Abstract
Purpose :
To investigate the relationship between dry eye disease (DED) and work functioning, unemployment, absenteeism, and worry about job loss in a general population.
Methods :
89,215 subjects (18–96 years, 59.5% female) from the Dutch population-based Lifelines cohort were included. DED was assessed using the validated Women’s Health study (WHS) questionnaire (either a clinical diagnosis of dry eye or both dryness and irritation symptoms often or constantly present). Unemployment, absenteeism, and worry were assessed with single-item questions. Work functioning was assessed in 36,399 working participants using the validated work role functioning questionnaire (WRFQ) 2.0. The relationships between DED and work functioning, unemployment, absenteeism, and worry about job loss were assessed with logistic regression models, corrected for age, sex, body mass index (BMI), income, education, smoking, and 48 comorbidities associated with dry eye.
Results :
9.1% of participants were defined as having DED: 8.5% had a previous clinical diagnosis of dry eye and 1.9% had highly symptomatic dry eye. Participants with DED had impaired overall work functioning compared to those without DED (49.4% vs 41.1%, OR 1.24, 95% CI 1.14-1.35, P=0.002, corrected for everything). Absenteeism was only slightly increased in DED participants (OR 1.10, 95% CI 1.01-1.20, P=0.04). DED carried a similar risk of impaired work functioning as rheumatoid arthritis and COPD. For participants with highly symptomatic dry eye (often or constant symptoms) impaired work functioning was even higher (60.3%) and at the level of obstructive sleep apnea syndrome and depression. The impaired work functioning scores seen with increasing symptom load were greater for undiagnosed subjects than for diagnosed subjects (interaction term ‘clinical diagnosis * dry eye symptoms’ P=0.002). After correction for comorbidities, DED was not associated with unemployment (OR 1.07, 95% CI 0.94-1.21, P=0.32), but remained tied to increased worry about job loss (OR 1.23, 95% CI 1.10-1.36, P<0.0005).
Conclusions :
In this large population-based study, DED was particularly linked to a substantially impaired work functioning, and less to unemployment and absenteeism. The impact of DED on work functioning is comparable to that of other severe chronic disorders, and undiagnosed subjects may be more affected. This highlights the importance of recognizing DED as a severe disorder and providing a diagnosis.
This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.