Treatment may help workers with arthritis

Workers need accommodations, rarely get them

Treatment with a tumor necrosis factor (TNF) alpha blocker may help keep workers with rheumatoid arthritis (RA) employed, at least those with disease duration of 10 years or less, says a new study.1

"Initially, we didn't find any effect in use of those drugs in helping people maintain employment; but in further analyses, it does look like it helps people with shorter disease duration stay employed," says Saralynn Allaire, ScD, the study's lead author and a researcher with Boston University School of Medicine.

The reason the medication might not help people with longer duration is that some of the effects become permanent, and no new treatment can offset those changes, says Allaire.

It's been known for a long time that people with rheumatoid arthritis who stop working do so in part because of the type of work that they do, which is generally physically demanding, says Allaire. For this reason, it's key for occupational health nurses to offer accommodations to these employees, she stresses.

Typically, people with arthritis don't consider themselves disabled, and may not realize that they have the right to ask for accommodations, says Allaire. "Instead, they tend to cut back and go part-time," she says. "But studies suggest that's not an effective solution to help people maintain employment. Instead, it's sort of a marker of exit from the workplace, and people become less committed to working."

Employees with musculoskeletal conditions, including rheumatoid arthritis, hardly ever receive accommodations, adds Allaire. "They are reluctant to ask for them, because then they have to disclose their condition. There is a lot of fear about that," she says. "Then people get upset with their coworkers because either they need help but don't ask for it, or in some cases, they ask for help and don't get it."

Under the Americans with Disability Act, employers can't reveal the condition to coworkers without permission, but resentment may occur if there is no explanation about why a worker is receiving accommodations, says Allaire. "People worry about that upfront, which is one reason they don't ask for accommodations in the first place," she says.

Since early rheumatoid arthritis is not a very visible disease, employees may have a lot of pain and stiffness that their coworkers can't see, says Allaire. "Sit down with the employee and discuss issues of working with other people. Then make a plan of action for what to do," she says.

Reference

1. Allaire S, Wolfe F, Niu J, et al. No evidence of reduction in premature work loss among persons with rheumatoid arthritis (RA) using anti-TNF alpha agents. Arthritis Rheum 2007; 56:S806.