A high physical workload and high job demands hamper the good prognosis in physical functioning in persons with early inflammatory joint conditions

Objective: To determine the influence of job characteristics on the prognosis of patients with early inflammatory joint conditions. Methods: In a prospective cohort study of 210 workers with inflammatory joint conditions present for <12 months, data were collected by questionnaires and medical examination at baseline and after 6 and 12 months. Outcomes were self-reported pain and physical functioning, and the presence of at least one swollen joint. Generalized estimation equations were used to study the influence of job characteristics on prognosis in pain and function, and logistic regression analysis to study prognosis in swollen joints. Results: Pain and physical functioning strongly improved during the first 6-month period (40 and 14%, respectively), and improvement slowed considerably in the second 6-month period. The proportion of workers with swollen joints dramatically decreased from 58 to 20 then 7%. The good prognosis in pain and physical functioning in the first 6 months was hampered by persistent high levels of inflammation, older age, low perceived health control and low social support. Job characteristics had no influence on the prognosis of pain and swollen joints, whereas workers with frequent manual material handling or high job demands improved ~50% less in physical functioning. Conclusions: Job characteristics had no influence on the disease characteristics pain and swollen joints, but strongly affected the consequences of disease in physical functioning. Among patients with early inflammatory joint conditions, who do not recover in functional abilities, adjustments in working conditions may be imperative.

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