Effects of cardiovascular comorbidities on work participation in rheumatic diseases: a prospective cohort study among working individuals.

Objective: To determine the risk of sick leave and work disability in relation to rheumatic diseases and cardiovascular comorbidities among working individuals.

Methods: Employees (n = 12,140) from 45 companies in The Netherlands were prospectively followed up from 1998-2008. Questionnaires were used to assess self-reported diseases and employment status. Company records provided individual sick leave data for the first 2.5 years of followup. For a selected sample of the cohort (50%), verification of self-reported diseases was sought through hospital record linkage. Poisson regressions and Cox proportional hazards models were applied to determine the impact of both self-reported and verified diseases on sick leave and work disability, respectively.

Results: The number of days and frequency of sick leave were increased in working individuals with self-reported rheumatic and cardiovascular disease (P < 0.001), but self-reported cardiovascular comorbidity did not result in more sick leave in those who also self-reported rheumatic disease. Work disability was also increased for both self-reported rheumatic disease and cardiovascular disease (P < 0.001), but again, no additive effects were found. In the sample verified by clinical review, the frequency or number of days of sick leave was significantly higher in employees with cardiovascular disease (P < 0.001), inflammatory rheumatic disease (P < 0.05), and osteoarthritis (P < 0.05) compared to employees without these diseases. Work disability in the verified sample occurred especially in patients with osteoarthritis (hazard ratio [HR] 12.36 [95% confidence interval (95% CI) 1.59-13.66]), fibromyalgia (HR 14.24 [95% CI 2.02-16.54]), and cardiovascular disease (HR 4.88 [95% CI 1.70-14.01]).

Conclusion: Rheumatic and cardiovascular diseases increased the risk of sick leave and work disability in a working population, but there was no indication that these effects convey an additive risk.