Method
The study was conducted in the health area of a tertiary hospital, where our health system in the COVID-19 period urged health professionals to use PPE during contact with patients.
These protective systems were mandatory among health workers, both in high-risk areas, and in general medical wards, central hospital radiology, and diagnostic imaging areas or outpatient clinics. This involved the use of different types of more or less tight-fitting masks, and sometimes glasses or screens.
Using a self-administered questionnaire addressed to health workers in our health area, we carried out a cross-sectional study during the first week of May 2020. In the previous month, the number of admissions for COVID-19 was very high and attendance protocols required the use of these devices by all workers.
Following the International Classification of Headache Disorders, Third Edition (ICHD-3) criteria,11 we define ‘de novo’ headache: ‘when a new headache occurs for the first time in close temporal relationship to use PPE, even when the headache has the characteristics of a primary headache (migraine, tension type of headache, cluster headache or one of the other trigeminal autonomic headaches)’.
The questionnaire collected the following information: (1) demographics; (2) medical history, including SARS-CoV-2 infection; (3) type and pattern of mask use: surgical masks versus self-filter masks of particles and liquid aerosols (FFP), average number of hours of use per day and use of other protective devices (glasses or screens); (4) frequency and characteristics of pre-existing primary headache (changes in headache frequency, attack duration and frequency, as well as drug use and response); (5) the main variable of the study was personal opinion about the presence of a new headache in the period in which these protective systems were mandatory; (6) presence of other symptoms potentially associated with the use of facial protection equipment; (7) we evaluated the self-perceived impact of the presence of new-onset headache using the Likert scale on social, occupational, family and personal aspects; (8) we also evaluated the self-perceived impact that headache conditions have on the performance of work activities and (9) lastly, we analysed self-perceived work stress by means of the Psychosomatic Problems Questionnaire (PPQ).13
The questionnaire was written after an analysis of the literature and a thorough reflection on the problem to be investigated. It included a request for voluntary collaboration, information on the reason for the survey, instructions for completing the questionnaire and consent. The average time taken to complete was about 20 min.
The information collection procedure chosen was the online survey. The survey was scheduled to be conducted over 5 consecutive days, between 1 May 2020 and 6 May 2020, with the data collected referring to the previous month.
The data collected in the study respects the anonymity of the subject and there is no possibility of access to any personal information of the individual. The data analysed are restricted to the study investigators, health authorities and the Ethics Committee, when required, in accordance with current legislation.