Presentation M O2

M O2 (Oral Presentation):
The contribution of individual and area-level factors to the onset of work disability in employed adults with lower limb joint pain

Presented by: Glenn S Pransky


Wilkie R1, Pransky GS23

  1. Arthritis Research UK Primary Care Centre, Primary Care Sciences, Keele University
  2. Center for Disability Research, Liberty Mutual Research Institute
  3. University of Massachusetts Medical School



Osteoarthritis is the most common joint condition in adults . Its most disabling manifestation, lower extremity (LE) joint pain, is strongly associated with functional disability. However the factors that predict work restriction in older adults with LE joint pain is unclear. Recently, there has been greater recognition that area level socio-economic factors impact health and work outcomes. Persons with joint pain may be restricted in work because of characteristics of the area they live in, such as poor employment opportunities, limited access to healthcare, or cultural norms for work participation. This study sought to examine individual and area-level socioeconomic factors that predict the onset of work restriction in employed persons with LE osteoarthritis.


Population-based prospective cohort study of working adults aged 50-59, with LE joint pain (hip, knee or foot pain or a combination) who maintained employment during a three year follow-up period (n=716). Work restriction was defined as inability to participate in the amount and kind of work as desired. Multi-level logistic regression assessed the association of onset of work restriction with baseline health factors (severity of knee pain/functional limitation, comorbidity, anxiety, depression, cognitive impairment, obesity), demographic and socio-economic factors, and area-level employment deprivation, adjusting for putative confounders. Interaction terms were added to examine if associations were moderated by area-level employment deprivation.


108 persons (15.1% of the total sample) reported the onset of new work restriction at three years. Severe LE joint pain and functional limitation (Adjusted OR 1.70; 95% CI 1.03, 2.83), number of affected body sites (>7) (OR 3.73; CI 1.39, 7.94) and area-level employment deprivation (OR 2.09; CI 1.06, 4.13) were independently associated with onset. There were significant interactions between area level deprivation and age and depression (e.g. those aged 55 to 59 and living in the mid deprived areas for employment deprivation had four times the odds (OR 3.7; CI 1.5, 9.3) of becoming restricted in work than those who were aged 50 to 54 and living in the least deprived areas.


The findings suggest that the prevention of work disability in older adults with LE osteoarthritis will require both condition-specific interventions to decrease pain and maintain function, and more efforts to provide alternative employment opportunities for those with progressive functional limitations.

Schedule Details

Monday September 29
10:45 - 12:15 Morning Concurrent Sessions (M O1 - M O12 and Seminar 1)
Session: Predictors of Work Disability
Room B