Arthritis Care & Research Vol. 67, No. 9, September 2015, pp 1246–1254 DOI 10.1002/acr.22601 V C 2015, American College of Rheumatology ORIGINAL ARTICLE Unpacking Early Work Experiences of Young Adults With Rheumatic Disease: An Examination of Absenteeism, Job Disruptions, and Productivity Loss ARIF JETHA, 1 ELIZABETH BADLEY, 1 DORCAS BEATON, 2 PAUL R. FORTIN, 3 NATALIE J. SHIFF, 4 AND MONIQUE A. M. GIGNAC 5 Objective. To examine work absenteeism, job disruptions, and perceived productivity loss and factors associated with each outcome in young adults living with systemic lupus erythematosus (SLE) and juvenile arthritis (JA). Methods. One hundred forty-three young adults, ages 18–30 years with SLE (54.5%) and JA (45.5%), completed an online survey of work experiences. Demographic, health (e.g., fatigue, disease activity), psychosocial (e.g., independence, social support), and work context (e.g., career satisfaction, job control, self-disclosure) information was collected. Partic- ipants were asked about absenteeism, job disruptions, and perceived productivity loss in the last 6 months. Log Poisson regression analyses examined factors associated with work outcomes. Results. A majority of participants (59%) were employed and reported a well-managed health condition. Employed respondents were satisfied with their career progress and indicated moderate job control. More than 40% of participants reported absenteeism, job disruptions, and productivity loss. Greater job control and self-disclosure, and less social sup- port, were related to a higher likelihood of absenteeism. More disease activity was related to a greater likelihood of re- porting job disruptions. Lower fatigue and higher job control were associated with a reduced likelihood of a productivity loss. Conclusion. Young adult respondents with rheumatic disease experienced challenges with employment, including absentee- ism, job disruptions, and productivity loss. While related to greater absenteeism, job control could play a role in a young person’s ability to manage their health condition and sustain productive employment. Greater attention should also be paid to understanding health factors and social support in early work experiences. INTRODUCTION Productive labor force participation is a hallmark of the transition to adulthood (1,2) and provides opportunities for the generation of income, development of self-identity, skill acquisition, and access to other health and social benefits (2–5). Although few studies exist, previous research shows that young adults with rheumatic disease are less likely to be employed when compared to their peers without any health conditions (6–9). Research has not examined at-work outcomes such as absenteeism (e.g., missed workdays attrib- uted to health), perceptions of work performance, or health- related job disruptions (e.g., arriving late to work, leaving early, missing meetings) (6). These outcomes can provide critical insight into early at-work experiences and may relate to the ability to sustain employment. Dr. Jetha’s work was supported by a Canadian Institutes for Health Research Frederick Banting and Charles Best Canadian Graduate Scholarship. 1 Arif Jetha, PhD, Elizabeth Badley, PhD: Dalla Lana School of Public Health, University of Toronto, and Toronto Western Research Institute, Toronto, Ontario, Canada; 2 Dorcas Beaton, BScOT, PhD: Institute for Work and Health and St. Michaels Hospital, Toronto, Ontario, Canada; 3 Paul R. Fortin, MD, MPH: Centre Hospitalier Universitaire de Qu ebec and Facult e de M edecine de L’Universit e Laval, Quebec City, Quebec, Canada; 4 Natalie J. Shiff, MD, MHSc: University of Saskatche- wan, Saskatoon, Saskatchewan, Canada; 5 Monique A. M. Gignac, PhD: Dalla Lana School of Public Health, University of Toronto, Toronto Western Research Institute, and Institute for Work and Health, Toronto, Ontario, Canada. Dr. Fortin has received speaking fees, consulting fees, and/ or honoraria (less than $10,000 each) from Lilly, AbbVie, and GSK. Dr. Shiff has received an honorarium (less than $10,000) from AbbVie. Address correspondence to Arif Jetha, PhD, Liberty Mutual Research Institute for Safety, 71 Frankland Road, Hopkinton, MA 01748. E-mail: Arif.Jetha@LibertyMutual.com. Submitted for publication January 22, 2015; accepted in revised form April 14, 2015. 1246