"Headache yesterday" at work. Pilot study of headache impact in an active workforce

Risk factors for airplane headache: A multivariable logistic regression analysis in a population of career flight personnel

IntroductionAirplane headache (AH) is a lesser-known headache disorder that occurs during and is caused by air travel. Although considered rare and current prevalence figures vary widely, it potentially affects millions annually. Risk factors for AH have not yet been adequately investigated, and so the present study aimed to identify risk factors associated with AH among a large cohort of frequent flyers.MethodsWe conducted a survey using an extensive questionnaire that highlighted 30 potential risk factors for AH. We compared individuals experiencing AH with those without headaches and those with other types of headaches. Two multivariate logistic regression models were developed from risk variables and assessed using the area under the curve (AUC) of their receiver operating characteristics, with 10-fold cross-validation applied for reliability.ResultsIn total, 2237 questionnaires were analysed; 279 participants reported aircraft headache, while 1563 reported other forms of headache. Model selection resulted in two significant models: model 1, distinguishing AH from no headache, and model 2, differentiating AH from other headaches. Both models demonstrated promising accuracy, with AUC values of 0.794 and 0.595, respectively.ConclusionsAH notably affects productivity and workdays lost. The identified risk factors align with risk factors for headache in general, as well as headache at high altitudes. Interestingly, folic acid supplementation could have a positive, protective effect. Further research is warranted to explore these relationships and potential preventive strategies.

The epidemiology of airplane headache: A cross-sectional study on point prevalence and characteristics in 50,000 travelers

BACKGROUND

The current knowledge on the epidemiology and clinical manifestation of airplane headache is mostly derived from case series and small cohort studies without evidence from large populations.

METHODS

This cross-sectional study was conducted over a five-month period in the arrival area of two international airports in Germany. 50,000 disembarking passengers were addressed about headaches during their flight to determine headache prevalence, and those confirming and willing to participate underwent a structured interview.

RESULTS

Headache during travel was reported by 374 passengers (0.75%), and 301 underwent a structured interview. One hundred and one (0.2%) met the diagnostic criteria of airplane headache. Six passengers suffered from migraines and 134 from tension-type headaches. The differences in the age and gender distribution between the airplane headache and non-airplane headache groups were not statistically significant. The onset (79.2%), duration (82.2%), and location (73.3%) of airplane headache mostly complied with current diagnostic criteria but pain intensity (42.6%) and quality (42.6%) did less so.

CONCLUSION

Our data suggest a substantially lower prevalence of airplane headaches than previously reported. The pain intensity and quality seem less characteristic than assumed, suggesting a need to refine the current diagnostic criteria.

Indirect costs attributed to headache: A nation-wide survey of an active working population

BACKGROUND

The economic burden of headache in European countries is substantial, mostly related to indirect work-productivity loss costs, yet data for Portugal is scarce.

METHODS

An anonymous web-based survey of headache was distributed to a convenience sample of Portuguese companies' workforces, to assess last-year headache and "yesterday"-point prevalence. Preexisting headaches were classified into migraine and non-migraine headache and work impact (absenteeism and presenteeism) was evaluated in relation to point prevalence. If no significant selection biases were detected, projected work-loss costs for the whole country were to be calculated.

RESULTS

Eleven (17%) of 65 invited companies participated, around 15,000 active workers were exposed to the survey and 3624 (24.3%) responded, 73% females, 84.3% with previous ("last-year") headaches, 53% with migraine. Due to participation and gender bias, national cost-projections were not calculated. Workday point-prevalence was 21% (migraine) and 9% (non-migraine headache), resulting in 14 employees with migraine losing, on average, 4 h and 32 min of work time. Presenteeism occurred in 29% of migraine and 15% of NMH employees. Yearly cost of each employee with a headache disorder was €664.88.

DISCUSSION

Headache has a significant economic burden, as measured by work loss costs, in Portugal. Company-based interventions should aim to support employees' access to headache diagnosis and treatment, including non-pharmacological coping strategies, in order to reduce headache related economic costs.