Factors Associated with the Prevalence of External Compression Headache Attributed to Personal Protection Equipment Usage

Restu Susanti, Yuliarni Syafrita

Abstract


Personal protective equipment (PPE) in the COVID-19 pandemic era is essential for healthcare workers to decrease the risk of infection. The PPE, such as N95 masks and goggles, can trigger external-compression headache (ECH). This study aimed to determine the factors associated with the prevalence of ECH attributed to PPE usage. It was an analytic-observational study with a cross-sectional design conducted at Dr. M. Djamil Hospital Padang in May 2020. The subjects were healthcare workers (doctors and nurses) who used level 3 PPE for a minimum of 4 hours. The diagnosis of ECH was determined by the International Classification of Headache Disorders (ICHD) 3rd edition criteria. The Headache Screening Questionnaire (HSQ) determined the pre-existing primary headaches. The association between variables was analyzed using chi-square and Kruskal-Wallis tests. P-value<0.05 was considered statistically significant. A total of 113 healthcare workers participated in this study, consisting of 46 (40.7%) males and 67 (59.3%) females. The median age was 30 (23–46) years. ECH occurred in 102 (90.3%) respondents. Pre-existing primary headaches were present in 79 (69.9%) respondents, including migraine in 28 (23.6%) and tension-type headaches (TTH) in 46 (40.7%) respondents. The frontalis (69%) and temporalis (50.4%) were the most affected muscles. In this study, the significant factor associated with ECH was pre-existing primary headache (p=0.001, OR=7.795). There was a significant association between the pre-existing TTH (p=0.022) and ECH. There was a non-significant association between pre-existing migraine and ECH (p=0.284). In conclusion, the pre-existing primary headache was associated with the prevalence of ECH attributed to PPE usage.


Keywords


External-compression headache; PPE; primary headache

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References


Guan WJ, Ni ZY, Hu Y, Liang WH, Ou CQ, He JX, et al. Clinical characteristics of coronavirus disease 2019 in China. N Engl J Med. 2020;382(18):1708–20.

Zhu N, Zhang D, Wang W, Li X, Huang B, Song J, et al. A novel coronavirus from patients with pneumonia in China, 2019. N Engl J Med. 2020;382(8):727–33.

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. 2020;60(5):864–77.

Kementerian Kesehatan Republik Indonesia. Pedoman pencegahan dan pengendalian coronavirus disease (COVID-19). 5th revision. Jakarta: Kementerian Kesehatan Republik Indonesia; 2020.

Wong JEL, Leo YS, Tan CC. COVID-19 in Singapore—current experience: critical global issues that require attention and action. JAMA. 2020;323(13):1243–4.

Budianto P, Putra SE, Hafizhan M, Tyas FNI, Febrianty AF, Prabaningtyas HR, et al. Relationship between tension-type headache and quality of sleep, excessive daytime sleepiness, and fatigue syndrome among healthcare workers during COVID-19. GMHC. 2021;9(3):185–92.

Headache Classification Committee of the International Headache Society (IHS). The International Classification of Headache Disorders, 3rd edition. Cephalalgia. 2018;38(1):1–211.

Lim ECH, Seet RCS, Lee KH, Wilder-Smith EPV, Chuah BYS, Ong BKC. Headaches and the N95 face-mask amongst healthcare providers. Acta Neurol Scand. 2006;113(3):199–202.

Ramirez-Moreno JM, Ceberino D, Gonzalez Plata A, Rebollo B, Macias Sedas P, Hariramani R, et al. Mask-associated 'de novo' headache in healthcare workers during the COVID-19 pandemic. Occup Environ Med. 2020;78(8):548–54.

Hajjij A, Aasfara J, Khalis M, Ouhabi H, Benariba F Jr, El Kettani C. Personal protective equipment and headaches: cross-sectional study among Moroccan healthcare workers during COVID-19 pandemic. Cureus. 2020;12(12):e12047.

Köseoğlu Toksoy C, Demirbaş H, Bozkurt E, Acar H, Türk Börü Ü. Headache related to mask use of healthcare workers in COVID-19 pandemic. Korean J Pain. 2021;34(2):241–5.

Zaheer R, Khan M, Tanveer A, Farooq A, Khurshid Z. Association of personal protective equipment with de novo headaches in frontline healthcare workers during COVID-19 pandemic: a cross-sectional study. Eur J Dent. 2020;14(S 01):S79–85.

Rapisarda L, Trimboli M, Fortunato F, De Martino A, Marsico O, Demonte G, et al. Facemask headache: a new nosographic entity among healthcare providers in COVID-19 era. Neurol Sci. 2021;42(4):1267–76.

Rebmann T, Carrico R, Wang J. Physiologic and other effects and compliance with long-term respirator use among medical intensive care unit nurses. Am J Infect Control. 2013;41(12):1218–23.

Shenal BV, Radonovich LJ Jr, Cheng J, Hodgson M, Bender BS. Discomfort and exertion associated with prolonged wear of respiratory protection in a health care setting. J Occup Environ Hyg. 2012;9(1):59–64.

Kolding LT, Do TP, Ewertsen C, Schytz HW. Muscle stiffness in tension-type headache patients with pericranial tenderness: a shear wave elastography study. Cephalalgia Rep. 2018;1:1–6.

Aaseth K, Grande RB, Lundqvist C, Russell MB. Pericranial tenderness in chronic tension-type headache: the Akershus population-based study of chronic headache. J Headache Pain. 2014;15(1):58.

Garcia Godoy LR, Jones AE, Anderson TN, Fisher CL, Seeley KML, Beeson EA, et al. Facial protection for healthcare workers during pandemics: a scoping review. BMJ Glob Health. 2020;5(5):e002553.

Szeinuk J, Beckett WS, Clark N, Hailoo WL. Medical evaluation for respirator use. Am J Ind Med. 2000;37(1):142–57.

Radonovich LJ Jr, Cheng J, Shenal BV, Hodgson M, Bender BS. Respirator tolerance in health care workers. JAMA. 2009;301(1):36–8.

Krymchantowski AV. Headaches due to external compression. Curr Pain Headache Rep. 2010;14(4):321–4.

Krymchantowski A, Barbosa JS, Cvaigman M, Lorenzatto W, Silva MT. Helmet-related, external compression headache among police officers in Rio de Janeiro. MedGenMed. 2004;6(2):45.

Ong JJY, Chan ACY, Bharatendu C, Teoh HL, Chan YC, Sharma VK. Headache related to PPE use during the COVID-19 pandemic. Curr Pain Headache Rep. 2021;25(8):53.

Goadsby PJ, Holland PR, Martins-Oliveira M, Hoffmann J, Schankin C, Akerman S. Pathophysiology of migraine: a disorder of sensory processing. Physiol Rev. 2017;97(2):553–622.

Blake P, Burstein R. Emerging evidence of occipital nerve compression in unremitting head and neck pain. J Headache Pain. 2019:20(1);76.

Or PP, Chung JW, Wong TK. A study of environmental factors affecting nurses’ comfort and protection in wearing N95 respirators during bedside procedures. J Clin Nurs. 2018;27(7–8):e147784.




DOI: https://doi.org/10.29313/gmhc.v10i1.8380

pISSN 2301-9123 | eISSN 2460-5441


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