LAUSR

Background The mechanical stress due to strenuous professional activity cannot be easily quantified, yet it may lead to a wide range of musculoskeletal complaints. In ankylosing spondylitis (AS) patients mechanic stress may lead to the occurrence and the aggravation of enthesitis (1) and a profession involving an intense physical strain is correlated with the radiologic progression (2). While studies regarding the professional activities in ankylosing spondylitis patients are focused on the disease’s impact on the work capacity, the type of labor may also influence the disease progression (3). Objectives To assess the relationship between the professional activity in AS patients, disease activity and radiological changes. Methods We enrolled 193 patients with AS admitted in the Rheumatology Department of the “Sf. Apostol Andrei” Emergency Clinical County Hospital. Patient evaluation was performed by a rheumatologist. All the data obtained from the medical history, clinical examination, laboratory tests and imaging studies was recorded at the same date. Data regarding the professional history, type of labor involved was also recorded. The physical strain due to professional activity was done using the methodology established by the National Institute for Medical Expertise and Recovery of Work Capacity which takes into account the amount of energy used in order to perform certain tasks. Results We included 193 patients, mostly men, 171 men (81.9%), with a mean age of 47.94±12,04 years and a mean disease duration of 20.07±11.18 years. At the moment of the evaluation 49.7% were still employed and 50.3% were retired due to work disability. Most patients had a professional qualification (89.2%), and manual labor was identified in 132 (6.,4%) of the patients. In the study cohort the professional physical strain was mostly low (39.4%) and medium (50.8%). Manual laborers (77.3%) had an active disease, with a mean BASDAI of 5.67(p=0.006) and a mean ASDAS-PCR of 3.2±1.23, the high and very high disease activity (ASDAS-PCR>2.1) being registered in 86.1% of them (p<0.001). Manual workers had an important functional deficit (BASFI=6.32±2.41) (p=0,001). Regarding radiological features, manual laborers had stage IV sacroiliitis in 68.9%of the cases, 82.6% had syndesmophytes, which were generalised in 59.8% of the cases (p=0.005). A high professional physical strain correlates with active disease (BASDAI=6.22), with the presence of bridging syndesmophytes (81.8%, p=0.009), and generalized syndesmophytes (68.8%, p=0.007). Conclusion Manual labor, with strenuous physical activities correlates with high disease activity, severe functional impairment and radiological changes in AS patients. References [1] .Jacques, Peggy, et al. “Proof of concept: enthesitis and new bone formation in spondyloarthritis are driven by mechanical strain and stromal cells.” Annals of the rheumatic diseases73.2 (2014): 437-445. [2] Ramiro, Sofia, et al. “Lifestyle factors may modify the effect of disease activity on radiographic progression in patients with ankylosing spondylitis: a longitudinal analysis.” RMD open 1.1 (2015): e000153. [3] 3. Sirjita N. Elemente de expertiză medicală şi recuperarea capacităţii de muncă. Editura TipArg, 2004 pp 112-118 Disclosure of Interests None declared