Migraine in the Workplace Helping manage migraine in the workplace. Information for employers and employees

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Meredith Daniel
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1 Migraine in the Workplace Helping manage migraine in the workplace Information for employers and employees

What is Migraine? Migraine is a much misunderstood and under-diagnosed condition. Studies have shown that migraine affects between 12-15% of people worldwide, including Ireland.

The Migraine Association of Ireland [MAI] has been operating since 1994 as a registered charity.

2 What is Migraine? Migraine is a much misunderstood and under-diagnosed condition. Studies have shown that migraine affects between 12-15% of people worldwide, including Ireland. This means that over half a million Irish people are migraineurs. Support Information Reassurance What is the Migraine Association of Ireland? The Migraine Association of Ireland [MAI] has been operating since 1994 as a registered charity. From modest beginnings, the association quickly developed into the exceptional support organisation and influential campaigner that it is today. This development has been recognised in the form of; Irish Patient Association of the Year Award Best Use of Information Technology Award 2006 for our website GSK Ireland IMPACT Award 2015 for Excellence in the Community The association is a member of the European Headache Alliance (EHA), the Neurological Alliance of Ireland (NAI) and the Disability Federation of Ireland (DFI). MAI has participated in the MEP Interest Group on the Brain, Mind and Pain workshop on Neurological Disorders and the workplace. Through these organisations, the interests of our migraineur members are widely represented and recognised. The MAI is world-renowned for its energy and determination in providing up-to-date quality information and advice, promoting the best treatment for migraine sufferers and raising awareness among health professionals and the general public about what can be a particularly debilitating condition. Our current patron is the President of Ireland, Michael D. Higgins. 2 Migraine is a complex neurological condition characterised by a severe, throbbing, one-sided headache which is often accompanied by other symptoms including: Aura, about 20% of migraineurs experience visual distortions Nausea and or vomiting Intolerance or sensitivity to noise, light and movement Pins and needles or numbness on one side Slurring of speech Confusion Loss of co-ordination In extreme cases, even temporary paralysis and loss of consciousness Understanding Migraine Migraine is a real medical condition just like diabetes, epilepsy or asthma, and is more prevalent than all three of these conditions together It is not just a headache and attacks can last from 4 72 hours Severe migraine attacks are classified by the World Health Organisation (WHO) as among the most disabling illnesses, comparable to dementia, quadriplegia and active psychosis The WHO classifies migraine as the 4th leading cause of disability worldwide among women and 6th overall 92% of Irish migraineurs say that attacks affect their performance at work. 3

Despite this, migraine is often under-treated and misunderstood.

A European workplace stigma study has shown that those living with a neurological disorder experienced discrimination and decreased opportunities for promotion in the workplace as well as lack of

However, individual attacks can be triggered by exposure to one or more trigger factors which cause an individual s migraine threshold to be crossed (see below figure).

3 Despite this, migraine is often under-treated and misunderstood. As those who suffer have no symptoms between attacks, colleagues often misunderstand the full extent of symptoms and associated impact, leading to stigma in the workplace. A European workplace stigma study has shown that those living with a neurological disorder experienced discrimination and decreased opportunities for promotion in the workplace as well as lack of understanding from colleagues and managers. Can my working environment cause a Migraine? Migraine is an episodic neurological condition. However, individual attacks can be triggered by exposure to one or more trigger factors which cause an individual s migraine threshold to be crossed (see below figure). The Migraine Threshold Migraine Threshold Build up of Triggers Attack Triggered e.g. missed meal e.g. late night e.g. stress at work e.g. menstruation Threshold raised/lowered by Genetic Factors Medication For many people, stress can be a trigger factor and there are many potential triggers to be found in the workplace, including: How do I know if an employee / colleague is suffering from a Migraine? There is no specific test for migraine, and a diagnosis is made based on careful history taking. It is described as an invisible illness as there are no obvious external signs of discomfort, and sufferers are well between attacks. Whereas some people may identify a pattern and their triggers, others find attacks can strike at any time and with very little warning. This unpredictable nature of migraine can lead to anxiety for an employee. During an attack, some people may appear very pale, be unable to concentrate or focus, and be unable to articulate as clearly as usual, or will slur their speech. Some people are more severely affected than others and unless you know a person well, these changes may not be noticeable immediately. Of course the more you understand the condition, the easier it will be to identify. Bear in mind that the individual nature of migraine means that individuals are not all affected in the same way. Managing Migraine in the workplace Despite the massive impact that migraine can have on job satisfaction (see figure below) only 50% of sufferers are receiving treatment. Sick leave policy can unfairly penalise migraineurs leading to presenteeism (the practice of going to work despite illness). But migraineurs don t need to struggle on. Long periods spent in front of a computer screen Delayed meals or irregular eating patterns Poor posture at an office desk Lack of exercise Loud noise or bright lights Dehydration Strong smells Air conditioning / lack of fresh air 4 I strongly agree 35% I somewhat agree 29% I neither er disagree nor agree 17% I somewhat disagree 12% I strongly disagree 7% 0% 10% 20% 30% 40% Migraine Association of Ireland Quality of Life Survey Migraine reduces my job satisfaction

