New research shows that people with Rheumatoid Arthritis and similar joint diseases have lower-than-average employment rates - though the impact the disorders have on working life can vary widely from person to person.

Among more than 43,000 German adults with some form of inflammatory rheumatic disease, employment rates were up to one-quarter lower than that of the general population.

With certain conditions, however, job rates were closer to the norm. And much depended on the duration of a person’s condition, education level and where in Germany a person lived.

Inflammatory rheumatic disease refers to a number of disorders marked by chronic inflammation, pain and stiffness in the joints - including Rheumatoid Arthritis (RA), systemic Systemic lupus erythematosus, and Systemic sclerosis (scleroderma). Some of the conditions, such as lupus and systemic sclerosis, also damage other structures and organs throughout the body.

In the new study, people with RA, lupus, systemic sclerosis or a condition called Wegener’s Granulomatosis in which blood vessel inflammation leads to joint pain and organ damage had significantly lower employment rates than the general population.

On the other hand, men and women with Ankylosing Spondylitis (AS), which primarily affects the spine, or arthritis related to the skin disease psoriasis were more likely to be on the job. Their employment rates were 6 to 8 percent lower than the average for the German population, researchers report in the April issue of the Journal of Rheumatology.

People with AS and psoriasis may have fared better employment-wise because the effects of the disorders on the joints may be less severe, according to study leader Dr. Wilfried Mau of Martin-Luther University Halle-Wittenberg.

Across the various rheumatic diseases, the odds of unemployment also depended on the duration of a person’s disease. For example, people who had had AS for less than 10 years had an employment rate comparable to the norm, while those who’d had the disease for a longer period had a job rate that was 9 to 12 percent lower than average.

People with RA - an autoimmune disorder in which the immune system mistakenly attacks the lining of the joints - were showing a modest impact on work ability within 5 years of diagnosis, but the effect grew stronger over time. The employment rate among women who’d had the disease for more than 10 years was more than 40 percent lower than the norm.

Job rates also depended on the region in which a person lived - being lower in economically depressed areas where general employment rates were lower. And education was a prime factor as well. In general, men and women with less than 10 years of education were one-third less likely to be employed than their more educated peers.

Mau said employers should realize that people with rheumatic diseases are typically “highly motivated to stay on the job,” and, with the help of some work modifications, can keep up with or out-pace their coworkers.

SOURCE: Journal of Rheumatology, April 2005.