Impact of fatigue on work productivity and health-related job loss, 2024, Macfarlane et al

Abstract

Background
Fatigue is commonly reported in population surveys and has been identified in patients with health conditions as a key co-morbidity which makes remaining in work challenging. Such patients, however, rarely have access to programmes to help them manage their fatigue.

Aims
To quantify the relationship between fatigue, work impairment and health-related job loss.

Methods
We use data from the Health and Employment After Fifty study, a longitudinal study of people aged 50–64 years when recruited through general practices in England in 2013–14. During follow-up, fatigue was measured using the Fatigue Assessment Scale, work impairment was assessed using the Work Productivity and Activity Impairment scale, and changes in employment status were recorded.

Results
A total of 2743 participants were eligible for the current analysis; 23% satisfied criteria for being fatigued. People who were fatigued were less likely to have a partner, university degree, be physically active and were more likely to be obese. Their job was more likely to involve shifts, be perceived as insecure, have reported difficulties coping with job demands, and be unsatisfying. After adjustment for socio-economic, lifestyle and work-related factors, they were almost twice as likely to report both work impairment (relative risk 1.8; 95% confidence interval [CI] 1.6, 2.1) and future health-related job loss, although the latter effect was only in those with other morbidities (incidence rate ratio 1.96; 95% CI 1.03–3.72).

Conclusions
Providing evidence-based support for workers with health conditions who experience fatigue may have an important impact at a population level in terms of extending working lives.


Key learning points

What is already known about this subject:

• Patients identify fatigue (in addition to pain) as key symptoms that make it challenging to remain working with a health condition.
  
  
• Whether fatigue independently predicts job loss is not clear.
  

What this study adds:

• Fatigue, in the context of other health conditions, approximately doubles the risk of health having an impact on productivity and leaving work due to ill health.
  
  
• The role of fatigue is independent of other factors.
  
  
• Taken together with data from qualitative studies and randomized controlled interventions, fatigue is likely a causal factor in leaving work due to ill health.
  

What impact this may have on practice or policy:

• People who are working, with fatigue in the context of a health condition, should be given access to evidence-based management for their symptoms to reduce the chance of having to leave work due to ill health.
  

Open access, https://academic.oup.com/occmed/advance-article/doi/10.1093/occmed/kqae056/7708734

 

"We acknowledge that fatigue may have arisen from different pathophysiological processes such as fatigue as a co-morbidity to an inflammatory condition, fibromyalgia, chronic fatigue syndrome and post-viral syndrome. We do not have further information on the nature of the fatigue and any related diagnoses, but have shown that irrespective of the mechanisms by which it has arisen it has an important impact in relation to work."

 

This whole idea of solving a problem with zero concern for its root cause is just so damn odd. It's never worked anywhere, will never work, but it's still the target of fanatical obsession and unwavering faith that they already have the solution, they just need to explain it the right way. Or whatever.