By Patricia B. Mirasol

Migraines cost businesses millions of dollars. In Singapore, a study showed that migraines, a neurological condition that can cause debilitating head pain, cost the Singaprean economy SGD1 billion per year. In Malaysia, the productivity loss at work due to migraines was nearly 20-fold higher for presenteeism (showing up to work despite being sick) than absenteeism. In the Philippines, a survey showed that workers lost 14 days due to migraines over a 90-day period. 

“Despite having migraines, employees choose to go to work,” said Associate Professor Dr. Ivy Chung, Deputy Dean of Health and Wellbeing Research Cluster at the University Malaya in Malaysia, as she presented the results of the Malaysia survey in a recent Progressive Alliance Towards Healthy Workplaces virtual roundtable. “Maybe this is (indicative of) Asian culture.”

“The significant impact of migraine on work productivity and regular activity appears to lead to substantial monetary loss, attributed to not only absenteeism but more importantly to presenteeism,” added Dr. Chung.

TRIGGERS AND INTERVENTIONS
Migraine symptoms include a headache that is severe, disabling, throbbing, and lasting from 4 to 72 hours; nausea, vomiting, and light and sound sensitivity. It is caused by a genetically induced hypersensitivity of the brain, said Dr. Wan Aliaa Binti Wan Sulaiman, a consultant physician and neurologist at the Universiti Putra Malaysia. Other triggers include environment, metabolism, hormones, and drugs. Specific examples are alcohol, excessive noise, eye strain, strong-smelling perfumes, lack of sleep, and a change of weather.

Changes in the physical environment can help, advised Dr. Sulaiman. Measures include changing fluorescent lights into less bright ones; providing glare protectors for computer screens; using noise-canceling headphones; and having a rest area that is dark and quiet. Other interventions include taking regular work breaks, keeping hydrated, and being physically active. 

Managing one’s stress also matters. Researchers have discovered links between stress and migraines.

ADDRESSING THE PROBLEM
There are unmet needs in migraine management and a need for awareness about intervention strategies at the individual and organizational level. Employers have a role to play in addressing these. A first step is to understand what migraine is. Another is to break the stigma around migraines in the workplace. 

The stigma is in plain sight and the reason many remain undiagnosed, said Azrul Mohd Khalib, head of Galen Centre for Health and Social Policy. Migraine sufferers are penalized under existing workplace policies that monitor absenteeism and sick leaves. Because of a lack of understanding and tolerance, they are labeled unproductive, difficult, and delicate, and as a result are deemed unsuitable for certain work and left out of the promotion ladder. Mr. Khalib said a low-hanging fruit would be an employee-focused migraine education program. So would adding migraine as part of occupational safety and human resource policies.

Novartis Switzerland shared its Migraine Care program’s key pillars in the virtual roundtable. These are: raising awareness among employees; helping managers enable their team; providing medical expert guidance; tele-coaching with nurses and tele-doctor consultations; and tracking improvement through a mobile app. Complementary access to innovative treatment was also given. The outcome was a 64% migraine disability reduction in nine months. Participants on average gained 10.8 migraine-free working days per year.

­­­The aforementioned Philippine survey was conducted by Wellbridge Health and Novartis Healthcare Philippines this year. It had a total of 727 respondents across 12 companies in the telecommunication, business process outsourcing, and information technology industries. As per the latest results, 511 screened positively for migraines. 

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