Although there is no cure for migraine with the right information, support and treatment the majority of migraineurs can bring their condition under control, reducing the frequency and severity of

The cost and impact of Migraine in the Workplace The cost of migraine to the Irish economy is estimated at over 252 million a year, including a loss of some 500,000 work days.

For many of these people this can have a significant impact on their performance at work and career.

4 Although there is no cure for migraine with the right information, support and treatment the majority of migraineurs can bring their condition under control, reducing the frequency and severity of attacks. Medications, dietary changes, relaxation and biofeedback can reduce, or even eliminate up to 90% of attacks. Migraine-specific medication can be effective in up to 80% of cases. The cost and impact of Migraine in the Workplace The cost of migraine to the Irish economy is estimated at over 252 million a year, including a loss of some 500,000 work days. In the Republic of Ireland, over half a million people suffer from migraine. On any given day, over 13,000 people in the country experience a migraine attack. For many of these people this can have a significant impact on their performance at work and career. 30% 25% 20% 15% 10% 5% 0% No Impact 8% Slight Impact 25% Moderate Impact 28% Fairly Severe Impact 24% Severe Impact 15% Migraine Association of Ireland Quality of Life Survey Impact of Migraine on job performance 14% did less well in education or gave up early 28% did less well in work or took an easier job 31% reported reduced earnings as a result of their headaches 42% felt employers and colleagues did not accept or understand 77% could not go to work on 1-3 days because num of their headache in the previous 3 months 42% could do less than half on 5 days or more in the previous 3 months Irish results of Eurolight European Quality of Life Study 2011 Everybody benefits if migraine is properly managed Benefits to employees Increased job satisfaction Better health and well-being Better social and family life Benefits to employers Increased productivity Less absenteeism Positive workplace environment Reduced presenteeism How can my employer help? The Migraine Association encourages employers and employees to work together in tackling the problem of migraine in the workplace. Employers are increasingly aware of the problems and benefits of properly managing migraine in the workplace (see below figure). I strongly agree 33% I somewhat agree 19% I neither disagree nor agree 24% I somewhat disagree 17% I strongly disagree 7% 0% 5% 10% 15% 20% 25% 30% 35% Migraine Association of Ireland Quality of Life Survey My employer is sympathetic towards the impact migraine has on me Increased understanding about migraine + Improved migraine management = More content and productive workforce

Minor adjustments to the work environment can have a dramatic impact, especially for migraineurs in terms of preventing and aborting an attack.

5 Minor adjustments to the work environment can have a dramatic impact, especially for migraineurs in terms of preventing and aborting an attack. The earlier an employee can take steps to abort an attack, the sooner they will be back to work. We would ask employers, where possible, to: While larger companies can afford to make many adjustments, smaller businesses can still implement small changes that can make the difference to their staff being fully able to partake in their workplace. Install and maintain a good lighting system which imitates natural daylight closely. Maintain efficient extractors if strong fumes or smells are produced Ensure that the noise levels from machinery are kept to a minimum Design ergonomic work stations Be conscious of employee stress levels Supply readily accessible drinking water Encourage employees to develop a contingency plan for when a migraine strikes at work Show general consideration in this area to send a positive signal to all staff Organise an outreach day for employees (see next page) Encourage a healthy work/life balance culture Consider allowing flexible working hours Provide a rest room Provide stress management training Migraine Corporate Outreach The Migraine Corporate Outreach service is an educational programme on migraine management, directed primarily at employees with migraine. Lasting about one hour, it can be a stand-alone event or part of a staff health and wellness day. It aims to provide migraineurs with the know-how to manage their migraine in general, with a special emphasis on the workplace. By the end of the session, participants should have acquired the tools to help reduce the frequency of attacks and lower the effect of migraine on their work. In addition, we can provide information and training to employers - our aim being to raise their awareness of the condition so that they can learn how to adapt the workplace to facilitate migraineurs. This can have a positive knock-on effect for all employees. 8 9

