Huibers, M J H, Leone, S S, Kant, I J et al. · Occupational and environmental medicine · 2006 · DOI
This study followed people on sick leave due to fatigue for four years to see whether those who met the clinical criteria for ME/CFS were more likely to remain unable to work. Researchers found that employees meeting CFS criteria at the start were about three times more likely to still be unable to work four years later compared to those with fatigue who didn't meet CFS criteria. This suggests that CFS-like illness is associated with longer-term work disability.
This study demonstrates that ME/CFS is associated with substantial, persistent work disability over a multi-year period—a finding critical for understanding the societal burden of disease and for motivating investment in early interventions. For patients, it validates the serious functional impact of ME/CFS and emphasizes the urgency of developing treatments that can prevent or reverse work incapacity early in the illness course.
This study does not prove that meeting CFS criteria causes work incapacity; it shows an association over time. The study does not test whether any specific intervention can prevent or reverse this outcome, nor does it clarify which biological or clinical features of CFS drive work disability. Correlation between CFS status and long-term work loss does not establish the mechanism or whether timely treatment could alter this trajectory.
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
Huibers, M J H, Leone, S S, Kant, I J, & Knottnerus, J A (2006). Chronic fatigue syndrome-like caseness as a predictor of work status in fatigued employees on sick leave: four year follow up study.. Occupational and environmental medicine. https://doi.org/10.1136/oem.2005.023176
BibTeX
@article{mecfsatlas-huibers-2006-chronic-fatigue,
author = {Huibers, M J H and Leone, S S and Kant, I J and Knottnerus, J A},
title = {Chronic fatigue syndrome-like caseness as a predictor of work status in fatigued employees on sick leave: four year follow up study.},
journal = {Occupational and environmental medicine},
year = {2006},
doi = {10.1136/oem.2005.023176},
note = {PubMed: 16698810},
url = {https://www.mecfsatlas.com/evidence/huibers-2006-chronic-fatigue},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-28. https://www.mecfsatlas.com/evidence/huibers-2006-chronic-fatigue
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