P036 Gout and work participation in British adults: findings from the Health and Employment After Fifty study

Abstract

Abstract Background/Aims The prevalence of gout is increasing in the UK and gout is the most common inflammatory arthritis among men aged 40 and older. As well as acute and chronic musculoskeletal manifestations, it is also associated with cardiometabolic disease and renal impairment. Given its risk factors and associated morbidities, it has potential to significantly impact work ability, but this has received little attention to date. Methods Data came from the Health and Employment After Fifty (HEAF) study, a cohort of 8134 men and women recruited in 2013-14 when aged 50-64. Consenting participants also agreed to data linkage to their Clinical Practice Research Datalink (CPRD) primary care records. Participants were coded as having gout if they had at least 2 CPRD records diagnosing/treating gout at any time before the baseline questionnaire. Annual follow-up questionnaires enquired about jobs altered mainly or partly because of health reasons which was coded as health-related job loss (HRJL). Other outcomes assessed were: any sickness absence in past 12 months (vs no sickness absence); prolonged sickness absence (defined as > 20 days of sickness absence in past 12 months vs less than 20 days); and any sickness absence because of musculoskeletal pain (vs no sickness absence because of musculoskeletal pain). Participants with gout who were in paid work at baseline were individually matched by sex and age (within 1 year) with 3 participants also working but without a diagnosis of gout. Associations between having gout and a subsequent work outcome were explored with multilevel logistic regression with random intercept, to account for the repeated measures for each participant, and results expressed as ORs with 95%CIs. Results Of the 7673 HEAF participants who consented to CPRD data linkage, 149 (1.9%) were classified with gout. The proportion of participants in work at baseline was similar among those with gout (73.8%) and without gout (67.9%). Participants with gout were mostly men, average age 58 years. Gout participants were more likely than controls to be: obese, previous smokers, heavy drinkers, to report fair/poor self-rated health (SRH) and to have prevalent hypertension as compared with those without gout. After adjustment for age, sex, time of follow-up, BMI, alcohol, and SRH, having gout was significantly associated with any sickness absence (OR = 2.68 95%CI 1.58,4.54) and musculoskeletal sickness absence (OR = 2.50 95%CI 1.15,5.43) but no association was seen with HRJL or prolonged sickness absence. Conclusion Gout was an independent risk factor for sickness absence but not health related job loss. As the impact of sickness absence associated with gout is likely to increase with rising disease prevalence and an older workforce, there is need to explore whether improved management of hyperuricaemia and gout can improve work outcomes. Disclosure S. D'Angelo: None. K. Walker-Bone: None. N. Goodson: None.