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Types and Etiology of Arthritis

Discuss about the Report for Ergonomic Solutions for Arthritic Workers.

The human skeleton is segmented at several places for the feasibility of movement. The meeting point of two bones capable of movement can be referred as a joint. Joints vary in types according to nature of the movement required for the concerned part of the body. These articulations provide strong connection between the bones, teeth and the cartilages. Arthritis is very common clinical condition that involves certain types of disorders of the joint. It results in inflammated joints along with symptoms such as swelling, pain and stiffness of the concerned part of the body. The condition is not gender or age specific, however, it is found to be more prevalent in women and older people. In UK around 10million people suffer from the condition (Nhs.uk 2016); the figure is more severe in US with around 50 million adults and 300,000 children affected with Arthritis (Arthritis.org 2016).

There are more than 120 types of arthritis affecting different joints of the body with different etiologies. However, worldwide the most common types that are prevalent among the population are Osteoarthritis and Rheumatoid Arthritis (Valderrabano et al 2009). Osteoarthritis the more common of the two usually occurs in women and at an old age. Cartilages, the flexible connective tissues that line the end of the bones forming a joint, tear or wear away in Osteoarthritis (Sakalauskien? and Jauniškien? 2010). It causes increased friction between the bones and eventually pain, swelling and stiffness. Increased friction may lead to bony spurs known as osteophytes. In severe conditions the patient might require a joint replacement when therapeutic interventions fail to provide enough comfort to lead a normal life. The most common areas affected by osteoarthritis are knee, hand, spine and hips. Associated risk factors include obesity, family history, age and injury to the concerned area. On the contrary Rheumatoid Arthritis is an autoimmune disorder where the immune system of the body acts against the synovium of the body, essential for the production of synovial fluid that lubricates the joints and ensures smooth movement of the joints (Wegner et al 2010). It eventually causes severe damage to the joints. The exact cause of the autoimmunity is not clear, although scientists have proven that the most potent risk factors are genetic predisposition and environmental factors. In Singapore around 45,000 (1% of the population) people in the population suffers from Rheumatoid Arthritis (Singhealth.com.sg, 2016).

Challenges for Arthritic Workers

Researches show that working can help a person with some kind of disorder or health issue compared to having an unemployed life. As already mentioned, Arthritis is not age specific, it can be prevalent among the population who are at their working age and cause diverse range of problems at their workplace, irrespective of their job. Arthritis is the most common disabling epidemic with episodic symptoms such as pain and fatigue that can affect the productivity of a worker. Studies suggest that work can alleviate the problems faced by a patient with arthritis, as the symptoms tend to occur less frequently (Tang et al 2011). With appropriate monitoring of working hours and condition in the workplace work can turn out to be therapeutic for such patients. Several countries have Equality Acts in regard to work rights for employees. If the concerned person qualifies as disabled according to the definitions of the Act, the employer has to provide adequate support to its employees by providing right tools and working conditions (Adamou et al 2011). Self-management of one’s condition is another aspect, which is indispensible in such cases. Consulting the physician to gain recommendations regarding the management of work can be of helpful for the patients. Several challenges are faced by workers with arthritis in a workplace. In many occasions people are unwilling to disclose their condition in their workplace, fearing embarrassment and humiliation. People are less aware of the fact that sharing the challenges they face during work can make their employers and colleagues understand the situation and act accordingly. The employers and the colleagues must be made aware of what arthritis is, how it affects the patients and how it can be managed by making appropriate changes and adjustments. Many workers with arthritis are not aware of theirs rights when they are being discriminated at their workplace (Varekamp and Van Dijk 2010). The Equality Act has provision for people for disability in mobility, vision or hearing. It is the responsibility of the management to address such workers and create a suitable environment for workers with disabilities. According to the laws it is not even mandatory for a person to disclose their disability during recruitment or interview of a job. They need to talk about their competency and eligibility for the job post (Lockwood, G., Henderson and Thornicroft 2012). Workers suffering from arthritis must have a clear idea about their requirements and take the help of their therapist for guidelines and aims that can help them manage their condition and allow a steady productivity. Adjustments are required in the workspace for arthritic workers to cope up to the challenges efficiently. Often the employer does not provide the required tools and adjustments which poses severe challenge to workers.

Findings

Any worker who has to perform a same motion repeatedly or frequently is at risk of developing arthritis over the years. It can affect a diverse group of people from different domains. A worker from an automotive repair company was studied for the purpose of this report. The worker was 42 years old and is working in this profession for about the past 10 years. His working hours were from 10 a.m. to 6 p.m., 5 days a week, with a one hour lunch break at 12:30 p.m. The particulars of the subject were collected by interviewing through questionnaire format.  The worker suffers from arthritis in the hands. From the ergonomic study conducted on the worker it was found out that he works in a standing posture or is required go under the bonnet and car to make repairs of different parts of the car. He often experiences back pain due to working for such prolonged hours in such postures. He uses various tools like ratchet, spanners and wrenches frequently and over long periods during his working hours for repairing purposes. He

He experiences recurrent phases of pain in the hands after as well as during his working hours. His employer and colleagues ate unaware of his condition. No changes or special adjustments are provided to the worker to reduce the symptoms of his disorder. According to him, arthritis causes a lot of difficulties in his working life, decreasing his productivity and increasing absenteeism due to uncontrolled pain at times.

