Working Girls

Sorry guys, but this is another study about women only (it probably can be associated to men quite successfully though).  Women with FM have great difficulty in managing a work life with their condition. Some women (like me) cannot work at all in their chosen profession: who wants a lawyer with fibro fog? Some work part-time and some struggle to work full-time. Reported work ability in women with FM varies from 34 to 77 per cent in studies from different countries.1

The factors which affect the ability to work in women with FM include pain, fatigue, impaired physical capacity and activity limitations. However, it is difficult to define to which extent symptom severity can be compatible with work.

A cross-sectional study of 129 women of working age with FM was categorized as working or non working. The average age of participants was 45.7 years, with an average of 10.5 years worth of symptoms. According to the American College of Rheumatology criteria, the average number of tender points was 14.8.

The main finding in this study was that working women (WW) displayed better ratings than non working women (NWW) in terms of pain, fatigue, stiffness, depression, disease specific health status and physical health related quality of life, which represent body functions and overall health status!

  • Physical capacity did not differ significantly between WW and NWW in terms of performance-based tests, where both groups showed lower capacity than the average population.
  • The number of pain localizations was significantly lower in WW than in NWW and global pain was significantly milder in WW than in NWW. The average pain of WW was well above 50 (0–100), which corresponds to the average pain level in previous studies of FM – this is measured using the Fibromyalgia Impact Questionnaire (a disease specific measure and comprises ten subscales of disabilities and symptoms ranging from 0 to 100). The average NWW pain was above 75 (0–100), which corresponds to the ratings of severely afflicted patients with FM. The results indicate that women with FM having moderate pain generally could be expected to work. Some women appear to be able to work despite severe pain, which raises the question if there are workplace related factors that support their ability to work. As such, the influence of work related factors on work ability in FM need to be studied further – it was not covered in this study.
  • 2011-04-20_Working-9-to-5 Global fatigue was found to be significantly lower in WW than in NWW as well as physical fatigue, reduced activity, and mental fatigue. Fatigue has previously been found to be an important factor for work disability; however, these results showed severe global fatigue with ratings of over 70 also in WW, indicating that fatigue might not be a critical factor for work disability.
  • Depression was rated significantly lower in WW than in NWW.
  • WW displayed a significantly better disease specific health status than NWW.
  • Physical health-related quality of life was significantly higher in WW than in NWW; however, the quality of life of workers in this study was very low as compared to a national sample.

The theory of the healthy worker effect suggests that healthier individuals are more likely to remain in the workforce BUT a limitation of this study is the cross-sectional design which does not allow analyses of cause and effect; that is: does working make women with FM healthier, or do healthier women with FM work?

  1. Henriksson CM, Liedberg GM, Gerdle B:  Women with Fibromyalgia: Work and Rehabilitation. Disabil Rehabil 2005, 27(12):685–695.


$95 000 settlement award against Colorado Children’s Hospital

Cecilia McMurray applied for a staff assistant position with Colorado Children’s Healthcare Access Program in Pediatric Medicine. Three interviews later, McMurray was offered the position of Staff Assistant II, contingent upon the successful completion of a pre-employment health screen. After a medical exam arranged by Children’s, the hospital withdrew its offer of employment to McMurray.

The US Equal Employment Opportunity Commission (EEOC) filed a disability discrimination lawsuit against Children’s Hospital Colorado in Aurora.

Denying a job to an applicant because of a disability violates the Americans with Disabilities Act (ADA). The EEOC filed suit in US District Court for the District of Colorado (EEOC v. Children’s Hospital Colorado, Case No. 11-cv-02104-REB-CBS) after first attempting to reach a pre-litigation settlement through its conciliation process.

Children’s Hospital Colorado will pay $95,000 to Cecilia McMurray, and furnish other relief, to resolve this case. The hospital entered into a consent decree and agreed to ensure all employees involved in the hiring process are trained on ADA requirements. Children’s Hospital Colorado will also report to the EEOC each time a person is denied hire due to a medical screen during the decree’s duration.

“The ADA is a complicated statute, and an employer’s obligations with respect to post-offer medical exams are particularly complex,” said EEOC Regional Attorney Mary Jo O’Neill. “Employers need to be very careful when they utilise pre-employment health screens. We applaud Children’s Hospital for taking steps to improve its hiring process to ensure that employees with disabilities are not excluded from employment.”

EEOC Denver Field Office Director Nancy Sienko added, “It is important that employers give applicants with disabilities a fair shake and make employment decisions based on facts and not myths, fears or stereotypes. We commend Children’s for ensuring its hiring decisions comply with the ADA.”

It’s a pity the hospital only took these ‘commendable’ steps after being filed with a lawsuit!

Still Working, FibroMAGICians?