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DOI: 10.1055/s-0032-1332742
Prevention of Headache in Adolescents: Population-Attributable Risk Fraction for Risk Factors Amenable to Intervention
Publication History
19 September 2012
22 October 2012
Publication Date:
08 January 2013 (online)
![](https://www.thieme-connect.de/media/neuropediatrics/201301/lookinside/thumbnails/10.1055-s-0032-1332742-1.jpg)
Abstract
Introduction Several risk factors for headache have been identified, some of which are potentially amenable to interventions. The potential effect of such interventions can be predicted by the population-attributable risk fraction (PARF). We assessed PARFs of the the following risk factors: neck muscle pain, chronic stress, alcohol consumption, smoking, coffee consumption, and physical inactivity. We studied the maximal possible effect achievable by avoidance of these risk factors.
Methods Two approaches to estimate PARFs are compared, which assess their cumulative and individual impact of risk factors by age: the Levin formula and the average attributable fraction.
Results The overall impact for removal of all six risk factors amounts to 19.7% for the average attributable fraction. Neck tension and consumption of alcohol ranked as the strongest population-attributable risk factor for any headache. The potential impact for migraine was considerably higher (43.8%). With increasing age, the overall impact of risk factors on headache increases by 18.9%.
Conclusion Based on the estimations of the most appropriate approach, up to 20% of headaches in general and up to 43% of migraine in adolescents might be preventable by removing risk factors amenable to intervention, with increasing proportions by age.
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References
- 1 Ellert U, Neuhauser H, Roth-Isigkeit A. [Pain in children and adolescents in Germany: the prevalence and usage of medical services. Results of the German Health Interview and Examination Survey for Children and Adolescents (KiGGS)]. Bundesgesund Gesundheitsforsch Gesundh 2007; 50 (5–6) 711-717
- 2 Stovner LS, Andree C. Prevalence of headache in Europe: a review for the Eurolight project. J Headache Pain 2010; 11: 289-299
- 3 Milde-Busch A, Blaschek A, Heinen F , et al. Associations between stress and migraine and tension-type headache: results from a school-based study in adolescents from grammar schools in Germany. Cephalalgia 2011; 31 (7) 774-785
- 4 Milde-Busch A, Blaschek A, Borggräfe I, Heinen F, Straube A, von Kries R. Associations of diet and lifestyle with headache in high-school students: results from a cross-sectional study. Headache 2010; 50 (7) 1104-1114
- 5 Blaschek A, Milde-Busch A, Straube A , et al. Self-reported muscle pain in adolescents with migraine and tension-type headache. Cephalalgia 2012; 32 (3) 241-249
- 6 Levin ML. The occurrence of lung cancer i… [Acta Unio Int Contra Cancrum. 1953] - PubMed - NCBI [Internet]. Available from http://www.ncbi.nlm.nih.gov/pubmed?term=(Levin%5BAuthor%5D)%20AND%20The%20occurence%20of%20lung%20cancer%5BTitle%5D
- 7 Greenland S. Morgenstern corrects a conceptual error. Am J Public Health 1983; 73 (6) 703-704
- 8 Benichou J. A review of adjusted estimators of attributable risk. Stat Methods Med Res 2001; 10 (3) 195-216
- 9 Gefeller O. Comparison of adjusted attributable risk estimators. Stat Med 1992; 11 (16) 2083-2091
- 10 Greenland S, Drescher K. Maximum likelihood estimation of the attributable fraction from logistic models. Biometrics 1993; 49 (3) 865-872
- 11 Eide GE, Gefeller O. Sequential and average attributable fractions as aids in the selection of preventive strategies. J Clin Epidemiol 1995; 48 (5) 645-655
- 12 Winter AC, Hoffmann W, Meisinger C , et al. Association between lifestyle factors and headache. J Headache Pain 2011; 12 (2) 147-155
- 13 Headache Classification Subcommmittee of the International Headache Society. The International Classification of Headache Disorders, 2nd edition. Cephalalgia 2004; (40) 669-74
- 14 Schulz P. Trier Inventory of Chronic Stress. Goettingen: Hogrefe; 2004
- 15 Morgenstern H. Uses of ecologic analysis in epidemiologic research. Am J Public Health 1982; 72 (12) 1336-1344
- 16 Rückinger S, von Kries R, Toschke AM. An illustration of and programs estimating attributable fractions in large scale surveys considering multiple risk factors. BMC Med Res Methodol 2009; 9: 7
- 17 Ulrich V, Gervil M, Olesen J. The relative influence of environment and genes in episodic tension-type headache. Neurology 2004; 62 (11) 2065-2069