Chronic headache disorders as a threat to brain health among employees of a city office in the Tokyo metropolitan area

Chronic headache disorders, especially migraine, are known to cause considerable loss of productivity and negatively affect brain health in the workplace. The present study aims to clarify how common chronic headache disorders are and how much productivity loss they are causing within administrative bodies. An intranet-based headache survey was conducted with employees of a city office located in the Tokyo metropolitan area. Headache classification among participants was made according to the ICHD-3 criteria. Headache days, headache intensity, headache-related disability, and productivity loss were analyzed in each headache group. We also explored what factors were linked to the likelihood of seeking medical care for headache. The response rate was 52.3%, with 1156 men and 764 women. Among individuals who had chronic headache during the 12 months preceding the survey, 116, 95, 93, and 214 had migraine without aura (MO), probable MO (pMO), migraine with aura (MA), and tension-type headache (TTH) as their most severe and distressing headache, respectively (6.0%, 4.9%, 4.8%, and 11.1%, respectively). MO, pMO, and MA were found to have more severe impact on daily activities and work productivity than TTH. Migraine-related presenteeism was proportional to headache frequency and intensity. A total of 63.1% of those who had active chronic headache had never sought care for their headaches, and only 10.4% of them were consulting a healthcare professional. The consultation rate was lower among younger headache sufferers. Migraine features, such as vomiting, photophobia, and worsening by physical activity, were associated with seeking medical care. The annual estimated wage loss due to headache was highest in the MO group, totaling 39,202,191.2 JPY (267,463.9 USD) per year, 81.6% of which was derived from presenteeism. It was estimated that active chronic headache disorders were responsible for 8.6% of the total wage. Many individuals with chronic headache disorders are underdiagnosed and undertreated within administrative bodies. Compared with TTH, migraine compromises brain health more severely and generates more economic loss. Our data imply that chronic headache disorders, particularly migraine, may lower the quality of public service.