Worker X

Frequency

Duration

Using ratchet, spanners and wrenches

Moe than 40x

1 Hour

Studies have shown that various types of jobs can cause osteoarthritis in the workplace due to continued activity of a joint (Centers for Disease Control and Prevention, 2009). The repeated mechanical stress on the joint may cause metabolic and physiological abnormalities in the concerned region. Accumulation of microtraumas due to vibrations from using tools at workplace is the most potent cause for the onset of osteoarthritis in workers. Hence, workers with such jobs are exposed to the risk factors compared to the normal population.

Hence in our particular case study, it is evident that the frequent and repeated use of the mentioned tools by the worker has led to his condition of arthritis in the joints of the hands. The severity of the condition needs to be assessed promptly and immediate changes must be made regarding his job, work arrangements and working hours.

Arthritis is a fluctuating disease that can be medically severe and physically invisible at the same time. There are no physical implications of its symptoms. Hence the primary step required to address the situation is to increase the understanding of the disease and the specific needs of workers who are suffering from it. Most importantly the employers must have clear understanding and adequate knowledge of the problems a person with arthritis at workplace might face, in order for the worker to remain employed and maintain a healthy productivity (Mancuso, Paget and Charlson 2000). The employer needs to bear additional provisions like sick leave and additional ergonomically designed equipment suitable for such patients.

Discussion of Solutions and Anticipated Challenges

The employee needs to keep the symptoms of the disease under control through medical and therapeutic intervention. Most of the common symptoms of arthritis including lack of mobility, pain, inflammation and stiffness can be reduced with the use of appropriate combination of drugs (Gignac 2004). During the early phase of diagnosis the patient often loses emotional and mental peace due to the fact that they are having a chronic lifelong disease. This often makes the patient lose temper at workplace (Li, Gignac and Anis 2006). Employers having knowledge of the condition are able to handle such situations with sensibility and ease. With progression of time these symptoms become control and the patient can continue working as normal. The employers must be lenient with sick leaves to allow the worker to make visits to the hospital or the physician whenever required. Employed people being diagnosed with the condition need to grant time off for the worker until the symptoms are stabilize by the prescribed drugs. 

The physician has a huge role to play to enable the patient manage his condition at work. They can elucidate how the patient’s condition is influence depending on what their job is and work they do at work. Often due to severity of the symptoms of arthritis patients tend to ignore other related health issues that might be prevalent. The physician needs to address such issues to avoid further detrimental health situations in the future.

Studies have found that people who have their disease under control often choose not to disclose their health condition to the employer and the colleagues (). Causes behind such decisions may arise from embarrassment of being treated as disabled, from the fear of discrimination at work and from the fear that his/her condition will not be comprehended in a sensible manner by others due to lack of knowledge. Appropriate employee management practices must be followed by the employer while communicating with employee to make them feel comfortable and instill them a sense of trust so that they feel confident to share serious issues. The employer must ensure confidentiality on issues according to the will of the employee. Understanding the capabilities and limitations of the worker caused by the occurrence of arthritis on part of the employer is indispensible in such cases.

It is the responsibility of the employer and the management to discuss the problems the worker is facing while at work and act according to find out new ways to overcome them. Adjustments largely depend on the type of work the worker performs. It may include the allotting the worker with less physical jobs and still utilize the skills or reducing the time they spent is works that can worsen their disease condition.

Discrimination is another widespread challenge that patients with arthritis face at work. It is unethical to and unlawful at certain countries to treat workers differently due to the presence or absence of a diseased condition (De Castro, Gee and Takeuchi 2008). The employer must not treat a disabled person in an unfavorable manner due to any issue that arises from their disability. Disability related sickness should be considered separately compared to general sickness.

Reasonable adjustments should be made for workers with arthritis to ensure that they have accessibility to things as non-disabled workers and maintain a steady work rate despite of several limitations. Flexible working hours and additional breaks or working from home may allow the worker to adapt to the symptoms with more ease (Munir et al 2005). Adjustments in duties and responsibilities can be changed according to the requirements and recommendation of the physician. Support can be provided to perform part of their job which is not suitable to manage the disease. The employer should provide the worker with equipment such as ergonomically designed tools that might reduce the impact of their working activities on their condition. While taking a decision or making adjustments the employers may also face certain challenges (Mancuso et al 2005). The employer needs to consider the rationality and practicality of the decision, the extent of the financial resources of the organization and the type and size of the organization.

Finally, workplace assessments can provide an insight on what adjustments the required and to what extent. An assessment can be done on on different aspects in a workplace by professional such as Occupational Health Therapists, Physiotherapists, Vocational Rehabilitation Counselor, an Access to Work Advisor or an Occupational Health Nursing Advisor. Assessment of the employee’s job and the physical environment can determine how the tasks can be modified and simplified according to the worker’s needs.

