title: Headaches and the N95 face-mask amongst healthcare providers.
abstract: BACKGROUND
  During the 2003 severe acute respiratory distress syndrome epidemic, healthcare workers mandatorily wore the protective N95 face-mask.
  
  
  METHODS
  We administered a survey to healthcare workers to determine risk factors associated with development of headaches (frequency, headache subtypes and duration of face-mask wear) and the impact of headaches (sick days, headache frequency and use of abortive/preventive headache medications).
  
  
  RESULTS
  In the survey, 212 (47 male, 165 female) healthcare workers of mean age 31 years (range, 21-58) participated. Of the 79 (37.3%) respondents who reported face-mask-associated headaches, 26 (32.9%) reported headache frequency exceeding six times per month. Six (7.6%) had taken sick leave from March 2003 to June 2004 (mean 2 days; range 1-4 days) and 47 (59.5%) required use of abortive analgesics because of headache. Four (2.1%) took preventive medications for headaches during this period. Multivariate logistic regression showed that pre-existing headaches [P = 0.041, OR = 1.97 (95% CI 1.03-3.77)] and continuous use of the N95 face-mask exceeding 4 h [P = 0.053, OR = 1.85 (95% CI 0.99-3.43)] were associated with development of headaches.
  
  
  CONCLUSIONS
  Healthcare providers may develop headaches following the use of the N95 face-mask. Shorter duration of face-mask wear may reduce the frequency and severity of these headaches.
authors.affiliation: Department of Medicine, National University Hospital, Singapore. mdcelch@nus.edu.sg
authors.forename: E C H
authors.initials: EC
authors.lastname: Lim
authors.forename: R C S
authors.initials: RC
authors.lastname: Seet
authors.forename: K-H
authors.initials: KH
authors.lastname: Lee
authors.forename: E P V
authors.initials: EP
authors.lastname: Wilder-Smith
authors.forename: B Y S
authors.initials: BY
authors.lastname: Chuah
authors.forename: B K C
authors.initials: BK
authors.lastname: Ong
mesh_terms: D000328:Adult; D000700:Analgesics / Q000627:therapeutic use; D004196:Disease Outbreaks; D005145:Face; D005260:Female; D006261:Headache / Q000188:drug therapy / Q000209:etiology*; D006282:Health Personnel; D006306:Health Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D016273:Occupational Exposure; D012134:Respiratory Protective Devices / Q000009:adverse effects*; D012307:Risk Factors; D045169:Severe Acute Respiratory Syndrome / Q000453:epidemiology
chemical_list: D000700:Analgesics