Risk factors for development of personal protective equipment induced headache: e-survey of medical staff in Baltic states

Mantas Jokubaitis (Coresponding Author), Reda Timofejavaitė, Mark Braschinsky, Linda Zvaune, Alo Rainer Leheste, Laura Gribuste, Paula Mattila, Sintija Strautmane, Austėja Dapkutė, Kristina Ryliškienė

Research output: Contribution to journalArticlepeer-review

1 Citation (Scopus)
3 Downloads (Pure)


Background: The COVID-19 pandemic led to an unprecedented increase in the use of personal protective equipment (PPE) among medical personnel. The goal of this study was to determine the risk factors and frequency of PPE-induced headache during the COVID-19 pandemic. Methods: From January 25 to March 1, 2021, an anonymous online survey was undertaken in the Baltic states. Results: In total, 2132 individuals participated. 52.3% experienced a PPE-induced headache. Usual onset time was between 2–3 h, lasting up to 1 h after PPE removal. The most common localization was in temporal and frontal regions. Headache usually occurred 2 to 3 days per week with an average pain score of 5.04 ± 1.80 points. Higher risk was associated with discomfort/pressure OR = 11.55, heat stress OR = 2.228, skin conditions OR = 1.784, long PPE use (duration 10-12 h) OR = 2,18, headache history prior PPE use OR = 1.207. Out of 52.3% respondents with PPE-induced headache, 45.5% developed de novo headache, whereas 54.5% had headache history. Statistically significant differences of PPE-induced headache between respective groups included severity (4.73 vs 5.29), duration (≥ 6 h 6.7% vs 8.2%), accompanying symptoms (nausea (19.3% vs 25.7%), photophobia (19.1% vs 25.7%), phonophobia (15.8% vs 23.5%), osmophobia (5.3% vs 12.0%)) and painkiller use (43.0% vs 61.7%). Conclusions: Over half of the medical personnel reported headache while using PPE. The risk was higher in individuals with headache history, increased duration of PPE use and discomfort while using PPE. Predisposed individuals reported PPE-induced headache which persisted longer, was more intense and debilitating than in the respondents with de novo headache.

Original languageEnglish
Article number1016
Pages (from-to)1-7
Number of pages7
JournalBMC Health Services Research
Issue number1
Publication statusPublished - Dec 2022
Externally publishedYes


  • Headache
  • Medical personnel
  • Personal protective equipment

Field of Science*

  • 3.2 Clinical medicine

Publication Type*

  • 1.1. Scientific article indexed in Web of Science and/or Scopus database


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