Systematic review of studies of productivity loss due to rheumatoid arthritis

Occup Med (Lond). 2006 Jan;56(1):18-27. doi: 10.1093/occmed/kqi171. Epub 2005 Nov 11.


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.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review
  • Systematic Review

MeSH terms

  • Absenteeism
  • Adult
  • Antirheumatic Agents / therapeutic use
  • Arthritis, Rheumatoid / epidemiology*
  • Disability Evaluation
  • Efficiency, Organizational*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Sick Leave / statistics & numerical data*


  • Antirheumatic Agents