I'm afraid I'll hurt the guys I work with," a 52-year-old patient recently told Dr. Michele Meltzer, a rheumatologist in the Philadelphia area. His weak, swollen, stiff knuckles were causing him to lose control over lifting and directing large loads on and off forklifts. A few times he lost sensation in his fingers and thought he was going to drop the loads on a co-worker. He just couldn't control his grip. And he was so tired.

Meltzer's patient has rheumatic arthritis, one of over 100 types of arthritis.

Arthritis in general affects one in seven people nationally, costing Americans about $64.8 billion in medical costs. Arthritis is also responsible for 427 million days of restricted activity, 156 million days in bed, and 45 million days lost from work each year, according to the Arthritis Foundation. Seventy-nine percent of arthritis sufferers are over age 45. But it's not just a disease concerning the aging workforce. Approximately 285,000 children and 8.4 million Americans age 17-44 are affected by arthritis, according to the foundation. Arthritis affects more women than men. Of the over 125 million workers in the US., 1.7 million reported activity limitations due to arthritis, according to the Census Bureau.

The most common type is osteoarthritis, which occurs from worn-out joints. It's possible that everyone over age 60 has it to some degree, but few have it bad enough to notice symptoms, according to the foundation. Besides pain, osteoarthritis can make the muscles around the affected joint weak, causing problems with balance and coordination. These symptoms are generally felt daily.

However, auto-immune types of arthritis, such as the rheumatoid arthritis that Meltzer's patient has, fibromyalgia, and systemic lupus erythematosus (lupus), which affect over 5.9 million Americans, can flare-up overnight, inflaming hand joints and making it near impossible for workers to grip tools or even move their fingers. Besides joint pain and stiffness, rheumatic arthritis' sufferers can experience extreme fatigue, making it difficult for them to concentrate on work, let alone working safely.

Mentally, arthritis sufferers lose confidence that they can control their own body, and sometimes feel like an outcast. One of the biggest problems is that arthritis sufferers don't look sick, but can be weak, tired and unable to perform everyday job duties. This causes problems with co-workers and bosses who may feel the employee is lazy and not carrying their own weight, says Meltzer. To exacerbate the problem, some arthritis sufferers fear getting fired or held back from promotions if they reveal their disability. Arthritis isn't covered by workers' comp and it's difficult to prove arthritis is truly disabling and receive coverage under disability insurance, says Meltzer. She's had patients come in who can't buy food, but can't work because of their disability.

With the prevalence of the disease, it's likely someone in your workplace suffers from arthritis. Considering its mental and physical affects, one person could unknowingly disrupt your carefully planned safety process. But with some education and a few adjustments to the work environment, an arthritis sufferer can work productively and safely, says Meltzer. Sure, many people with arthritis already work safely-those who go for treatment and understand their limitations. Joe Wilson, who says he is an arthritis "victim," finds work tiring but manages duties safely, he says. When he has trouble lifting packages of paper at the print shop he runs, he asks his assistant for help. He has yet to have an accident.

But problems with arthritis and safety occur when someone is trying to hide it, or is afraid to ask for help, says Meltzer. There are times Wilson doesn't want to talk about his disability. It makes him feel vulnerable. A package delivery service-worker he once asked for help carrying a load responded by asking him why he couldn't carry it himself. "An old football injury," he answered.

There's no cure in sight, and the numbers are growing. By the year 2020, the Arthritis Foundation predicts the prevalence of arthritis to increase 57 percent, to 59.4 million Americans.

Assuring safe work practices

So how can you assure those with arthritis at your worksite are working safely?

The key is to make sure the employee's disease has been diagnosed by a doctor, so they know how their specific type of arthritis will affect their work situation, says Teresa J. Brady, a medical advisor for The Arthritis Foundation. For example, someone with fibromyalgia experiences problems with sleep deprivation, so a rotating shift is not in their best interest. Brady suggests one of the easiest ways to find this kind of information is to contact The Arthritis Foundation. The foundation can supply anything from pamphlets on symptoms and social security benefits to support groups, or even an instructor for an arthritis training course at your worksite (call 1-800-283-7800 or contact www.arthritis.org).

Once the employee has been diagnosed, remedies are similar to ergonomic solutions. In fact, bursitis and tendonitis, two repetitive motion disorders, are types of arthritis, says Brady.

Do a risk assessment: What are the activities that strain the joint? Does the employee have adequate control over his finger and wrist joints to handle the job? Can he turn knobs on a control panel easily? Can he grip a tool? Sometimes there are simple answers to such problems: foam padding on a tool can help a person's grip. Brady even suggests felt-tip pens that write more easily than ball-point pens for any employee doing extensive writing. ·

  • Offer the employee light duty or more flexible or part-time hours, or allow them to work at home more, if that's possible. Often, an arthritis sufferer can work safely for six hours, but after that becomes too tired to concentrate, says Meltzer. ·
  • Encourage the employee to follow the doctors orders. Arthritis can be managed with the right medication and exercise, says Brady. ·
  • Working safely can be difficult when you're tired or preoccupied and uncomfortable in your environment. Overcome the psychological problems associated with arthritis in the workplace by encouraging the employee to be open about his disability. A free and open discussion, where the arthritis sufferer can explain why he goes home early or zones out in the middle of the day, and where his co-workers can ask questions about the disease, can help everyone involved feel they belong, says Meltzer.

Most of Meltzer's patients want to work hard and work safely. That's possible, but not always easy, she says.

"Having arthritis is like being a prisoner in your own body," says Wilson.