P139 Inflammatory bowel disease and impairment of working life

Mtir, M.(1)*;Kchir, H.(1);Mechergui, N.(2);Cherif, D.(1);Debbabi, H.(1);Yacoub, H.(1);Hassine, H.(1);Maamouri, N.(1);

(1)La Rabta University Hospital, Department of gastro-enterology B, Tunis, Tunisia;(2)Charles Nicolle University Hospital, Department of occupational medicine, Tunis, Tunisia;

Background

Inflammatory bowel disease(IBD) is a lifelong illness that mainly affects patients of working age with a significant impact on their professional life. In fact, the maintenance and promotion of employees is one of the important social goals and can be considered as a determinants of health for IBD patients.
The aim of the study was to analyze the impact of disease on the working life among IBD patients and to characterize the breadth of challenges they experience in their workplace.

Methods

We conducted a cross-sectional study including working patients followed for IBD, over a 9-months period. We collected sociodemographic, clinico-biological and evolutionary data. We performed a survey among these patients using a self-report questionnairy on employment status, IBD-related difficulties at work and sick leave.

Results

We included 45 patients: 80% Crohn disease and 20% ulcerative colitis. The mean age was 44 years [20-72], the sex-ratio M/F was 0.7 and the average of follow-up was 9 years [1-18]. Civil servants represented 33% of the total population, those in the private sector 47%, and those in the liberal profession 20%. The most important socio-professional category was manual workers with 51%. Thirty-seven patients(82%) developed their disease after being employed with a mean delay of 142 months[2-648]. The average number of working hours per week was 38.84 [9-60]. The majority of the employees worked full time(84%), only seven subjects worked part-time, two of them because of their IBD. One in three patients claimed to have been exposed to at least one harmful agent during their professional career. The main complaint reported by the patients during the daily work was about physical fatigue (69%). The digestive symptoms were mainly abdominal pain(53%) evaluated according to VAS with a mean intensity of 2.8 [0 - 10], subocclusive syndrome(40%), presence of diarrhea(38%), incontinence and fecal impaction(22%) which was worsened by the absence of accessible restrooms(33%). Psychological repercussions such as anxiety and depression were mentioned in 27% of cases. The average absenteeism during the last twelve months was 49.6 days [0-240] and the average number of hospitalization days was 30.7 [0-150]. Twenty patients(44%) claimed that they were subject to a salary restriction because of their illness. Only five people had alreadỳ benefited from a contact with the occupational medicine and health service.

Conclusion

IBD has a negative impact on the working life of patients, due to uncomfortable symptoms, days of absenteeism, and unadapted workplaces, which can affect career plans, professional achievement, and income. Appropriate supports and accommodations to the workplace are needed in order to improve their working experience.