Misunderstanding of migraine an additional problem for sufferers

Forty per cent of workers claim employers and colleagues fail to accept or understand their disability

Next time a colleague or an employee doesn’t turn up for work because of a bad headache, pause for a minute before rolling your eyes in “not again” frustration.

This person may be suffering from migraine and if they are then it's not "just" a headache. Migraine is recognised as a disability by the World Health Organisation (WHO) and is ranked as the seventh most disabling disease in the world. Migraine is the fourth most disabling condition for women worldwide and the third most disabling for those between 25 and 50 years of age.

There are over 500,000 migraine sufferers in Ireland and five per cent experience a chronic episode on 15 or more days out of every month. The estimated cost to the Irish economy is €252m a year between absenteeism and reduced productivity.

According to the Irish findings of a recent European-wide study among those who suffer from frequent and severe migraine attacks (at least four episodes per month), 12 per cent have lost their jobs because of the condition and 84 per cent say their careers and earnings have been affected. Over 30 per cent ended up in A&E because of their condition and 23 per cent were hospitalised due to an attack.

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These numbers alone are a compelling reason for employers to make workplaces more migraine friendly. However, employers also have a legal obligation to do so and TCD associate law professor, Caoimhín MacMaolin, goes into the whole legal side of things in a chapter in Migraine, Not Just Another Headache, which is published by the Migraine Association of Ireland.

As a recognised disability, migraine is afforded the same “reasonable” workplace accommodations as any other debilitating condition. In practice this means employers have a duty of care under the 1998-2007 Employment Equality Acts. Failure to comply may be deemed discriminatory as will any adverse treatment of those with an officially diagnosed form of the condition in relation to access to employment or promotion.

A carrot or a stick can be used to make organisations step up, but Patrick Little, CEO of the Migraine Association of Ireland, would much prefer to see employers opting for the carrot as in many cases the changes that can make a difference don't cost a lot of money.

To make it as easy as possible for organisations to engage, his association provides free advice about what helps those with migraine to cope and workplace adaption grants are available to help cover the cost. The association is also willing to go into companies to educate staff about the condition.

Educating people 

“Typical workplace triggers for people are strong smells, artificial or flickering lights, loud noise, poor posture and screen glare,” says Little.

“We estimate that 500,000 work days a year are lost as a result of migraine and almost 70 per cent of people with migraine say it has a moderate to severe impact on their work. What we need is employers and colleagues alike to be more sympathetic to and respectful of those with the condition and to some extent this is down to educating people about migraine. It is not ‘just’ another headache. It is a complex neurological condition that affects everyone differently.”

Little is not suggesting that employers, particularly hard-pressed SMEs, should have to spend big money on migraine-friendly initiatives when moving someone away from noise or getting them a screen shield or a window blind would greatly improve the situation.

“It’s really about engaging with people and identifying what will help them individually,” he says.

“It may be as simple as asking everyone to refrain from using heavy scents at work, making sure equipment is at the right height to avoid neck strain and visual stress or replacing fluorescent tubes with lights using incandescent or LED bulbs as they are usually okay. Another common trigger is patterns, so replacing a heavily patterned carpet or wallpaper with something a lot quieter can be a big help.

“Misconceptions around the disease can lead to stigma, isolation and decreased opportunities for promotion which is why education, getting a proper diagnosis and learning to manage the condition are so important,” Little adds.

“In the Eurolight Quality of Life Study in 2011, over 40 per cent of those with migraine felt their employer and their colleagues did not accept or understand their illness.”

Managing migraine

Employer help

– Get the ergonomics right. Make sure people's chairs, desks and computer screens are at the right height to avoid poor posture.
– Review the lighting system. Provide anti-glare screens or blue light blocking glasses.
– Turn off backlights on TVs and other monitors.
– Choose neutral decor and avoid heavily patterned carpets/wall coverings.
– Fit window blinds or add tinted coating if bright external light is an issue.
– Monitor heating, cooling and ventilation systems to ensure a comfortable working environment.
– Educate people about the condition.
– Cut unnecessary noise and provide a quiet space people can escape to.
– Provide drinking water.

Self-help
– Identify triggers.
– Take breaks, stay hydrated, eat regularly.
– Manage stress.
– Avoid stiffness by moving about and stretching. Ask for a desk in a quieter area.
– Move away from a window/bright light.
– Use dimmer switches on devices.