Major sex differences in migraine prevalence among occupational categories: a cross-sectional study using UK Biobank

DOI: https://doi.org/10.1186/s10194- 021- 01356- x

Abstract-Summary Gender-related differences regarding an association of migraine with important occupational characteristics has been hardly studied.

The current study scrutinizes gender-specific differences in the prevalence of migraine across a broad spectrum of occupational categories, shedding also light on associations with important job-related features such as shift work, job satisfaction, and physical activity.

Prevalence ratios of migraineurs compared to healthy controls among different occupational categories and job-related variables were estimated using log- binomial regression analyses.

We detected a differential prevalence pattern of migraine in relation to different

job categories between men and women.

In men, migraine appears to be more prevalent in highly physically demanding

occupations (PR 1.38, 95% CI [0.93, 2.04]).

Migraine is also more prevalent in jobs that frequently involve shift or night shift

work compared to healthy controls.

Our results show that migraine is genderdependently associated with physically

demanding jobs and shift working.

Extended: Our results show striking differences between men and women in the

prevalence of migraine dependent on occupational categories.

Introduction Among the modifiable risk factors, work-related stressors have recently been found to be associated with migraine onset [109].

In a prospective cohort study [110] it has been found that a high effort-reward imbalance among women employed in the public sector is associated with an increased risk of a new migraine onset.

Brief review of the literature it emerges that finding possible correlations between migraine pathogenesis and work-related issues is a complex process, since many interconnected factors may increase the risk for the development of this disorder.

This highlights the need for a more precise approach for studying the association between work-related risk factors, sex and migraine, to be able to clarify some diverging results in the literature [111].

The aim of this study is therefore to investigate the gender-specific association between occupational categories and work-related features such as physical activity involved, shift work, job satisfaction and migraine, using the large population-based UK Biobank cohort.

1.1

Epidemiology

37

Materials and Methods In order to investigate the prevalence of migraineurs among the various job catego- ries we used the “Job code at visit” variable, that broadly divides the participants into nine different subgroups, according to the Standard Occupational Classification (SOC2000): managers and senior officials, professional occupations, associate pro- fessional and technical occupations, administrative and secretarial occupations, skilled trades occupations, personal service occupations, sales and customer service occupations, process, plant and machine operatives and elementary occupations.

Covariates such as ethnic background, educational status, age, BMI and neuroti- cism are associated both with the exposure (job and job-related issues) and the outcome (migraine), therefore they were considered confounders.

We performed the calculations for PR and 95% CI using two models: (i) adjust- ing for sociodemographic confounders such as age, BMI, ethnic background (ii) as model (i) including education level and neuroticism as well [112].

In three cases it was not possible to perform the analysis for the first model: occupational category and heavy manual or physical work for women and shift work for men.

Results From the data we can see that migraineurs are slightly more prevalent in jobs that involve constant shift or night shift work, and this holds true especially for women. Migraine results to be more prevalent in men that are more often involved in heavy manual or physical work (fully adjusted PR 1.38, 95% CI [0.93, 2.04]) and in walking or standing (fully adjusted PR 1.41, 95% CI [1.02, 1.95]).

The same feature is shared by women, with higher prevalence of migraine among participants with jobs characterized by frequent walking/standing (fully adjusted PR 1.23, 95% CI [1.02, 1.48]).

Female migraineurs are more prevalent among jobs that involve shift work (fully

adjusted PR 1.45, 95% CI [1.14, 1.83]).

Migraine appears to be less prevalent among women moderately happy with

their job (fully adjusted PR 0.76, 95% CI [0.52, 1.12]).

Discussion While other studies focused only on a very particular work sector (e.g. health pro- fessionals) [110–113], we considered nine different job categories (according to SOC2000) as well as important job related features such as work-related physical activity, shift work and job satisfaction.

Stratifying by sex we were able to perform more precise analyses, highlighting sex-specific differences on the prevalence pattern of migraine among the various job-related features.

The analyses on the work-related physical activity show that frequent heavy manual physical work is related to higher prevalence of migraine among men, while for women there is no significant difference compared with the healthy controls.

Our analyses show that migraine is more prevalent in jobs characterized by fre-

quent shift and night shift work.

38

1 Public Health

This allowed us to give an estimation of the prevalence of migraine among dif-

ferent work-related groups, but not to assess risk or incidence.

Conclusion Previous studies showed how particular job-related features exert a differential impact on women and men in terms of migraine risk.

This research shows that migraine is more prevalent in physically demanding

occupations, especially in men.

Migraine is also more prevalent in jobs that involve frequently shift or night shift

work, and the prevalence is even higher in women.

Acknowledgement A machine generated summary based on the work of Affatato, Oreste; Miguet, Maud; Schiöth, Helgi B.; Mwinyi, Jessica. 2021  in The Journal of Headache and Pain.

1.2

Personal and Societal Burden

Machine generated keywords: child, migraine patient, adolescent, score, sleep, child adolescent, school, udh, measure, tth, hrqol, gbd, stress, hru, mida.

Migraine remains second among the world’s causes of disability, and first among young women: findings from GBD2019