BACKGROUND: Coronavirus disease 2019 (COVID-19) is an emerging infectious disease of pandemic proportions . Healthcare workers in Singapore working in high-risk areas were mandated to wear personal protective equipment (PPE) such as N95 face mask and protective eyewear while attending to patients .
OBJECTIVES: We sought to determine the risk factors associated with the development of de novo PPE-associated headaches as well as the perceived impact of these headaches on their personal health and work performance . The impact of COVID-19 on pre-existing headache disorders was also investigated .
METHODS: This is a cross-sectional study among healthcare workers at our tertiary institution who were working in high-risk hospital areas during COVID-19 . All respondents completed a self-administered questionnaire .
RESULTS: A total of 158 healthcare workers participated in the study . Majority [126/158 (77.8 %) ] were aged 21-35 years . Participants included nurses [102/158 (64.6 %) ], doctors [51/158 (32.3 %) ], and paramedical staff [5/158 (3.2 %) ]. Pre-existing primary headache diagnosis was present in about a third [46/158 (29.1 %) ] of respondents . Those based at the emergency department had higher average daily duration of combined PPE exposure compared to those working in isolation wards [7.0 (SD 2.2) vs 5.2 (SD 2.4) hours, P <.0001] or medical ICU [7.0 (SD 2.2) vs 2.2 (SD 0.41) hours, P <.0001]. Out of 158 respondents , 128 (81.0 %) respondents developed de novo PPE-associated headaches . A pre-existing primary headache diagnosis (OR = 4.20 , 95% CI 1.48-15.40; P = .030) and combined PPE usage for> 4 hours per day (OR 3.91 , 95% CI 1.35-11.31; P = .012) were independently associated with de novo PPE-associated headaches . Since COVID-19 outbreak , 42/46 (91.3 %) of respondents with pre-existing headache diagnosis either``agreed"or``strongly agreed"that the increased PPE usage had affected the control of their background headaches, which affected their level of work performance .
CONCLUSION: Most healthcare workers develop de novo PPE-associated headaches or exacerbation of their pre-existing headache disorders.