The combined effect of indoor climate and psychosocial stressors on subsequent headaches: A prospective study of the general working population in Norway

This prospective panel study explores the link between indicators of poor indoor climate and psychosocial stressors in the work environment with subsequent headaches. A random sample of the Norwegian working population (18 to 66 years) was examined, using self-reported health symptoms and work exposures collected in 2009, 2013 and 2016. This study included repeated measurements of 6681 workers attending at least two consecutive interviews (16,493 observations). The results were analysed using generalized estimating equations (GEEs), adjusting for sex, birth year, occupation, education, baseline mental health and the presence of headache at baseline. Headaches were prevalent in 25.4% of cases, with odds ratios (ORs) increasing with poor indoor climate (OR continuous = 1.14, 95% CI: 1.08–1.19) and number of psychosocial stressors (OR continuous = 1.09, 95% CI: 1.04–1.14). The OR amongst individuals concurrently exposed to both poor indoor climate and psychosocial stressors was 1.49 (95% CI: 1.26–1.75). Approximately one in five headache cases were attributable to this combined exposure. Measures implemented to reduce the prevalence of headaches in the work environment should consider the combined impact of a poor indoor climate and psychosocial stressors.