Elena Ruiz de la Torre Gómez de Barreda. President of EHA MIGRAINE AND WORK A COMPLETE VISION OF THE WORKER WITH MIGRAINE IN THE SOCIO- LABOR FIELD Elena Ruiz de la Torre Gómez de Barreda. President of EHA María Teresa Bernal García. Member of the Spanish Association of Specialists in Occupational Medicine (AEEMT)

What factors show more relation with the aftermath of the disease What is the start point? What factors show more relation with the aftermath of the disease How can we act to improve? 3-Design interventions based on data obtained 1-Survey data 2-Results of the statistical study

EUROPEAN MIGRAINE AND WORK STUDY Design of this study: Research Group in Occupational Medicine, with the scientific endorsement of the Spanish Association of Specialists in Occupational Medicine (AEEMT). The intellectual property of this work corresponds to EHA, represented by their president, Ms. Elena Ruiz de la Torre

EUROPEAN MIGRAINE AND WORK STUDY Participating countries: Spain, Ireland, England, Italy, Germany and France Data on common basis: on the EHA server Priority language: English with choice options (Spanish, French, Italian and German) Channel the project in each country through societies or associations of occupational physicians or occupational nurses All the participating authors will be included in the subsequent project dissemination documents

Person who works and suffers migraine PERSONAL AND FAMILY CIRCUMSTANCES CLINICAL AND CARING SITUATION WORKING AND SOCIAL SITUATION Person who works and suffers migraine

OBJECTIVES OF THE STUDY To know the situation of the worker with migraine within the companies, their personal, social and clinical-assistance conditions Starting point for subsequent improvement initiatives, implementation of preventive measures and maximum integration of migraine workers within companies Facilitate the maximum benefit in subsequent interventions for: Working affected people For health caregivers who perform their control and follow-up For the companies For society Results will make possible to compare results among countries and apply subsequent protocols based on each countries’ regulations for the prevention of occupational risks.

EUROPEAN MIGRAINE AND WORK STUDY Start planned: Pilot Project in Spain in April 2018 Global start rest countries May 2018 Completion of data collection: November 2018 Sample size for each participating country: Minimum of 500 workers for each country Desirable objective 1000 workers for each country

EUROPEAN MIGRAINE AND WORK STUDY Previous materials: Informed consent Medical training material. Power point with diagnostic criteria of the pathology Patient brochure (migraine and work) Questionnaire (approximate data collection time 6 min): In paper format : Word / pdf if there is no Internet access. Later it has to be turned to the electronic format In electronic format through the EHA website: link- https: //it.surveymonkey.com/r/77TGQBK Contact for questions : mail available in the corresponding country https://it.surveymonkey.com/r/77TGQBK

EUROPEAN MIGRAINE AND WORK STUDY Subsequent statistical treatment by an expert centralized in Spain: descriptive, bivariate and multivariate Diffusion Global study publications Individualized for each country Presentation of results in appropriate national and international forums

5- Dissemination and presentation of the project 1-Prepare materials and contact societies and associations at each country 2- Once the project has been accepted, collect the number of participating occupational physicians / nurses 3- Collection of data from April-November 2018 (minimum 500 per country, optimum 1000 per participating country) 4- Perform statistical study and analysis of the results obtained and prepare the results documents / publications 5- Dissemination and presentation of the project

EUROPEAN MIGRAINE AND WORK STUDY CRITERIA OF INCLUSION OF THE WORKER IN THE STUDY: Voluntary participation With informed consent (for epidemiological use of the data) – SEE ATTACHMENT Compliance with migraine criteria-SEE ANNEX (for the doctor) To be working at the time of the survey, or have been employed in the previous year