The programme including a presentation and Q&A session covers: Types of migraine and their symptoms Identifying and eliminating trigger factors How to manage migraine Migraine medications

6 The programme including a presentation and Q&A session covers: Types of migraine and their symptoms Identifying and eliminating trigger factors How to manage migraine Migraine medications Complementary treatments for migraine Reasonable adjustments and helpful hints for dealing with migraine in the workplace Supports available from the Migraine Association of Ireland Specialist medical services available for migraineurs It is well recognised that work impacts on social cohesion and quality of life. Creating a healthy working environment can be a facilitator rather than a barrier to a person living with migraine. 10 Membership is 36 minimum for adult members (30 online) and 10 for students, oap or unemployed in the Republic of Ireland. For members in Northern Ireland membership costs 30 and 10 for student, oap or unemployed. Membership Adult Student/OAP/ Unemployed Payment Method Area Republic of Ireland Northern Ireland Standing Order Credit Card Cheque/draft (recommended) Laser Postal Order Your Personal Details (These details will be used by the MAI only) Date: / / 201 Title First Name Surname Address Tel No. Mobile Dte of Birth (optional) Tick here if you would like to receive our BrainStorm newsletter Tick here if you would like to receive our newsletter Migra-zine. Please clearly write your address in the space provided above. Tick here if you would like to hear more about volunteering opportunities within the MAI Standing Order To the manager of: Bank Branch IBAN BIC Please pay the following sum (on a monthly basis): * OTHER or Please pay the following sum (on a yearly basis): * other to the account of the Migraine Association of Ireland at AIB Bank, Capel Street, Dublin 1, IBAN IE32AIB BIC AIBKIE2D Starting on / / ** and to be paid on the corresponding date each month/ year until further notice. Note to Bank: Please use the customers name as narrative on bank statements Name of Account Holder(s) Account Number Signature(s) Date * This amount qualifies for tax relief. ** Please leave this blank and we will complete before sending forms to bank Card Payments Annual Membership Form MEMBERSHIP FORM RETURN TO MAI (Unit 14, Block 5, Port Tunnel Business Park, Clonshaugh, Dublin 17, D17 WK24) YOUR BANK DETAILS I wish to pay by: VISA MASTERCARD LASER And authorise you to debit my account with the sum of (see minimum amounts listed above) Card Number Expiry date (mm/yy) Signature(s) Date Please tick the box if you would like to receive electronic communications from MAI e.g. electronic newsletter, renewal reminders, notification of future events, etc.

7 MAI Services Seminars & Workshops Self-Help Groups Health Professional Resources Migraine Action Week Information Stands & Publications Brainstorm quarterly newsletter & Migra-zine CALL-SAVE HELPLINE (ROI) (NI) (10.00am 4.00pm, Monday to Friday) To book a Corporate Outreach session, contact: Address: Migraine Association of Ireland, Unit 14, Block 5, Port Tunnel Business Park, Clonshaugh, Dublin 17, D17 WK24 Phone: / Advice Line: (Specialist Nurse 10am - 12pm, Monday - Thursday) info@migraine.ie Leaflet supported by a National Lottery Grant from HSE Dublin North

MIGRAINE ASSOCIATION OF IRELAND. Migraine & Women. Her life can be hers AGAIN

MIGRAINE ASSOCIATION OF IRELAND Migraine & Women Her life can be hers AGAIN What is Migraine? Migraine and Women Migraine is 3 times more common in women than in men, this is largely due to hormonal changes