Unmasking the Pain – De Novo Headache Associated with Mask Usage among Healthcare Workers in the Post-pandemic Scenario

Background: The extensive use of face masks during the COVID-19 pandemic was crucial for infection control; however, it is associated with unintended health challenges, including de novo headaches among healthcare workers (HCWs). As wearing masks remains the norm in high-risk environments, exploring the impact in the post-pandemic world is vital. Objective: To determine the prevalence, characteristics, and associated risk factors of de novo headaches related to mask use among HCWs. Methods: A cross-sectional study was conducted among 400 HCWs from multiple tertiary and secondary care hospitals in an Indian city. Data were collected through a structured questionnaire using Epicollect5, including demographic details, work conditions, mask type, and headache characteristics. De novo headache was defined as a new-onset headache temporally related to mask use. Data were analyzed using SPSS v26. Multivariable logistic regression analysis identified factors associated with headache. Results: The prevalence of mask-associated de novo headache was 16.5% (range: 13–20.5%). Most headaches were bilateral, affecting the frontal or temporal region, with onset within 3 hours of mask use. Over half experienced headaches ≥3 days/week, and most reported that the headaches were associated with N95 mask use. The prevalence of de novo headache was higher among nurses (32.7%), followed by those having respiratory illness (30.7%), using another PPE (27.3%), aged >30 years (23.1%), working in inpatient departments (18.7%), and female HCWs (18.4%). Factors such as being a nurse (AOR = 3.39, 95% CI 1.75–6.57) and having a respiratory illness (AOR = 2.42, 95% CI 1.11–5.27) were found to be significant in multivariable analysis. Conclusion: Mask-associated de novo headaches persist as a notable occupational health issue post-pandemic, particularly among nurses and individuals with respiratory illnesses. Targeted interventions such as ergonomic mask design, break schedules, and occupational screening are necessary to mitigate this preventable morbidity.