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Chronic Fatigue Syndrome May Mean Job Loss
Study Finds Half of Subjects with Chronic Fatigue Syndrome Became Unemployed
BOSTON--July 23, 1998--People with chronic fatigue syndrome (CFS) may lose their jobs as a direct result of their condition, according to a study by a Harvard Medical School researcher.
Their symptoms, such as persistent fatigue, headaches, joint and muscle pain, fever, cognitive difficulty, and depression prevent a high proportion of CFS sufferers from working, the study indicates. The findings appear in the July/August issue of Psychosomatic Medicine. A 1997 four-city study by the Centers for Disease Control found that the prevalence of CFS ranges from 4.0 to 8.7 per 100,000.
"The people's impairments may keep them from getting to work. And if they get there, their symptoms may compromise their ability to work," says Norma Ware, the study author and assistant professor of medical anthropology in Harvard Medical School's Department of Social Medicine. Getting to work in the morning can be a challenge because joint pains may prohibit those with CFS from grasping a steering wheel, or they might fall asleep en route. Once they reach the workplace, their symptoms may compromise their ability to think, listen, speak, write, and perform physical tasks.
The study examines the "role constriction" caused by CFS in 66 New Englanders from ages 27 to 72, most of whom had been ill for more than five years. Of the 66 subjects, 50 had held jobs at the onset of their illness, but when Ware interviewed them, 25 had become unemployed. "Role constriction works to push chronically ill persons out of the work force and away from the social mainstream," she writes.
The 25 who had lost their jobs attributed the loss to CFS, which has no known cause, though past studies have pointed to immune deficiency, viral infection, and psychiatric linkages.
The 25 subjects who were still employed had devised ways to resist role constriction by hiding or working around their condition. "They find different strategies to compensate for their deficiencies, for example, a nurse might move into a desk job," says Ware.
Some of these working subjects strive to appear well by dressing up and wearing extra make-up. They might avoid office events that could reveal their impairments. Some conserve energy for their jobs by using free time to rest, time that otherwise would be dedicated to family and friends. Others, like the nurse, work less, doing easier tasks and eliminating business travel.
The best solution to balancing work and CFS, suggests Ware, is for businesses to create a flexible schedule that allows people to take breaks, arrange the order of their tasks, and work from home when necessary.
"A big problem is being able to say, 'I'll be functional from 9 to 5.' Instead, they need a more flexible schedule so they can work when they feel able," says Ware.
The study was funded by the National Institute of Allergy and Infectious Diseases.