Creating migraine-friendly workplaces

Neurological and mental illnesses affect over 30 % of the population in Europe and represent an urgent health problem. The "Swiss Brain Health Plan" initiative was therefore recently launched to address this challenge and develop targeted measures to improve the brain health of the Swiss population 1. It is also supported at the political level.

One million people affected

Migraine is one of the main causes of illness-related disability in Switzerland. It affects over one million Swiss people, many of whom are of working age 2. Migraines are characterized by recurring, severe headache attacks accompanied by nausea, vomiting, sensitivity to light and noise and a strong need to withdraw. This is accompanied by concentration disorders, fatigue and drive problems, which also reduce performance. Attacks are often triggered or exacerbated by external environmental stimuli such as strong light, noise or heat, or internal circumstances such as stress, hormonal fluctuations or sleep disorders. Attacks can last from hours to days. In some cases, they are preceded by temporary neurological symptoms such as visual disturbances, known as an "aura". It is usually not possible to continue work or everyday activities during a migraine attack.3

It is estimated that around 15 % of the working population suffers from migraines.4 Many sufferers do not speak openly about their illness in order to avoid being stigmatized as "lazy at work" or "not resilient enough". This lack of understanding often leads to career setbacks or job changes. This is all the more regrettable because openly dealing with this illness, acceptance and targeted measures in the working environment can relieve the burden on those affected. This is also beneficial for companies.5

Strong stigmatization

Presenteeism, i.e. reduced work performance due to migraine without actual absence from work, accounts for almost 90 % of a company's migraine-related productivity loss, more than absenteeism 6. However, presenteeism, i.e. reduced work performance due to an illness, is difficult to measure and often goes unnoticed in the working environment. In the Japanese Fujitsu headache project, several thousand employees of a large company were asked about their own headaches, their quality of life and their knowledge of migraines. E-learning and online consultations were offered to impart knowledge about migraines. The results of the study underline the prevalence of migraine in the workplace (16.7 % of respondents) and show a high level of stigmatization, inadequate medical care and a heavy burden on those affected. Surprisingly, the information measures alone achieved a great deal: 83 % of the respondents without headaches changed their attitude to the illness. Many employees then sought headache expertise for the first time. The calculated savings per employee/year amounted to US$ 4531 4. A Swiss study also showed that monthly counseling of employees with migraine was able to reduce the restrictions - measured with the Migraine Disability Score (MIDAS) - and yielded a return on investment of 4.9 for the company.7

These examples show the potential of targeted measures to provide information and education about migraine in the workplace. Further possibilities exist in the adaptation of the workplace and flexibility in work design by employers.8

The Swiss Headache Society (SKG) has launched the "Migraine Friendly Workspace" initiative (www.headache.ch/migraene/migraine-friendly-workspace) based on expert knowledge and data on migraines. This initiative is part of the Swiss Brain Health Plan. The "triple e" concept is based on the three pillars of empowerment, environment and engagement. In principle, the concept harmonizes well with the basic principle of occupational health management (OHM) in order to support companies in their efforts to improve the health of their employees and complements the "Friendly Workspace" campaign already known/established in OHM. What is special, however, is that it specifically addresses the individual needs of people with migraines and attaches great importance to the commitment to destigmatization. The following points make up a migraine-friendly workplace and are part of the campaign:

Empowerment: Information material is provided by SKG. In addition to printed material, this also includes online seminars. We compile information on the available and recommended acute medication ("emergency kit") and provide information on the nearest migraine experts and contact points. Employers enable interested employees to take part in sports programs or self-organized activities to prevent headaches.

Environment: The company has a place of retreat that those affected can go to during the attack. Ideally, this is a room that can be darkened and is protected from noises and smells. Alternatively, a couch with light and noise shielding can be provided in a quiet area of the workplace. Migraine sufferers who report triggers for their attacks in the workplace, such as strong direct light, will be advised on how to adapt their workplace. The environment also includes colleagues: Understanding and flexibility throughout the team is a prerequisite for a migraine-friendly atmosphere.

Commitment: Companies show their "colors" and declare their commitment to being a migraine-friendly workplace. They are published on the SKG website as such employers. They are flexible in finding solutions so that employees with migraine can have a fulfilling career. This can include working from home, job rotation, targeted counseling or flexible working hours.

The first companies are currently being evaluated for advice. The aim of this project is to provide employers with the best possible support and to work together with occupational health experts to implement specific measures in the workplace. The OHM officers can make a valuable contribution here to improving employee satisfaction, productivity and health.