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      The Impact of Self-Reported Recurrent Headache on Absenteeism and Presenteeism at Work Among Finnish Municipal Female Employees

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          The aim of this cross-sectional, observational study was to determine the impact of self-reported headache on absenteeism and presenteeism in a female working-age population.

          Subjects and Methods

          The study population consisted of 594 Finnish female municipal employees, who answered self-administered questionnaires including sociodemographic, lifestyle, health, and work-related data. Sickness absence days were obtained from the official records of the employer. Headache recurrence was defined by asking whether headache was occasional or recurrent. Headache impact was measured by the HIT-6.


          In our study, 456 (77%) females had headache, and headache was recurrent in 178 (39%). The self-reported recurrence of headache was related to age, AUDIT-C, health-rated quality-of-life, self-rated work ability, depressive symptoms, and work stress ( P for linearity <0.001). They also had more depressive symptoms and work stress ( P for linearity <0.001). Mental work load was highest in those with recurrent headache ( P=0.042), and work engagement was highest in those without headache ( P=0.038). There was no statistically significant difference in absenteeism days between the headache groups when adjusted with confounding variables. Presenteeism was associated with the recurrence of headache ( P for linearity <0.001). Presenteeism and the HIT-6 score were significantly associated in the recurrent headache group ( P=0.009).


          Headache was not related to absenteeism, but the self-reported recurrence of headache was clearly associated with presenteeism in this female working-age population.

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          Most cited references 27

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          The global burden of headache: a documentation of headache prevalence and disability worldwide.

          This study, which is a part of the initiative 'Lifting The Burden: The Global Campaign to Reduce the Burden of Headache Worldwide', assesses and presents all existing evidence of the world prevalence and burden of headache disorders. Population-based studies applying International Headache Society criteria for migraine and tension-type headache, and also studies on headache in general and 'chronic daily headache', have been included. Globally, the percentages of the adult population with an active headache disorder are 46% for headache in general, 11% for migraine, 42% for tension-type headache and 3% for chronic daily headache. Our calculations indicate that the disability attributable to tension-type headache is larger worldwide than that due to migraine. On the World Health Organization's ranking of causes of disability, this would bring headache disorders into the 10 most disabling conditions for the two genders, and into the five most disabling for women.
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            A six-item short-form survey for measuring headache impact: the HIT-6.

            Migraine and other severe headaches can cause suffering and reduce functioning and productivity. Patients are the best source of information about such impact. To develop a new short form (HIT-6) for assessing the impact of headaches that has broad content coverage but is brief as well as reliable and valid enough to use in screening and monitoring patients in clinical research and practice. HIT-6 items were selected from an existing item pool of 54 items and from 35 items suggested by clinicians. Items were selected and modified based on content validity, item response theory (IRT) information functions, item internal consistency, distributions of scores, clinical validity, and linguistic analyses. The HIT-6 was evaluated in an Internet-based survey of headache sufferers (n = 1103) who were members of America Online (AOL). After 14 days, 540 participated in a follow-up survey. HIT-6 covers six content categories represented in widely used surveys of headache impact. Internal consistency, alternate forms, and test-retest reliability estimates of HIT-6 were 0.89, 0.90, and 0.80, respectively. Individual patient score confidence intervals (95%) of app. +/-5 were observed for 88% of all respondents. In tests of validity in discriminating across diagnostic and headache severity groups, relative validity (RV) coefficients of 0.82 and 1.00 were observed for HIT-6, in comparison with the Total Score. Patient-level classifications based in HIT-6 were accurate 88.7% of the time at the recommended cut-off score for a probability of migraine diagnosis. HIT-6 was responsive to self-reported changes in headache impact. The IRT model estimated for a 'pool' of items from widely used measures of headache impact was useful in constructing an efficient, reliable, and valid 'static' short form (HIT-6) for use in screening and monitoring patient outcomes.
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              The cost of headache disorders in Europe: the Eurolight project.

              Headache disorders are very common, but their monetary costs in Europe are unknown. We performed the first comprehensive estimation of how economic resources are lost to headache in Europe.   From November 2008 to August 2009, a cross-sectional survey was conducted in eight countries representing 55% of the adult EU population. Participation rates varied between 11% and 59%. In total, 8412 questionnaires contributed to this analysis. Using bottom-up methodology, we estimated direct (medications, outpatient health care, hospitalization and investigations) and indirect (work absenteeism and reduced productivity at work) annual per-person costs. Prevalence data, simultaneously collected and, for migraine, also derived from a systematic review, were used to impute national costs.   Mean per-person annual costs were €1222 for migraine (95% CI 1055-1389; indirect costs 93%), €303 for tension-type headache (TTH, 95% CI 230-376; indirect costs 92%), €3561 for medication-overuse headache (MOH, 95% CI 2487-4635; indirect costs 92%), and €253 for other headaches (95% CI 99-407; indirect costs 82%). In the EU, the total annual cost of headache amongst adults aged 18-65 years was calculated, according to our prevalence estimates, at €173 billion, apportioned to migraine (€111 billion; 64%), TTH (€21 billion; 12%), MOH (€37 billion; 21%) and other headaches (€3 billion; 2%). Using the 15% systematic review prevalence of migraine, calculated costs were somewhat lower (migraine €50 billion, all headache €112 billion annually).   Headache disorders are prominent health-related drivers of immense economic losses for the EU. This has immediate implications for healthcare policy. Health care for headache can be both improved and cost saving. © 2011 The Author(s). European Journal of Neurology © 2011 EFNS.

                Author and article information

                J Pain Res
                J Pain Res
                Journal of Pain Research
                21 August 2020
                : 13
                : 2135-2142
                [1 ]Department of Clinical Neurosciences, University of Turku , Turku, Finland
                [2 ]Department of General Practice, University of Turku and Turku University Hospital , Turku, Finland
                [3 ]Unit of Primary Health Care, Kuopio University Hospital , Kuopio, Finland
                [4 ]Department of Clinical Neurosciences, University of Turku and Turku University Hospital , Turku, Finland
                [5 ]Mutual Insurance Company Ilmarinen , Helsinki, Finland
                Author notes
                Correspondence: Kirsi Malmberg-Ceder Email kirmal@utu.fi
                © 2020 Malmberg-Ceder et al.

                This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License ( http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms ( https://www.dovepress.com/terms.php).

                Page count
                Figures: 1, Tables: 5, References: 41, Pages: 8
                Original Research


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