University of Oulu

Rossi, H-R, Uimari, O, Arffman, R, et al. The association of endometriosis with work ability and work life participation in late forties and lifelong disability retirement up till age 52: A Northern Finland Birth Cohort 1966 study. Acta Obstet Gynecol Scand. 2021; 100: 1822– 1829.

The association of endometriosis with work ability and work life participation in late forties and lifelong disability retirement up till age 52 : a Northern Finland Birth Cohort 1966 study

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Author: Rossi, Henna-Riikka1,2; Uimari, Outi1,2; Arffman, Riikka1,2,3;
Organizations: 1Department of Obstetrics and Gynecology, Oulu University Hospital, Oulu, Finland
2PEDEGO Research Unit, University of Oulu, Oulu, Finland
3Medical Research Center Oulu (MRC Oulu), University of Oulu, Oulu, Finland
4Infrastructure for Population Studies, Faculty of Medicine, University of Oulu, Oulu, Finland
5Center for Life-Course Health Research, Faculty of Medicine, University of Oulu, Oulu, Finland
Format: article
Version: published version
Access: open
Online Access: PDF Full Text (PDF, 0.5 MB)
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Language: English
Published: John Wiley & Sons, 2021
Publish Date: 2021-11-15


Introduction: Endometriosis may cause a deterioration of daily functioning due to related symptoms such as pain, fatigue and psychological distress. Accordingly, endometriosis may jeopardize work ability, as suggested in mainly survey-based case–control studies, including clinically established cases at fertile age. This is the first general population-level study to evaluate how endometriosis is associated with (1) self-rated work ability and sick leave dates at age 46 years, (2) registered disability and unemployment days between age 46 and 48 and (3) lifelong emergence of registered disability retirement up to age 52.

Material and methods: Endometriosis case identification was based on the Care Register for Health Care and self-reported diagnosis from a population-based birth cohort, which covers 96% of children born in Northern Finland in 1966. A total of 348 women with endometriosis and 3487 women without endometriosis were identified. Questionnaire data on Work Ability Index Score was collected at age 46. Unemployment and disability days were determined from the Social Insurance Institution of Finland and the Finnish Center for Pensions registers. Finally, each individual’s first-ever granted pension decision and diagnoses were collected until age 52 years. The associations between endometriosis and work ability were assessed using logistic regression models.

Results: Endometriosis was associated with poor work ability at age 46 (odds ratio [OR] 1.62, 95% confidence interval [CI] 1.06–2.47). Furthermore, the association between endometriosis and over 10 days of absenteeism was increased (OR 1.53; 95% CI 1.05–2.23). Between ages 46 and 48, women with endometriosis had 10 days more disability days (55.5 vs 45.5, p = 0.030) in comparison to women without endometriosis, but 20 days less unemployment days (40.6 vs 59.2 days, p = 0.013). There were no differences in early retirement between the study groups until age 52.

Conclusions: Our study showed that endometriosis associates with poor work ability at age 46. Women with endometriosis have more disability days. However, their employment rate and risk of early retirement are comparable to those of women without endometriosis at late fertile age.

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Series: Acta obstetricia et gynecologica Scandinavica
ISSN: 0001-6349
ISSN-E: 1600-0412
ISSN-L: 0001-6349
Volume: 100
Issue: 10
Pages: 1822 - 1829
DOI: 10.1111/aogs.14210
Type of Publication: A1 Journal article – refereed
Field of Science: 3123 Gynaecology and paediatrics
Funding: The study was funded by The Academy of Finland (315921, 321763), Sigrid Jusélius Foundation, The Finnish Medical Association and Ahokkaan Säätiö. NFBC1966 received financial support from University of Oulu Grant nos. 65354 and 24000692, Oulu University Hospital Grant nos. 2/97, 8/97 and 24301140, Ministry of Health and Social Affairs Grant nos. 23/251/97, 160/97, 190/97, National Institute for Health and Welfare, Helsinki Grant no. 54121, Regional Institute of Occupational Health, Oulu, Finland Grant nos. 50621, 54231 and ERDF European Regional Development Fund Grant no. 539/2010 A31592.
Academy of Finland Grant Number: 315921
Detailed Information: 315921 (Academy of Finland Funding decision)
321763 (Academy of Finland Funding decision)
Copyright information: © 2021 The Authors. Acta Obstetricia et Gynecologica Scandinavica published by John Wiley & Sons Ltd on behalf of Nordic Federation of Societies of Obstetrics and Gynecology (NFOG). This is an open access article under the terms of the Creative Commons Attribution-NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.