Castro-Marrero, Jesús, Faro, Mónica, Zaragozá, María Cleofé et al. · BMC public health · 2019 · DOI
This Spanish study looked at 1,086 people with ME/CFS to understand why some are unable to work. Researchers found that more than half (58.6%) were unemployed due to illness. Several factors made work disability more likely, including severe fatigue and pain, autonomic problems (like dizziness or heart issues), neurological symptoms, depression, sleep problems, and having pain start at an older age.
Work disability profoundly impacts quality of life and financial security for ME/CFS patients. This study quantifies the scale of unemployment (nearly 60%) and identifies modifiable and non-modifiable factors that contribute to work loss, providing evidence to guide targeted workplace interventions and support policies.
This cross-sectional study cannot establish causation—it shows associations at a single time point but cannot determine whether severe symptoms cause work disability, whether unemployment worsens symptoms, or whether other unmeasured factors drive both outcomes. The findings are specific to a Spanish cohort and may not generalize to other populations with different healthcare systems or cultural work environments.
About the PEM badge: “PEM required” means post-exertional malaise was an explicit required diagnostic criterion for participant inclusion in this study — not that PEM was studied, observed, or discussed. Studies using criteria that do not require PEM (e.g. Fukuda, Oxford) are tagged “PEM not required”. How the atlas works →
The first block is for the primary paper and is the citation you should use in research work. The atlas-snapshot line only applies if you are specifically referring to this atlas’s reading of the paper on the date shown.
Primary citation
Castro-Marrero, Jesús, Faro, Mónica, Zaragozá, María Cleofé, Aliste, Luisa, de Sevilla, Tomás Fernández, & Alegre, José (2019). Unemployment and work disability in individuals with chronic fatigue syndrome/myalgic encephalomyelitis: a community-based cross-sectional study from Spain.. BMC public health. https://doi.org/10.1186/s12889-019-7225-z
BibTeX
@article{mecfsatlas-castro-marrero-2019-unemployment-work,
author = {Castro-Marrero, Jesús and Faro, Mónica and Zaragozá, María Cleofé and Aliste, Luisa and de Sevilla, Tomás Fernández and Alegre, José},
title = {Unemployment and work disability in individuals with chronic fatigue syndrome/myalgic encephalomyelitis: a community-based cross-sectional study from Spain.},
journal = {BMC public health},
year = {2019},
doi = {10.1186/s12889-019-7225-z},
note = {PubMed: 31253111},
url = {https://www.mecfsatlas.com/evidence/castro-marrero-2019-unemployment-work},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-26. https://www.mecfsatlas.com/evidence/castro-marrero-2019-unemployment-work
Contribute
Private, reviewed by a human. Not a public comment thread.