Epilepsy-related employment prevalence and retirement incidence in the German working population: 1994-2009

Epilepsy-related employment prevalence and retirement incidence were investigated in the German working population from 1994 to 2009. The overall mean prevalence of employment of people with epilepsy was 5.1 +/- 0.2 per 1000 workers. The employment rate among people with epilepsy increased from 63.5% in 1994 to 65.9% in 2000 (0.4% annually) and then more steeply from 66.8% in 2001 to 76.9% in 2009 (1.4% annually). A prominent increase in rate of employment of people with epilepsy since 2001 was temporarily associated with approval of leviteracetam in 2000 (P<0.001, OR = 8.3, CI = 6.45-10.12). The overall mean employment rate of people with epilepsy was lower than that of the general population (68.5% vs 90.1%, P<0.001). The overall mean incidence of epilepsy-related retirement (RI) during the study was 4.6 +/- 1.6/1000, similar to the RI for people with other illnesses (5.1 +/- 0.8/1000), and the risk of retiring because of epilepsy was not higher than that for other illnesses over the entire study period (P = 0.52, OR = 1.11, CI = 0.86-1.43). The RI among workers with epilepsy, however, sharply declined from 8.3/1000 in 1994 to 2.9/1000 in 2000 (- 65%, < 0.001), followed by a slight increase and stabilization at 3.9/1000 workers between 2001 and 2009. The decline in RI among people with epilepsy was temporarily associated with legislation of the Law on Support of Employment in 1996 (P = 0.032, OR = 2.15, CI = 1.17-2.89) and approval of lamotrigine in 1993 (P = 0.024, OR = 2.64, CI = 2.17-3.88). These patterns suggest that drug treatment and legislative laws may have led to increased employment and reduced retirement rates for people with epilepsy. (C) 2011 Elsevier Inc. All rights reserved.