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Original research
Mask-associated ‘de novo’ headache in healthcare workers during the COVID-19 pandemic


Objectives The pandemic caused by the new coronavirus (COVID-19) has changed care activities of health professionals. We analysed the possible association between the appearance of ‘de novo’ headache according to the type of mask used, the related factors and the impact of the cephalalgia on health professionals.

Methods Cross-sectional study in a tertiary hospital in Extremadura, Spain. We provided an online questionnaire to healthcare workers during the period of maximum incidence of COVID-19 in our setting.

Results The subjects are n=306, 244 women (79.7%), with an average age of 43 years (range 23–65). Of the total, 129 (42.2%) were physicians, 112 (36.6%) nurses and 65 (21.2%) other health workers. 208 (79.7%) used surgical masks and 53 (20.3%) used filter masks. Of all those surveyed, 158 (51.6%) presented ‘de novo’ headache. The occurrence of a headache was independently associated with the use of a filter mask, OR 2.14 (95% CI 1.07 to 4.32); being a nurse, OR 2.09 (95% CI 1.18 to 3.72) or another health worker, OR 6.94 (95% CI 3.01 to 16.04); or having a history of asthma, OR 0.29 (95% CI 0.09 to 0.89). According to the type of mask used, there were differences in headache intensity, and the impact of a headache in the subjects who used a filter mask was worse in all the aspects evaluated.

Conclusion The appearance of ‘de novo’ headache is associated with the use of filter masks and is more frequent in certain healthcare workers, causing a greater occupational, family, personal and social impact.

  • clinical medicine
  • health and safety
  • occupational health practice
  • public health
  • exposure assessment

Data availability statement

All data relevant to the study are included in the article. No obstante, all the data with which this work has been prepared are available to any researcher upon reasonable and understandable request to the corresponding author.

This article is made freely available for use in accordance with BMJ’s website terms and conditions for the duration of the covid-19 pandemic or until otherwise determined by BMJ. You may use, download and print the article for any lawful, non-commercial purpose (including text and data mining) provided that all copyright notices and trade marks are retained.

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