Epilepsy at Work: Evaluating the Cost of Epilepsy in the Workplace

Abstract

EVIDENCE THAT EPILEPSY AFFECTS PEOPLE'S ABILITY TO WORKMost people with epilepsy indicate that their employment has been affected in some way by epilepsy. Surveys of the problems they encounter in daily life frequently reveal that people with epilepsy have difficulties getting jobs and endure a broad range of difficulties while at work (1,2). Over the past 30 years, many studies in the U.K. have investigated these difficulties by comparing the employment prospects of people with epilepsy with those of the general population. These studies highlighted a wide variety of problems that can be faced.Initial studies by Gordon and Russell (1958) (3) and Crombie et al. (1960) (4) revealed that people with epilepsy were less likely to be employed, and 540% of those of employable age reported serious difficulties with employment at some time. More recently, Scambler and Hopkins (1980) (5) showed excess unemployment rates for people with epilepsy, and Elwes et al. (6) demonstrated that in an area of England with a high unemployment rate, 48% of people with epilepsy who were potentially economically active were unemployed compared with 19% of age-and sex-matched individuals from the general population. Jacoby (1995) (7) noted that where seizures were well controlled and uncomplicated by other handicaps, people with epilepsy, in general, do not experience problems with employment. In a large community-based study of patients in a region of north England, she concluded that people with epilepsy are at a higher risk of unemployment and also of underemployment. In this study, 22% of men and 23% of women with epilepsy who were potentially economically active were unemployed. This compared with 12 and 8% in the general population, respectively (8). In this study it also was demonstrated that people with epilepsy are more likely to be employed in unskilled and manual occupations.From these studies and others, it is seen that the ability of people with epilepsy to work may be affected in sev-

Quality of life and the self-perception impact of epilepsy in three different epilepsy types

“…Rates of unemployment have consistently been found to be higher among individuals with more frequent seizures. 5,16,26 Finally, fear of employer and discrimination or stigmatization at work appears to significantly influence the employment situation. 3 The association of QOLIE-31 domains with epilepsy syndromes showed a statistically significance only in the Cognition Domain.…”

Medical and employment-related costs of epilepsy in the USA

“…While it has been well documented that individuals with epilepsy are more likely to be unemployed or underemployed than their peers [9], little information exists in the literature on the impact of both short-and long-term disability in terms of costs. While this study is an important step in examining the impact of epilepsy on employment, its assessment is limited by the dataset used.…”

The socioeconomic, cultural, and emotional implications of starting or withholding treatment in a patient with a first seizure

“…Individuals may find that their roles are reconsidered by employers if they are engaged in posts that involve exposure to physical risk, for example, working with firearms, machinery, or heights. Although in most developed countries, legislation exists to protect individuals with disabilities such as epilepsy in the workplace, in reality individuals often report that their role in the workplace is reevaluated because of seizures, and in some cases they may feel their position is more vulnerable (Heaney, 1999).…”