Women workers and managers more prone to headaches

In a study by Norway’s National Institute of Occupational Health, a range of occupational psychological, social, and mechanical factors were identified as predictors of headache severity. The study showed that seven out of 16 psychological, social and mechanical factors had a particular impact. Role conflict in an employee’s work life, lack of control over work, and job dissatisfaction were most commonly associated with the occurrence of a severe headache.


Headache is a very common health problem. The worldwide point prevalence of headache, regardless of type, has been estimated to be as high as 46% in the general adult population (Stovner et al, 2007).

Most previous studies on the effects of psychological and social factors on health have investigated a rather small number of exposure factors – mainly looking at the demands of a job, the amount of control a worker has over the job, and the and support they receive. The results of these studies have been conflicting.

While some studies (Mäki et al, 2008; Kopec and Sayre, 2004) found no association between job control, job demands and job strain with headache, a large French panel study (Sjösten et al, 2011) found a marked decline in headache prevalence after retirement. This was especially strong for those whose ‘work stress’ was high – those with demanding jobs, very physical work, and who had low job satisfaction.

The aim of a current study (Christensen and Knardahl, 2012) was to examine a broad set of psychological, social and mechanical factors as predictors of headache.

About the survey

The latest study was part of the research project ‘The new workplace: Work, health, and participation in the new work life’. Data were obtained by work environment surveys in a variety of organisations in Norway, with a two-year follow up period. Respondents were recruited from 34 organisations – 16 private and 18 public – representing a wide variety of job types.

The questionnaire included questions on background, work organisation, psychological and social factors at work, organisational change, attitudes towards work, personality, physical activity, smoking, alcohol use, mental health, mastery of work, working ability, and health complaints. Questions about physical work – in the form of heavy lifting – and frequency of working with hands raised above shoulder height were also answered. Previous studies had shown such factors to be important where workers suffered shoulder and neck pain.

Baseline data, to which 6,421 of the invited employees contributed, were gathered from November 2004 to May 2008. The follow-up data, to which 3,574 of the invited employees also contributed, were gathered from September 2006 to May 2010. All variables were measured at both time points, and analyses were performed both cross-sectionally as well as prospectively.

Key findings and discussion

The survey found that 48.7% of workers reported that they had experienced headaches at some time during the previous four weeks. While lower levels of headache severity were associated with older respondents, higher headache severity had a strong association with female respondents. Headache severity was also seen to be related to job type, with legislators, senior officials and managers most affected.

Ordinal logistic regression models also revealed that seven of 16 psychological and social factors investigated were prospectively related to headache severity, but there was no relationship with mechanical factors.

The following work factors were most consistently related to more severe headaches: higher quantitative demands and role conflict; lower decision control; control over work intensity; and job satisfaction. Decision control, control over work intensity, and job satisfaction were shown to have an impact on headache severity across a two-year period, while the reverse seems to be indicated for quantitative demands.

Although no cross-lagged effects for role conflict were observed, synchronous models supported the possibility of an effect of each of these factors on headache severity over a time span shorter than two years.

At the same time, this study indicates that some psychological and social factors are related to headache severity analyses, while synchronous models suggest that the association between psychological and social factors and headache is not merely due to adverse health influencing work or working conditions reported by respondents.


Stovner, L. J., Hagen, K., Jensen R., Katsarava, Z., Lipton, R. B., Scher, A. I. et al (2007), ‘The global burden of headache: a documentation of headache prevalence and disability worldwide’, Cephalalgia: an international journal of headache, Vol. 27, No. 3, 2007, pp. 193–210.

Mäki, K., Vahtera, J., Virtanen, M., Elovainio, M., Keltikangas-Järvinen, L. and Kivimäki, M. (2008), ‘Work stress and new-onset migraine in a female employee population’, Cephalalgia: an international journal of headache, Vol. 28, No. 1, 2008, pp. 18–25.

Kopec, J. A. and Sayre, E. C. (2004), ‘Work-related psychosocial factors and chronic pain: a prospective cohort study in Canadian workers’, Journal of Occupational and Environmental Medicine, Vol. 46, No. 12, 2004, pp. 1263–71.

Sjösten, N., Nabi, H., Westerlund, H., Singh-Manoux, A., Dartigues, J. F., Goldberg, M., et al (2011), ‘Influence of retirement and work stress on headache prevalence. A longitudinal modelling study from the GAZEL Cohort Study’, Cephalalgia: an international journal of headache, Vol. 31, No. 6, 2011, pp. 696–705.

Christensen, J. O. and Knardahl, S. (2012), ‘Work and headache: A prospective study of psychological, social, and mechanical predictors of headache severity’, Pain, Vol. 153, No. 10, 2012, pp. 2119–2132.

Bjørn Tore Langeland, National Institute of Occupational Health

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