Background & Aims

Celiac disease (CD) affects around 1% of the population worldwide. Data on work disability in patients with CD remain scarce. We estimated work loss in patients with CD, including its temporal relationship to diagnosis.

Methods

Through biopsy reports from Sweden’s 28 pathology departments, we identified 16,005 working-aged patients with prevalent CD (villus atrophy) as of January 1, 2015, and 4936 incident patients diagnosed with CD in 2008 to 2015. Each patient was matched to up to 5 general-population comparators. Using nationwide social insurance registers, we retrieved prospectively recorded data on compensation for sick leave and disability leave to assess work loss in patients and comparators.

Results

In 2015, patients with prevalent CD had a mean of 42.5 lost work days as compared with 28.6 in comparators (mean difference, 14.7; 95% confidence interval [CI], 13.2-16.2), corresponding to a relative increase of 49%. More than one-half of the work loss (60.1%) in patients with CD was derived from a small subgroup (7%), whereas 75.4% had no work loss. Among incident patients, the annual mean difference between patients and comparators was 8.0 days (range, 5.4-10.6 days) of lost work 5 years before CD diagnosis, which grew to 13.7 days (range, 9.1-18.3 days) 5 years after diagnosis. No difference in work loss was observed between patients with or without mucosal healing at follow-up.

Conclusions

Patients with CD lost more work days than comparators before their diagnosis, and this loss increased after diagnosis. Identifying patients with an increased risk of work loss may serve as a target to mitigate work disability, and thereby reduce work loss, in patients with CD.

中文翻译：

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乳糜泻患者的工作损失：一项基于人群的纵向研究

背景与目标

乳糜泻 (CD) 影响全世界约 1% 的人口。CD 患者工作障碍的数据仍然很少。我们估计了 CD 患者的工作损失，包括其与诊断的时间关系。

方法

通过瑞典 28 个病理科的活检报告，我们确定了截至 2015 年 1 月 1 日的 16,005 名工作年龄的 CD（绒毛萎缩）流行患者，以及 2008 年至 2015 年诊断为 CD 的 4936 名新发患者。每个患者最多匹配 5 个一般人群比较器。使用全国社会保险登记册，我们检索了有关病假和残疾假补偿的前瞻性记录数据，以评估患者和比较者的工作损失。

结果

2015 年，患有 CD 的患者平均损失了 42.5 个工作日，而对照组为 28.6 个（平均差，14.7；95% 置信区间 [CI]，13.2-16.2），相对增加了 49%。CD 患者中超过一半的工作损失（60.1%）来自一个小亚组（7%），而 75.4% 没有工作损失。在新发患者中，患者和对照者之间的年平均差异为 CD 诊断前 5 年失去工作的 8.0 天（范围，5.4-10.6 天），诊断后 5 年增加到 13.7 天（范围，9.1-18.3 天）。在随访中观察到黏膜愈合或不愈合的患者之间的工作损失没有差异。

结论

CD 患者在诊断前比对照者损失更多的工作日，并且这种损失在诊断后增加。识别出失业风险增加的患者可以作为减轻 CD 患者工作障碍的目标，从而减少失业。