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Headache Medicine Connections

Article

Headache Medicine Connections

Year: 2021, Volume: 1, Issue: 2, Pages: 12-22

Original Article

Mask and Personal Protective Equipment (PPE) Associated Headache: A Cross-Sectional Study among the COVID-Time Physicians in Bangladesh

Received Date:28 November 2021, Accepted Date:05 December 2021, Published Date:14 December 2021

Abstract

We investigated the prevalence of mask/PPE associated headache among Bangladeshi physicians during COVID 19 pandemic along with the risk factors and headache characteristics. Headache severity was assessed by the Headache Impact Test (HIT-6). This is a cross-sectional, online Google form based study among 200 physicians from different hospitals in Dhaka conducted from December 2020 to April 2021. We compared characteristics of ‘mask associated headache’ and ‘no headache’ groups as well as of groups with and without previous headache. Independent factors associated with headache occurrence and severity were identified. Majority participants were male (129, 64.5%) with mean (SD) age of 35.4(7.5) years. Filter masks (146, 73%) were mostly used along with other PPE (139, 69.5%). Headache prevalence was 71% and 59.9% developed new onset headache. Doctors with a pre-existing primary headache disorder [OR: 5.40, 95% CI: 2.03-14.41; P=0.001] had the highest risk of developing headache. Headache occurrence was independently associated with working in the COVID unit [OR: 2.47, 95% CI: 1.18-5.18; P=0.017] and combined mask & other PPE usage [OR: 2.35, 95% CI: 1.13-4.84;P=0.021] for ≥ 6months [OR:2.06, 95%CI:1.05-3.99; P=0.036]. Most headaches were dull aching (33.8%), lasted for 1-4 hours (58.5%) & relieved within 1 hour of mask removal (43.6%). Headache Impact Test (HIT-6) score was substantial too severe among the doctors with previous headaches [OR: 2.91, 95%CI: 1.43-5.92; P=0.003] and those having moderate to severe stress levels [OR: 2.56, 95%CI: 1.19-5.55; P=0.017]. Most physicians with previous primary headache develop mask/PPE associated headache with considerable impacts on daily life.

Keywords: Headache, Mask, COVID­19, Doctors

References

  1. Guan Wj, Ni Zy, Hu Y, Liang Wh, Ou Cq, He Jx, et al. Clinical Characteristics of Coronavirus Disease 2019 in China. New England Journal of Medicine. 2020;382(18):1708–1720. Available from: https://dx.doi.org/10.1056/nejmoa2002032
  2. Mao L, Jin H, Wang M, Hu Y, Chen S, He Q, et al. Neurologic Manifestations of Hospitalized Patients With Coronavirus Disease 2019 in Wuhan, China. JAMA Neurology. 2020;77(6):683–690. Available from: https://dx.doi.org/10.1001/jamaneurol.2020.1127
  3. Hussain M, Begum T, Batul SA, Tui NN, Islam MN, Hussain B. Healthcare workers during the COVID-19 pandemic: Experiences of doctors and nurses in Bangladesh. International Journal of Health Planning and Management. 2021;36(31):174–181. Available from: https://doi.org/10.1002/hpm.3154
  4. Lim ECH, Ong BKC, Seet RCS. Headaches and the N95 face-mask amongst healthcare providers. Acta Neurologica Scandinavica. 2007;116(1):73. Available from: https://dx.doi.org/10.1111/j.1600-0404.2006.00788.x
  5. Ong JJY, Bharatendu C, Goh Y, Tang JZY, Sooi KWX, Tan YL, et al. Headaches Associated With Personal Protective Equipment – A Cross‐Sectional Study Among Frontline Healthcare Workers During COVID‐19. Headache: The Journal of Head and Face Pain. 2020;60(5):864–877. Available from: https://dx.doi.org/10.1111/head.13811
  6. Krymchantowski AV. Headaches Due to External Compression. Current Pain and Headache Reports. 2010;14(4):321–324. Available from: https://dx.doi.org/10.1007/s11916-010-0122-x
  7. Rahmani Z, Kochanek A, Astrup JJ, Poulsen JN, Gazerani P. Helmet-induced headache among Danish military personnel. Scandinavian Journal of Public Health. 2017;45(8):818–823. Available from: https://dx.doi.org/10.1177/1403494817731417
  8. Pestronk A, Pestronk S. Goggle migraine. N Engl J Med. 1983;308:226–227. Available from: https://doi.org/ 10.1056/nejm198301273080422
  9. Jacobson RI. More "goggle headache": supraorbital neuralgia. N Engl J Med. 1983;308:1363.
  10. O'brien JCJ. Swimmer's Headache, or Supraorbital Neuralgia. Baylor University Medical Center Proceedings. 2004;17(4):418–419.
  11. Krymchantowski A, Barbosa JS, Cvaigman M. Helmet-related, external compression headache among police officers in Rio de Janeiro. MedGenMed. 2004;6:45.
  12. Chew NWS, Lee GKH, Tan BYQ, Jing M, Goh Y, Ngiam NJH, et al. A multinational, multicentre study on the psychological outcomes and associated physical symptoms amongst healthcare workers during COVID-19 outbreak. Brain, Behavior, and Immunity. 2020;88:559–565. Available from: https://dx.doi.org/10.1016/j.bbi.2020.04.049
  13. Kosinski M, Bayliss MS, Bjorner JB. A six-item short-form survey for measuring headache impact: the HIT-6. Qual Life Res. 2003;12:963–974. Available from: https://doi.org/10.1023/a:1026119331193
  14. Ramirez-Moreno JM, Ceberino D, Plata AG, Rebollo B, Sedas PM, Hariramani R, et al. Mask-associated ‘de novo’ headache in healthcare workers during the COVID-19 pandemic. Occupational and Environmental Medicine. 2021;78(8):548–554. Available from: https://dx.doi.org/10.1136/oemed-2020-106956
  15. İpek S, Yurttutan S, Güllü UU, Dalkıran T, Acıpayam C, Doğaner A. Is N95 face mask linked to dizziness and headache? International Archives of Occupational and Environmental Health. 2021;94:1627–1636. Available from: https://doi.org/10.1007/s00420-021-01665-3
  16. ROBERGE RJ, COCA A, WILLIAMS WJ, PALMIERO AJ, POWELL JB. Surgical mask placement over N95 filtering facepiece respirators: Physiological effects on healthcare workers. Respirology. 2010;15(3):516–521. Available from: https://dx.doi.org/10.1111/j.1440-1843.2010.01713.x
  17. Wu S, Harber P, Yun D, Bansal S, Li Y, Santiago S. Anxiety During Respirator Use: Comparison of Two Respirator Types. Journal of Occupational and Environmental Hygiene. 2011;8(3):123–128. Available from: https://dx.doi.org/10.1080/15459624.2011.549780
  18. Elisheva R. Adverse Effects of Prolonged Mask Use among Healthcare Professionals during COVID-19. Journal of Infectious Diseases and Epidemiology. 2020;6(3):6–10. Available from: https://dx.doi.org/10.23937/2474-3658/1510130

Copyright

© 2021 Published by World Headache Society. This is an open-access article under the CC BY license (https://creativecommons.org/licenses/by/4.0/)

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