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Employment and Work Impact of Chronic Migraine and Episodic Migraine

Stewart, Walter F. PhD; Wood, G Craig MS; Manack, Aubrey PhD; Varon, Sepideh F. PhD; Buse, Dawn C. PhD; Lipton, Richard B. MD

Journal of Occupational and Environmental Medicine: January 2010 - Volume 52 - Issue 1 - p 8-14
doi: 10.1097/JOM.0b013e3181c1dc56
Original Articles

Objective: To determine work impact of chronic migraine (CM) versus episodic migraine (EM).

Methods: Data were from the 2005 American Migraine Prevalence and Prevention study, a longitudinal population survey of more than 11,000 migraineurs. Lost productive time (LPT) was measured as missed work hours plus reduced productivity hour equivalents.

Results: Those with CM were 19% less likely to be working for pay compared with migraineurs with ≤3 headache-days/month. On average, those with CM lost 4.6 hours/wk from headache compared with 1.1 hours for those with ≤3 headache-days/month. Those with 10 to 14 headache-days/month or with CM accounted for 9.1% of employed migraineurs, 20.8% of work-related LPT, and 35% of the overall lost work time when considering medical leave and unemployment.

Conclusions: The work impact of CM and high frequency EM will be underestimated if employment status is not measured.

From the Geisinger Clinic (Dr Stewart, Dr Wood), Center for Health Research, Danville, Pa; Allergan Pharmaceuticals (Dr Manack, Dr Varon), Irvine, Calif; Department of Neurology (Dr Buse, Dr Lipton), Albert Einstein College of Medicine, Bronx, NY; The Montefiore Headache Center Unit (Dr Buse, Dr Lipton), Bronx, NY.

CME Available for this Article at

Walter Stewart and coauthors received support as follows: The American Migraine Prevalence and Prevention (AMPP) study was sponsored by the National Headache Foundation through a grant from Ortho-McNeil Neurologics, Inc. Additional support provided by Allergan Pharmaceuticals.

The JOEM Editorial Board and planners have no financial interest related to this research.

Address correspondence to: Dr Walter Stewart, Geisinger Clinic, Center for Health Research, MC 44-00 100 N. Academy Avenue, Danville, PA 17822; E-mail:

©2010The American College of Occupational and Environmental Medicine