Air pollution and daily ED visits for migraine and headache in Edmonton, Canada

BackgroundA variety of environmental factors have been identified as possible triggers for migraine and other headache syndromes.ObjectiveWe analyzed associations between air pollution and emergency department (ED) visits for migraine and headache.MethodsAnalysis was based on 56 241 ED visits for migraine and 48 022 ED visits for headache to Edmonton hospitals between 1992 and 2002. A Poisson model of counts hierarchically clustered by day of week, month, and year was applied using generalized linear mixed models. Temperature and relative humidity were included as covariates.ResultsFemales accounted for 78.5% of migraine visits and 56.3% of headache visits. An interquartile range (IQR) increase (6.2 μg/m3) in daily average particulate matter of median aerodynamic diameter less than 2.5 μm (PM2.5) was associated with increases in visits of 3.3% for migraine (95% confidence interval [CI]: 0.6-6.0), lagged 2 days, and 3.4% for headache (95% CI: 0.3-6.6), lagged 0 days, among females in the cold season (October-March). PM2.5 was also associated with cold season migraine visits among females at lag 0 and 1 day (P < .1). In the warm period (April-September), a 2.3-ppb IQR increase in sulfur dioxide was associated with a 2.5% increase in migraine visits (95% CI: 0.3-4.6) among females, whereas a 12.8-ppb IQR increment in nitrogen dioxide was associated with a 6.8% increase in headache visits (95% CI: 1.5-12.5) for males.ConclusionsFindings provide preliminary evidence of an association between air pollution and ED visits for migraine and nonspecific headache. Findings were most consistent for particulate matter.