Employment, work disability and quality of life associated with Ankylosing Spondylitis. Results from the Ankylosing Spondylitis Registry of Ireland (ASRI)


Bernie McGowan1,2, Orla Reynolds1, Maria Lynch1, Miriam O Sullivan1,3, Bryan Whelan1,3, Carmel Silke1,3.


1. The North Western Rheumatology Unit, Our Lady’s Hospital, Manorhamilton, Co Leitrim 2. The Dept of Pharmacology and Therapeutics, Trinity College Dublin. 3. The Dept of Medicine, NUIG


The results of international studies have identified that unemployment has a negative impact on physical and mental health1.In Ireland it is estimated that approximately 10% (458,825) of the Irish population are unemployed due to work disability. Unemployment rates in people with Ankylosing Spondylitis (AS) can be up to three times higher than in the general population.


To identify the prevalence of work disability (WD) in a cross-sectional study of patients with ankylosing spondylitis (AS) attending the NWRU and the associated clinical characteristics associated with their work disability (WD).


In collaboration with the Ankylosing Spondylitis Registry of Ireland (ASRI) data on patients attending the NWRU with a diagnosis of AS was routinely recorded on the ASRI database and included in the study analyses. The main outcome variable (WD) referred to all patients who were unemployed or working part-time directly as a result of their AS. Independent T-tests were carried out to identify differences between the two groups. Functional status and disease activity were measured using the BASDAI, BASFI, ASQoL and HAQ scores. Spinal and hip mobility were assessed using the Tragus to wall, cervical rotation, chest expansion, schobers test and lumbar flexion measures. The relationship between WD and extra-articular manifestations (EAMs) such as enthesitis, uveitis, dactylitis psoriasis, and other co-morbidities were also assessed.


In total 128 patients 113 males (88.3%) and 15 females (11.7%), mean age 47.0 (±13.3) were included in the study. The average disease duration since diagnoses was 9.7yrs (±9.4) and a total of 38 patients (29.7%) were either unemployed or working part-time as a direct result of their AS. Several variables had statistically significantly different values in patients with WD compared to those without WD. The result of the independent T-test identified that disease duration (p =0.041), Bath AS Functional Index (BASFI; p = 0.010), tragus to wall (p = 0.016), cervical rotation (p = 0.03) and AsQOL (p = 0.010), retained an independent association with work disability. WD did not correlate significantly with age, gender, marital status or number of co-morbidities. preprocess


The prevalence of WD in a cohort of Irish patients with AS attending the NWRU was 30% similar to the findings of other studies. The main factors associated with WD in this group were longer disease duration, structural damage and poorer quality of life. preprocess