Systematic review of studies of productivity loss due to rheumatoid arthritis

Wayne Burton*, Alan Morrison, Ross Maclean, Eric Ruderman

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

216 Scopus citations


Background: Rheumatoid arthritis (RA) is a chronic, debilitating disease with a significant impact on workplace productivity. Aim: To perform a systematic review of studies of the relationship between RA and reduced workplace productivity. Methods: Screening of 307 titles identified in bibliographic database searches resulted in 38 articles subject to systematic review. Productivity loss was expressed by three different measures: work disability, work loss (synonymous with absenteeism or short-term sick leave) and work limitation (reduction in productivity while present at work). Results: A median of 66% (range 36-84%) of employed RA subjects experienced work loss due to RA in the previous 12 months, for a median duration of 39 days (range 7-84 days). The times from RA diagnosis until a 50% probability of being work disabled varied from 4.5 to 22 years. In inception cohort studies, the baseline variables consistently predictive of subsequent work disability were a physically demanding work type, more severe RA and older age. Conclusions: RA-related work-disability rates were similar in the USA and European countries. An apparent decrease in the prevalence of RA-related work disability since the 1970s may be related to a decrease in physically demanding work rather than to epidemiologic changes in RA. The majority of the literature addresses permanent disability and temporary work loss; none of the studies reviewed reported the effect of RA on presenteeism, i.e. work limitation from the employer perspective, and there are few published studies of the effectiveness of disease-modifying anti-rheumatic drugs in reducing work-related productivity loss.

Original languageEnglish (US)
Pages (from-to)18-27
Number of pages10
JournalOccupational Medicine
Issue number1
StatePublished - Jan 2006


  • Economics
  • Employment
  • Epidemiology
  • Rheumatoid arthritis
  • Risk factors

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health


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