Alexander Forbes’ Myrna Sachs on managing arthritis in the workplace.
With a rising number of people in Africa living with rheumatoid arthritis, which usually strikes during one’s most productive working years and can result in disability, employers need to ensure they adhere to reasonable workplace accommodations if requested by incapacitated employees.
Rheumatoid arthritis is a chronic inflammatory disorder that affects the lining of your joints, causing a painful swelling that can eventually result in bone erosion and joint deformity.
These diseases have the fourth highest global impact on disability-adjusted life years and are one of the second leading causes of disability as measured by years lived with disability, according to the 2010 Global Burden of Disease. Many countries in Africa have reported an increased number of individuals with the disorder.
According to the World Health Organization, rheumatoid arthritis tends to strike during the most productive years of adulthood, between the ages of 20 and 40 and is a chronic disabling condition often causing pain and deformity – more commonly in women. Within 10 years, at least half of the affected individuals in developed countries become incapacitated or are unable to hold down a full-time job.
No employee is legally obliged to inform their employer of a disability or impairment. However, if the employee requires reasonable accommodation, it is in their advantage to disclose the disability.
The employer’s role
Early involvement by the employer plays a role as an adjunct intervention at the workplace to ensure the affected employee remains productive. All employers have the responsibility to ensure that the employees experiencing difficulties in performing daily duties and in accessing the work environment due to rheumatoid arthritis are assisted through reasonable accommodation. In this way, the way a job is normally performed can be modified to improve and maintain their productivity in line with legislation.
Therefore, education programmes aimed at coping with pain, disability, maintenance of ability to work, and social participation may be used as supportive interventions.
Rheumatoid arthritis in adults often leads to work disability if there is a mismatch between individual capability and work environmental demands. The course of treatment greatly determines how individuals function.
The goal is to intervene early with anti-rheumatic pharmaceutical treatment to delay progression of symptoms and maintain productivity. Occupational therapy early on in the disease progression often leads to delayed onset of debilitating symptoms and increased likelihood to cope within the workplace.
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Individuals with functional limitations in physically demanding jobs are often accommodated in more sedentary positions, which often increases the demands placed in smaller joints in their hands for manual dexterity and repetitive hand tasks. The challenge is that rheumatoid arthritis often affects small joints first, which makes sedentary jobs inappropriate. Even though sedentary positions may decrease absenteeism, it exacerbates presenteeism.
These employees experience functional limitations and their ability to perform and execute work duties gets incapacitated as the condition progresses. They are protected by the Employment Equity Act and require management at the workplace.
Workplace wellness programmes often assist companies in identifying high-risk individuals who may be at risk of developing chronic conditions, which without intervention, may result in further disability.
The employer should embark on an incapacity management process following the outcomes as a result of:
- rheumatoid arthritis from monthly, quarterly or six-monthly performance reviews;
- signs of demotivation or change in work behaviour investigations; and
- observed changes in physical ability to move around and execute daily duties.
As part of the incapacity management process, the employer will have an opportunity to establish supportive engagement to determine the possible problems and solutions.
Ways that an employer can make the workplace more arthritis-friendly include the following:
- Adjustable sit or stand workstations or desks to make the work easier by allowing the employee to alternate sitting and standing positions;
- Encouraging standing up and walking around or changing tasks every 20 to 30 minutes;
Moving a workstation to the ground floor to remove the need to climb stairs and providing accessible restrooms and break rooms;
- Providing assistance with lifting or other physically demanding non-essential tasks, reducing or eliminating physical exertion;
- Adaptive devices, tools or equipment to assist employees with rheumatoid arthritis;
- Ensuring that the workstation is ergonomically appropriate; and
- Allowing flexible hours to start and end the workday later, as people with rheumatoid arthritis may need time in the morning to loosen up their joints
While education and professional training may be limiting factors, there are certain occupations that are better suited for people who have rheumatoid arthritis, such as those with flexible hours, telecommuting, and low stress.