V HERON1,2, P BUSSA2, M GINGOLD3,4, R KITCHING2,3,5, K POLKINGHORNE2,3, J RYAN2,3
1Department of Nephrology, Austin Health, Heidelberg, Australia, 2Department of Nephrology, Monash Health, Clayton, Australia, 3Monash University Department of Medicine, Clayton, Australia, 4Department of Rheumatology, Monash Health, Clayton, Australia, 5Monash University Centre for Inflammatory Diseases, Clayton, Australia
Aim: To investigate the relationship between ANCA-associated vasculitis (AAV), work disability, and employment in a cohort of Australian patients of working age.
Background: AAV may impact individuals of working age. Those affected frequently experience ongoing morbidity and reduced quality of life due to low-grade disease activity, disease relapses, fatigue, psychosocial factors, immunosuppressant toxicity, and irreversible end-organ damage. These effects can impact on the ability of an individual to work.
Methods: Patients completed an employment questionnaire in addition to a Work Productivity and Activity Impairment Questionnaire: Specific Health Problem at the time of their Vasculitis Clinic appointment.
Results: 47 respondents were included in the study. They had an average age of 47.8 ± 11.9 years (range 22 – 63 years) and a median disease duration of 60 months (range 10.2 – 318.5 months). 68.1% of the respondents were currently employed. 20.6% of those employed at the time of diagnosis were no longer working and 10.6% had experienced a significant reduction in work hours since their diagnosis. 23.4% of participants were work disabled, including 12.7% dependent on the disability support pension. 41.9% considered themselves work impaired and 44.7% reported that their financial stability had been adversely impacted by their vasculitis diagnosis. Fatigue was a commonly reported complaint impacting on work and productivity. Work disabled patients were significantly more likely to be obese and less likely to have completed tertiary education. Work disabled patients tended to be older, MPO-ANCA positive, and have renal involvement and lung involvement.
Conclusions: Work disability is common in Australians with AAV. The potentially modifiable factors of fatigue and obesity are at least associated with, and likely contribute to work disability.
Vanessa Heron is a third year nephrology advanced trainee working at Austin Health. She has previously worked as a renal registrar at Monash Health and Toowoomba Hospital.