Occup Environ Med 2006 May 12; (Read article online)

Huibers MJ, Leone SS, Kant I, Knottnerus JA

Objective Many chronic fatigue syndrome (CFS) patients are unemployed or unable to work, but most prognostic studies have failed to assess occupational outcomes in CFS. We aimed to assess whether CFS-like caseness (meeting the criteria for CFS) predicts work status in the long-term. Methods We conducted a prospective study in a sample of fatigued employees absent from work. Data were collected at baseline and four years later, and included CFS-like caseness and work status (inactive work status and full work incapacity). We used multiple logistic regression models to determine the association between CFS-like caseness and work status, controlling for potential confounders. Results CFS-like cases at baseline were three times more likely to be unable to work at follow-up than fatigued employees who did not meet CFS criteria at baseline (ORs between 3 and 3.3). These associations grew even stronger when we controlled for demographic and clinical confounders (ORs between 3.4 and 4.4). Conclusion A CFS-like status (compared to non-CFS fatigue) proved to be a strong predictor of an inactive work status and full work incapacity in the long-term. Since little is known about effective interventions that prevent absenteeism and work incapacity or facilitate return to work in subjects with chronic fatigue, there is a great need for powerful early interventions that restore or preserve the ability to work, especially for workers who meet criteria for CFS.