EUROPEAN MIGRAINE AND WORK STUDY DIAGNOSTIC CRITERIA: Migraine without aura A. At least 5 attacks that meet B-D criteria B. Headache that lasts from 4 to 72 hours (without treatment or insufficiently treated) C. Headache that meets two of the following characteristics: One-sided location Pulsatile characteristic From moderate to severe intensity of pain Worsened by or causing avoidance of habitual physical activity (e.g., walking or climbing stairs) D. During the headache, one of the following occurs: Nausea and / or vomiting Photophobia or phonophobia. E. Not attributed to another disease

EUROPEAN MIGRAINE AND WORK STUDY DIAGNOSTIC CRITERIA: Migraine with aura A. At least 2 attacks that meet criterion B B. Migraine with aura that meet the B-C criteria for any of the subforms (migraine with typical aura, non-migraine headache with typical aura, headache without typical aura, familial hemiplegic migraine, sporadic hemiplegic migraine, or basilar-type migraine) C. Not attributed to another disease

EUROPEAN MIGRAINE AND WORK STUDY DIAGNOSTIC CRITERIA: Migraine with typical aura A. At least 2 attacks that meet B-D criteria B. Aura consisting of at least one of the following symptoms, but not motor weakness: Fully reversible visual symptoms including positive features (eg, light flashes, scotomas or lines) and / or negative features (loss of vision) Fully reversible sensory symptoms including positive features (pins and needles) and / or negative features (numbness) Fully reversible alterations of dysphasic language C. At least 2 of the following: Visual homonymous symptoms and / or unilateral sensory symptoms At least one of the symptoms of the aura develops gradually from> / = 5 minutes and / or different aura symptoms occur in succession of > / = 5 minutes Each symptom lasts > / = 5 and </ = 60 minutes D. The headache meets the B-D criteria for "Migraine without aura" beginning during the aura or followed by the aura within 60 minutes E. Not attributed to another disease

EUROPEAN MIGRAINE AND WORK STUDY DIAGNOSTIC CRITERIA: Migraine without typical aura As the "Migraine with typical aura", except: B. Aura consisting of at least one of the following, with or without speech alterations but without motor weakness: Fully reversible visual symptoms including positive features (eg, light flashes, scotomas or lines) and / or negative features (loss of vision) Fully reversible sensory symptoms including positive features (pins and needles) and / or negative features (numbness) C. Headache that does not occur during the aura or followed by the aura within 60 minutes

EUROPEAN MIGRAINE AND WORK STUDY DIAGNOSTIC CRITERIA: Chronic migraine Description: Headache that appears for 15 days or more per month for more than three months, and that, at least for 8 days a month, has characteristics of migraine headache . Diagnostic criteria A. Headache (tensional or migrainous type) during a period of 15 or more days per month for more than 3 months2 that meets criteria B and C. B. It appears in a patient who has suffered at least five seizures that meet the B-D criteria for 1.1 Migraine without aura and / or criteria B and C of 1.2 Migraine with aura. C. During a period of 8 or more days per month for a period of more than 3 months, it meets any of the following: 1. Criteria C and D for the 1.1 Migraine without aura. 2. Criteria B and C for 1.2 Migraine with aura. 3. At the time of appearance, the patient believes that it is migraine, and is relieved with a triptan or ergot derivatives. D. Without better explanation for another diagnosis of ICHD-III.

EUROPEAN MIGRAINE AND WORK STUDY

Electronic access - link to the survey QUESTIONNAIRE Electronic access - link to the survey personal information migraine data labor data data of the medical professional / nurse who collects the survey https://it.surveymonkey.com/r/77TGQBK

Helpdesk and consultants: English: Andrea Rodríguez German: Maria-Teresa Bernal Italian: Patrick Cadeddu French: Maria-Jesus Terradillos Global Coordination: Mª Teofila Vicente and the Goup od Research in Occupational Medicine With the scientific support of the Spanish Association of Specialists in Occupational Medicine Contact: info@europeanheadachealliance.org. From this address the question will be redirected to the person in the country the request comes from.

THANK YOU FOR YOUR COOPERATION