* Recall the prevalence and gender/age distribution of migraine in a survey of about 20,000 Chicago bank employees.
* Define the contributions of absenteeism and decreased productivity to migraine-related work loss.
* Describe the most productive strategies for dealing with migraineurs in the workplace.
Large, epidemiologic survey studies have established that migraine headaches affect approximately 6% of men and 18% of women in the United States and that the condition peaks during the prime working years (25 to 55 years of age). The consequent economic burden experienced by employers is substantial. The majority of this economic burden is realized by employers in terms of lost productivity, a combination of costs attributable to absenteeism and to lost productivity while on the job (“presenteeism”). Although large survey studies have produced estimates of national prevalence and have suggested substantial national costs, specific employers are rarely able to apply these projections to their specific workforce. Using demographic and payroll data available from a large financial services corporation with over 80,000 employees, this study used established prevalence data to estimate corporate costs stemming from migraine-related absenteeism and reduced on-the-job productivity to total at least $21.5M and $24.4M. In addition, a comparison of predicted prevalence and cost impact was conducted using a simpler and less costly health risk appraisal. This assessment proved to be a reliable tool in assessing prevalence of migraineurs in this corporation’s workforce. Its use with a sample of 19,853 employees at this corporation produced prevalence rates of 7.7% of men and 23.4% of women, estimates closely comparable to those of national surveys. Suggestions are made regarding a corporate response to the substantial costs of lost productivity associated with migraine headache.