Financial and occupational burden of leg ulcers in an active Portuguese tertiary hospital population: absenteeism, unemployment and retirement

OBJECTIVE: The prevalence of leg ulcers (LUs) increases with age. Nevertheless, a significant number of working-age individuals are affected by hard-to-heal (chronic) wounds that last throughout their adult lives, impacting work capacity and leading to absenteeism, unemployment and subsequent financial burden. METHOD: A retrospective observational study was carried out between January 2022 and June 2024 at a Portuguese tertiary hospital, which included working-age patients living with LUs. Patients who were unemployed and retired for reasons other than LUs were excluded from the study. Clinical data on wound care and work activity were registered, and the Work Productivity and Activity Impairment questionnaire General Health version 2 (WPAI-GH) was applied. Results: A total of 24 patients were included, with a mean age of 53.6±11.0 years. LUs had a median evolution of six years (interquartile range: 3-20) and 19 (79%) patients had recurrent ulcers. A total of 11 (46%) patients were unemployed or had retired early due to their LUs. A reduction of monthly income after developing the ulcer was noted in 43.5% of patients. The median number of work days missed by employed patients in the previous year was 39 (interquartile range: 2.5-317.5); three patients were on leave for ≥1 year. CONCLUSION: LU was related to incapacity for work and loss of income in almost half of the study cohort. Longer duration of the ulcers, recurrence rates and work that required prolonged standing were positively associated with unemployment and retirement. By establishing earlier and more efficient treatment plans, clinicians can reduce duration of treatment and work incapacity in people with LUs.