Mahin Hosseininejad1, Elaheh Kabir-Mokamelkhah1, Mohammad Hossein Harirchian2, Razieh Sirous1, Saber Mohammadi1, Samaneh Kabiri2

1Occupational Medicine Research Center, Department of Occupational Medicine, School of Medicine, Iran University of Medical Science,Tehran, Iran
2Iranian Center of Neurological Research, Tehran University of Medical Science, Tehran, Iran

Keywords: Central nervous system, fatigue, multiple sclerosis, return to work, worker


Objective: Multiple sclerosis (MS) is a chronic disease of the central nervous system that is usually diagnosed at the working-age (20-45 years) and can negatively affect patients’ job performance and ability in work. The purpose of this study was to investigate occupational, individual, and disease-related factors in the return to work in patients with MS.

Materials and Methods: This study was performed on all patients with clinically definite MS according to the McDonald criteria who were referred to a neurology clinic from September 2019 to April 2020. The Health and Safety Executive Questionnaire and Multidimensional Fatigue Inventory Questionnaire were used to assess job stress and fatigue level. Level of disability was assessed in patients through the validated version of the Expanded Disability Status Scale (EDSS). Based on the patients’ return to work status, individuals were divided into two groups: the patients who returned to work (full time, part-time) and who did not return to work. Then, these two groups were compared in terms of occupational, individual, and disease-related factors.

Results: Of 191 patients with MS, 127 (64%) returned to work after one year of diagnosis. The rate of returning to work was higher among younger patients, males and patients with the relapsing-remitting MS. Physical jobs, moderate level of neurological disability (EDSS >3) and severe fatigue were independently associated with unemployment.

Conclusion: Findings of our study showed that older age, female gender, having a physical job, neurological disability, and severe fatigue were associated with no return to work in MS patients. Due to the high prevalence of MS in young people at working age, facilitating employment, adjusting factors related to the work environment, and support of colleagues and supervisors can play an important role in reducing stress and improving the general condition of the disease in these patients.

Ethics Committee Approval

The study was approved by the Iran University of Medical Sciences Ethics Committee (protocol no: IR.IUMS.FMD.REC.1397.201, date: 20.11.2018).

Peer Review

Externally peer-reviewed.

Author Contributions

Surgical and Medical Practices: M.H.H., Concept: E.K-M., M.H.H., Design: E.K-M., Data Collection or Processing: R.S., S.K., Analysis or Interpretation: M.H., S.M., Literature Search: M.H., E.K-M., M.H.H., Writing: M.H., E.K-M.

Conflict of Interest

No conflict of interest was declared by the authors.

Financial Disclosure

The authors declared that this study received no financial support.