Understanding the employment landscape in people with systemic sclerosis.

OBJECTIVE:Systemic sclerosis (SSc) can restrict employment participation. Our objectives were to comparatively evaluate health factors, work factors and workplace accommodations between those who are employed and those who recently gave up employment. METHODS:A cross-sectional study was conducted of employed and recently working, but now unemployed individuals with SSc. Demographics, employment sectors, health factors, flare frequency, work context, and information about the need, availability and use of workplace supports were collected. RESULTS:Participants were 140 individuals (108 (77.1%) women, 32 (22.9%) men) where 110 (78.6%) were employed and 30 (21.4%) unemployed. Participants worked in Education/Health/Sciences/Arts (n=51, 36.4%), Sales/Retail (n=23, 16.5%), Banking/Insurance/Business/Technology (n=22, 15.7%), Government (n=15, 10.7%), Construction/Utilities (n=10, 7.1%), and Manufacturing/Agriculture/Mining/ Logging (n=10, 7.1%). Employed participants had a lower mean age (48.4 versus 54.3 years), and higher level of education (77.3% with post-secondary education versus 22.7% without). Those who had no flares were most frequently employed (41.7%), compared to those who had 1-2 flares (35.2%) and ≥3 flares (23.1%). The availability of workplace accommodations differed significantly between the employed and unemployed: flexible hours (75.2% versus 41.4%, p=0.005), more rest periods (81.8% versus 46.7%, p=0.0001), special equipment (87.5% versus 50.0%, p=0.0001), and alternative work-schedule flexibility (70.2% versus 38.8%, p=0.003). CONCLUSION:Health factors alone do not differentiate those who are employed and those who gave up employment. This study lays the groundwork for where SSc-specific efforts in workplace policies/practices should be directed, especially workplace support.