A change in certain work conditions may help adults with rheumatoid arthritis (RA) stay on the job, preliminary research suggests.

The survey of nearly 600 adults with RA found that certain work-related factors, such as whether workers received ergonomic adjustments to their workstations, and the difficulty of the commute to work, were tied to the risk of work disability.

People whose personal work space was modified to make them more comfortable were 60 percent less likely to currently be away from work, compared with those who reported no such workstation adjustments. These included, for example, a change in the position of a computer keyboard, or a footstool added to a person’s desk area.

In addition, men and women who reported more problems getting to work, including physical difficulty in doing so, were at greater risk of work disability, defined as being off of work for at least six months due to RA symptoms.

But the strongest factor the study found was self-employment; survey respondents who were self-employed were five times less likely to report work disability than those who weren’t.

Self-employment is “obviously not for everyone,” said the study’s lead author, Dr. Diane Lacaille, of the Arthritis Research Centre of Canada in Vancouver. Still, she told Reuters Health, it’s important for people with RA to know that if they have the option of self-employment, which often entails working from home, it might reduce their risk of work-related disability.

Lacaille and her colleagues report their findings in the journal Arthritis & Rheumatism.

Rheumatoid arthritis is an autoimmune disorder in which the immune system mistakenly attacks the lining of the joints, causing repeated episodes of inflammation, stiffness and pain. Over time, the affected joints may lose their normal shape and alignment.

Discovering the modifiable factors that determine RA patients’ ability to stay on the job is important because the condition often strikes in middle-age or earlier, frequently in the prime of a person’s working life, Lacaille noted.

“The cost of loss of work productivity,” she said, “is greater than the cost of treating the disease,” which includes medication and, when necessary, hospitalization and surgery.

Lacaille and her colleagues found several factors other than self-employment, ergonomically friendly workstations and smoother commutes that were related to a lower risk of disability. RA patients whose families supported their staying on the job were less likely to be work disabled. So were those who said their work was important to them.

Of all these factors, work-space modifications would be the easiest to tackle, Lacaille said. She noted that some changes, such as providing a footstool for a desk worker’s feet or using books to raise a computer screen to eye level, “can be quite easy and not expensive.”

SOURCE: Arthritis & Rheumatism, October 15, 2004.