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Headache-related work absences have a considerable socio-economic effect says specialist study

Eight out of ten people who took part in a study carried out by a specialist headache centre felt they were much less effective at work and 91 per cent said they felt hampered by headaches on a daily basis, according to the March issue of Cephalalgia.

“Migraines and tension-type headaches are much more common in people’s forties, when they are often at their most productive, so the socio-economic implications of this chronic disease are considerable” says Gabrielle Vinding from the Danish Headache Centre at the University of Copenhagen.

But it’s not just people who consult specialist services that add to the economic burden, she says. European and American studies suggest that as many as 18 per cent of people suffer lifetime migraines. And the lifetime prevalence of tension-type headaches in Denmark is thought to be as high as 78 per cent.

“In Denmark the total cost of all headache disorders is approximately €74 million per million inhabitants per year” she points out.

“Previous studies have suggested that up to 37 per cent of Danish people have tension type headaches several times a month, 10 per cent have them weekly and up to three per cent have chronic headaches for more than 15 days a month, for most of their life."

55 people took part in the study, which included a structured interview, headache diary and self-administered questionnaire. The survey was carried out over a one-month period and focussed on outpatients paying their first or second visit to the clinic, which has an intake of about 1,000 patients a year.

The participants ranged in age from 20 to 78, with an average age of 41. Median headache frequency in the 30-day period before interview was 15 days and the headache intensity was two on a scale of zero to three.

Headache-related work absences in the previous year ranged from zero to 365 days, with an average of 57 days and a median of 12 days.

Just under one in five patients had been absent from work for more than 60 days because of headaches and 10 per cent had been absent for a full year.

Headaches had also had a profound effect on their lives. 29 per cent had changed their place of work because of their headaches, 46 per cent had ruled out particular jobs and 40 per cent said it restricted their career.

58 per cent said they were dependent on their family and friends and nine per cent had decided not to have any more children.

The survey used the same questions as research carried out in Denmark in 2001 on a cross-section of the general public. That found that nearly a third of people had consulted their family doctor because of a headache and three percent had been hospitalised because of headache.

“Although the general population results are predictably lower than our specialist sample, the figures do indicate that headaches can have quite an impact on the work environment” says Vinding.

“For example, 90 per cent of our employed study subjects had been absent from work in the last year because of a headache, but the figure for the general population was still 12 per cent.

“Severe and frequent headache is costly, both in terms of direct and indirect costs” concludes Vinding. “The socio-economic effects are particularly felt in healthcare services, sick leave and effectiveness in the workplace.

“And people suffering from chronic headache also report significant limitations when it comes to work, family and leisure activities.

“Prevention, early intervention and effective headache strategies for headache disorders may therefore be highly cost-effective, both for the individual and society.“

Annette Whibley | alfa
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