TY - JOUR

T1 - Increased risk of long-term sickness absence, lower rate of return to work, and higher risk of unemployment and disability pensioning for thyroid patients

T2 - a Danish register-based cohort study

AU - Nexo, M A

AU - Watt, T

AU - Pedersen, J

AU - Bonnema, S J

AU - Hegedüs, L

AU - Rasmussen, A K

AU - Feldt-Rasmussen, U

AU - Bjorner, J B

PY - 2014/9

Y1 - 2014/9

N2 - CONTEXT: Little is known about how thyroid diseases affect work ability.OBJECTIVE: The objective of this study was to evaluate the risk of work disability for patients with thyroid disease compared with the general population.DESIGN, SETTING, AND PARTICIPANTS: In a longitudinal register study, outpatients (n = 862) with nontoxic goiter, hyperthyroidism, Graves' orbitopathy (GO), autoimmune hypothyroidism, or other thyroid diseases and their matched controls (n = 7043) were observed in the years 1994-2011 in Danish national registers of social benefits, health, and work characteristics. Cox regression analyses estimated adjusted hazard ratios (HRs) for the first year after diagnosis and subsequent years.MAIN OUTCOME MEASURES: Transitions between work, long-term sickness absence, unemployment, and disability pension were measured.RESULTS: Patients differed significantly from the general population with regard to sickness absence, disability pension, return from sickness absence, and unemployment. In the first year after diagnosis, higher risks of sickness absence was seen for GO (HR 6.94) and other hyperthyroid patients (HR 2.08), who also had lower probability of returning from sickness absence (HR 0.62) and higher risk of disability pension (HR 4.15). Patients with autoimmune hypothyroidism showed a lower probability of returning from sickness absence (HR 0.62). In subsequent years, GO patients had significantly higher risk of sickness absence (HR 2.08), lower probability of return from sickness absence (HR 0.51), and unemployment (HR 0.52) and a higher risk of disability pension (HR 4.40). Hyperthyroid patients also had difficulties returning from sickness absence (HR 0.71).CONCLUSIONS: Thyroid patients' risk of work disability is most pronounced in the first year after diagnosis and attenuates in subsequent years. GO patients have the highest risk of work disability.

AB - CONTEXT: Little is known about how thyroid diseases affect work ability.OBJECTIVE: The objective of this study was to evaluate the risk of work disability for patients with thyroid disease compared with the general population.DESIGN, SETTING, AND PARTICIPANTS: In a longitudinal register study, outpatients (n = 862) with nontoxic goiter, hyperthyroidism, Graves' orbitopathy (GO), autoimmune hypothyroidism, or other thyroid diseases and their matched controls (n = 7043) were observed in the years 1994-2011 in Danish national registers of social benefits, health, and work characteristics. Cox regression analyses estimated adjusted hazard ratios (HRs) for the first year after diagnosis and subsequent years.MAIN OUTCOME MEASURES: Transitions between work, long-term sickness absence, unemployment, and disability pension were measured.RESULTS: Patients differed significantly from the general population with regard to sickness absence, disability pension, return from sickness absence, and unemployment. In the first year after diagnosis, higher risks of sickness absence was seen for GO (HR 6.94) and other hyperthyroid patients (HR 2.08), who also had lower probability of returning from sickness absence (HR 0.62) and higher risk of disability pension (HR 4.15). Patients with autoimmune hypothyroidism showed a lower probability of returning from sickness absence (HR 0.62). In subsequent years, GO patients had significantly higher risk of sickness absence (HR 2.08), lower probability of return from sickness absence (HR 0.51), and unemployment (HR 0.52) and a higher risk of disability pension (HR 4.40). Hyperthyroid patients also had difficulties returning from sickness absence (HR 0.71).CONCLUSIONS: Thyroid patients' risk of work disability is most pronounced in the first year after diagnosis and attenuates in subsequent years. GO patients have the highest risk of work disability.

KW - Adult

KW - Cohort Studies

KW - Comorbidity

KW - Denmark

KW - Disabled Persons

KW - Female

KW - Goiter

KW - Graves Disease

KW - Humans

KW - Hyperthyroidism

KW - Hypothyroidism

KW - Longitudinal Studies

KW - Male

KW - Middle Aged

KW - Pensions

KW - Registries

KW - Return to Work

KW - Risk Factors

KW - Sick Leave

KW - Thyroid Diseases

KW - Unemployment

KW - Young Adult

U2 - 10.1210/jc.2013-4468

DO - 10.1210/jc.2013-4468

M3 - Journal article

C2 - 24937367

VL - 99

SP - 3184

EP - 3192

JO - Journal of Clinical Endocrinology and Metabolism

JF - Journal of Clinical Endocrinology and Metabolism

SN - 0013-7227

IS - 9

ER -