Analysis Highlights Occupational, Sex Differences Among Migraineurs

Results of a cross-sectional study using data from United Kingdom (UK) Biobank showed that migraine is gender-dependently associated with physically demanding jobs and shift work. Findings were published in The Journal of Headache and Pain.

Migraine predominantly affects women, and due to its highly debilitating symptoms, it has an important impact on individuals’ personal life and work productivity, the researchers explained.

Work-related stressors have been identified as one of the many modifiable risk factors associated with migraine onset. These can include heavy workloads, emotional stress, shift working, and sleep disturbances, while retirement has also been linked with a significant decrease in headache prevalence.

In an effort to investigate gender-specific associations between occupational categories and work-related features, investigators analyzed data from the UK Biobank cohort, an ongoing population-based initiative that began in 2006.

Using the “Job code at visit” variable, the researchers assessed migraine prevalence based on 9 subgroups, broken down further by “mainly walking or standing, whether it involves heavy manual or physical work, or whether it involves shift or night shift work,” they said.

A total of 413,297 controls and 2415 migraineurs—verified via a diagnosis listed on hospital registries—were included in the final analysis. In the cohort, migraine was more prevalent among women than men (3:1 ratio).

Data on occupational categories were available for 1569 migraineurs and 277,241 controls. The adjusted analyses revealed:

• In men, migraine appeared to be more prevalent in highly physically demanding occupations (prevalence ratio [PR], 1.38; 95% CI, 0.93-2.04)
• Migraine was more prevalent in jobs that frequently involve shift or night shift work compared with healthy controls
• This prevalence was especially high in women (shift work PR, 1.45; 95% CI, 1.14-1.83; night shift work PR, 1.46; 95% CI, 0.93-2.31)
• Higher prevalence of migraine was found among women with jobs characterized by frequent walking/standing (PR, 1.23; 95% CI, 1.02-1.48)
• Migraine appeared to be less prevalent among women moderately happy with their job (PR, 0.76; 95% CI, 0.52-1.12)

UK Biobank is characterized by older individuals, and migraine is more prevalent among people in their late 30s, marking a limitation to this analysis. In addition, the majority of Biobank participants are White and British, limiting generalizability of the findings.

“Not all the participants answered all the work-related questionnaires, and this forced us to perform analyses with different degrees of precision, due to the variation in sample sizes,” the researchers added. “For this reason, it was not always possible to detect clear differences among subgroups.”

Despite the study’s cross-sectional nature, the authors noted findings can be a powerful tool for policy makers to help improve work environments and workers’ health.

Overall, “study results support the assumption of gender-specific differences in work-related stressors associated to migraine,” they concluded.

Reference

Affatato O, Miguet M, Schiöth HB, Mwinyi J. Major sex differences in migraine prevalence among occupational categories: a cross-sectional study using UK biobank. J headache Pain. Published online December 4, 2021. doi:10.1186/s10194-021-01356-x