Further there may be lack of professional support and resources required for the employer and its employee to overcome the work related challenges. Support and information can be provided by government organization aimed to reduce work related obstacles for disabled workers.

Conclusion and Recommendations

The most potent solution that can help tackle the challenges of our concerned worker is adjustments of duties and tasks the employee is performing. As the task of the worker demands repeated and frequent use of tools and It is impractical to carry out automotive repairing without the repeated use of such tools, his employer must make adjustments in his task. He should be allotted a job which is less frequent and does not pose any additional threat in worsening his diseased state. To make such adjustments, assistance is required from certain professionals who can assess the condition of the worker as well as jobs that are suitable for the worker. A physician and an occupational therapist are necessary to perform the assessments and recommend the tasks that can be performed by the disabled worker with minimum risk factors. The occupational therapist must consult with the employer and make specific changes in the working hours and provide tools and equipment that will aid the worker in performing his tasks.

The employee must visit his physician on a regular basis to monitor the progress of his condition and makes changes accordingly by consulting with his employer and occupational therapist. This can keep his arthritic effects under control on the long run and ensure that he performs his tasks with least interruption and reasonable productivity. 

References

Adamou, M., Wadsworth, A., Tullett, M. and Williams, N., 2011. Hidden impairments, the Equality Act and occupational physicians. Occupational medicine, 61(7), pp.453-455.

Arthritis.org. (2016). What Is Arthritis?. [online] Available at: https://www.arthritis.org/about-arthritis/understanding-arthritis/what-is-arthritis.php [Accessed 26 Nov. 2016].

Centers for Disease Control and Prevention, 2009. Prevalence and most common causes of disability among adults--United States, 2005. MMWR: Morbidity and mortality weekly report, 58(16), pp.421-426.

De Castro, A.B., Gee, G.C. and Takeuchi, D.T., 2008. Workplace discrimination and health among Filipinos in the United States. American Journal of Public Health, 98(3), pp.520-526.

Gignac, M.A., Badley, E.M., Lacaille, D., Cott, C.C., Adam, P. and Anis, A.H., 2004. Managing arthritis and employment: Making arthritis?related work changes as a means of adaptation. Arthritis Care & Research, 51(6), pp.909-916.

Li, X., Gignac, M.A. and Anis, A.H., 2006. Workplace, psychosocial factors, and depressive symptoms among working people with arthritis: a longitudinal study. The Journal of rheumatology, 33(9), pp.1849-1855.

Lockwood, G., Henderson, C. and Thornicroft, G., 2012. The Equality Act 2010 and mental health. The British Journal of Psychiatry, 200(3), pp.182-183.

Mancuso, C.A., Paget, S.A. and Charlson, M.E., 2000. Adaptations made by rheumatoid arthritis patients to continue working: a pilot study of workplace challenges and successful adaptations. Arthritis Care and Research, 13(2), pp.89-99.

Mancuso, C.A., Rincon, M., Sayles, W. and Paget, S.A., 2005. Longitudinal study of negative workplace events among employed rheumatoid arthritis patients and healthy controls. Arthritis Care & Research, 53(6), pp.958-964.

Munir, F., Jones, D., Leka, S. and Griffiths, A., 2005. Work limitations and employer adjustments for employees with chronic illness. International Journal of Rehabilitation Research, 28(2), pp.111-117.

Nhs.uk. (2016). Arthritis - NHS Choices. [online] Available at: https://www.nhs.uk/Conditions/Arthritis/Pages/Introduction.aspx [Accessed 26 Nov. 2016].

Sakalauskien?, G. and Jauniškien?, D., 2010. Osteoarthritis: etiology, epidemiology, impact on the individual and society and the main principles of management. Medicina (Kaunas), 46(11), pp.790-7.

Singhealth.com.sg. (2016). Rheumatoid Arthritis - Singapore Health Hospitals and Doctors. [online] Available at: https://www.singhealth.com.sg/PatientCare/ConditionsAndTreatments/Pages/Rheumatoid-Arthritis.aspx [Accessed 26 Nov. 2016].

Tang, K., Escorpizo, R., Beaton, D.E., Bombardier, C., Lacaille, D., Zhang, W., Anis, A.H., Boonen, A., Verstappen, S.M., Buchbinder, R. and Osborne, R.H., 2011. Measuring the impact of arthritis on worker productivity: perspectives, methodologic issues, and contextual factors. The Journal of rheumatology, 38(8), pp.1776-1790.

Valderrabano, V., Horisberger, M., Russell, I., Dougall, H. and Hintermann, B., 2009. Etiology of ankle osteoarthritis. Clinical Orthopaedics and Related Research®, 467(7), pp.1800-1806.

Varekamp, I. and Van Dijk, F.J.H., 2010. Workplace problems and solutions for employees with chronic diseases. Occupational medicine, 60(4), pp.287-293.

Wegner, N., Lundberg, K., Kinloch, A., Fisher, B., Malmström, V., Feldmann, M. and Venables, P.J., 2010. Autoimmunity to specific citrullinated proteins gives the first clues to the etiology of rheumatoid arthritis. Immunological reviews, 233(1), pp.34-54.

Cite This Work

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[Accessed 01 March 2024].

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