The objective of this study was to assess the epidemiological aspects of headache in a workplace setting and the economical impact. By sending a questionnaire to 1781 employees of a Dutch manufacturing company we tried to assess the prevalence of headache and headache subtype within this working place. Besides the personal view of each responder regarding his/her headache subtype, the International Headache Society (IHS) criteria were used to classify headaches on the basis of reported features. Moreover the missing labour days, as a result of headache, during the previous 4 weeks were measured, as well as the loss of productivity at the working place during an episode of headache; from this an estimate of the economic loss could be calculated. The response rate of the questionnaire was 60.8%. The lifetime prevalence of headache amongst the responders was 53.3%. Of these, 34.5% thought their headache was tension-type headache, 10.6% thought it was migraine, 5.4% mentioned daily headache, and 18.2% mentioned another type of headache. According to the IHS criteria the differentiation was somewhat different: 26.2% of the headache could be classified as tension-type headache and 15% as migraine. When the costs for lost labour days and loss of productivity as a result of all types of headache were accumulated, the economic loss was estimated at 18.933 US dollars in 4 weeks (for the group of responders). In conclusion, headache is related to a substantial economic loss; migraine is probably underestimated in a workplace setting.
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