveys with an 89% follow-up rate after survey 3.

Patients self-reported pain, fatigue, and disease activity levels using 11-point visual analog scale. In addition, they completed the Workplace Activity Limitations Scale (WALS) and the Copenhagen Psychosocial Questionnaire, which assessed difficulties/limitations experienced in the workplace due to rheumatic disease symptoms and feelings of job insecurity, respectively.

The researchers analyzed longitudinal trajectories for pain, fatigue, and disease activity, categorizing patients into persistent low and high pain/fatigue/disease activity groups.

A total of 124 individuals (mean age, 28.5±4.5 years; 81.5% women) with rheumatic disease, who fully completed at least 2 surveys, were included in the study.

At baseline, patients reported moderate levels of pain (mean±SD, 4.69±2.44), fatigue (mean±SD, 5.92±2.33), and disease activity scores (mean±SD, 4.18±2.63).

Higher WALS scores correlated significantly with persistently high pain (relative risk [RR], 1.02; 95% CI, 1.01-1.03), fatigue (RR, 1.02; 95% CI, 1.01-1.03), and disease activity levels (RR, 1.02; 95% CI, 1.01-1.03) over time.

Greater job insecurity correlated significantly with persistently high pain (RR, 1.14; 95% CI, 1.04-1.25) and disease activity levels (RR, 1.11; 95% CI, 1.00-1.22) over time; however, persistent fatigue did not significantly correlate with job insecurity.

Study limitations included potential recall and reporting bias due to use of self-reported outcome measures. Although the sample size of this study was sufficient to allow for a complex statistical analysis, a larger sample size may have revealed additional disease symptom trajectories and provided additional insight into the relationship between working conditions and health.

“The present study is among the first to highlight a relationship between workplace and labor market conditions and rheumatic disease symptom trajectories among young adults,” the study authors said. “Findings suggest the need to examine approaches that jointly strengthen the social determinants of health and clinical approaches to disease management to improve work participation and to promote health.”


Jetha A, Tucker L, Shahidi FV, et al. How does job insecurity and workplace activity limitations relate to rheumatic disease symptom trajectories in young adulthood? A longitudinal study. Arthritis Care Res (Hoboken). Published online July 22, 2022. doi:10.1002/acr.24982