Are migraine headaches disabilities under the ADA?

-headache-ThinkstockPhotos-100615844.jpgThe ADA does not contain a list of medical conditions that constitute disabilities. Instead, the ADA has a general definition of disability that each person must meet (EEOC Regulations . . ., 2011). Therefore, some people with migraine headaches will have a disability under the ADA and some will not.

A person has a disability if he/she has a physical or mental impairment that substantially limits one or more major life activities, a record of such an impairment, or is regarded as having an impairment (EEOC Regulations . . . , 2011). For more information about how to determine whether a person has a disability under the ADA, visit http://AskJAN.org/corner/vol05iss04.htm.


The above is an excerpt from the article, “Accommodation and Compliance Series: Employees with Migraine Headaches.” For more information please visitwww.askjan.org.

How Prevalent are Migraines? How are they Treated?

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How prevalent are migraine headaches?

According to the National Headache Foundation, an estimated 28 million Americans have migraine headaches. The World Health Organization considers migraines to be one of the most debilitating diseases in the world. In addition, an estimated 14 million Americans have undiagnosed migraine headaches (Lawrence, 2004).

Migraines are the second most prevalent headache syndrome in the United States. Statistics show that 157 million workdays each year are lost due to the severity of migraine headaches (Fackelmann, 2005).

Migraines are more prevalent in women, affecting women three times more than men. Estrogen levels are a key trigger for increased migraines in women, but how the changes trigger migraines is unknown. Women often report that their migraine occurs during or right before the onset of their menstrual cycle. In addition, some women experience migraines during pregnancy or menopause. Contraceptives and hormone replacement therapies have also been shown to cause more severe migraines (Mayo Clinic, 2005).

How are migraine headaches treated?

As of today, there is no cure for migraines. Often, individuals with migraines look at treating or preventing the migraine. Preventive medications are used to reduce the number of attacks for individuals that have two or more migraines a month. Examples of some of the prescribed medications are Beta-blockers, Anti-depressants, and Divalproex Sodium. Many individuals who take preventive medications also take medication to treat the severity of the migraine (Lawrence, 2004).

Accommodating Employees with Migraine Headaches

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People with migraine headaches may develop some of the limitations discussed below, but seldom develop all of them. Also, the degree of limitation will vary among individuals. Be aware that not all people with migraine headaches will need accommodations to perform their jobs and many others may only need a few accommodations. The following is only a sample of the possibilities available. Numerous other accommodation solutions may exist.

Questions to Consider:

  1. What limitations is the employee with migraines experiencing?
  2. How do these limitations affect the employee and the employee’s job performance?
  3. What specific job tasks are problematic as a result of these limitations?
  4. What accommodations are available to reduce or eliminate these problems? Are all possible resources being used to determine possible accommodations?
  5. Has the employee with migraines been consulted regarding possible accommodations?
  6. Once accommodations are in place, would it be useful to meet with the employee with migraines to evaluate the effectiveness of the accommodations and to determine whether additional accommodations are needed?
  7. Do supervisory personnel and employees need training regarding migraine headaches?

Accommodation Ideas

Lighting Triggers:

  • Add fluorescent light filters to existing fluorescent lights to create a more natural lighting
  • Change lighting completely
  • Provide an anti-glare filter for computer monitor
  • Provide a liquid crystal display monitor that has a better refresh rate
  • Move employee to a private area to allow for personal adjustment to appropriate lighting
  • Allow the employee to wear sunglasses or anti-glare glasses in the work area
  • Allow telework

Noise Triggers:

  • Move employee to a more private area or away from high traffic areas
  • Provide an environmental sound machine to help mask distracting sounds
  • Provide noise canceling headsets
  • Provide sound absorption panels
  • Encourage coworkers to keep non-work related conversation to a minimum

Smell/Fragrance Triggers:

  • Implement a fragrance-free policy
  • Request that employees voluntarily refrain from wearing fragrances
  • Allow telework
  • Move the employee to an area where the fragrances are not as strong
  • Allow a flexible schedule
  • Provide air purification systems

Other:

  • Provide flexible leave when the employee is experiencing a migraine
  • Allow the employee to telework when the employee is experiencing a migraine
  • Do not mandate attendance at after-hours social functions if an employee is affected by a disruption in sleep patterns
  • Provide the employee with a dark, private area to go to when experiencing a migraine

Situations and Solutions:

An employee who works in a cubicle setting was experiencing migraine headaches that were triggered by the noise level; she was located in a high traffic area by the copy machine. The employer accommodated this employee by moving her to an area with less traffic and providing an environmental sound machine.

A computer programmer experienced migraines that were triggered by the noise level in his cubicle and the overhead fluorescent lighting. As an accommodation, his employer provided him with a noise canceling headset, disabled the fluorescent light above his cubicle, and provided natural task lighting.

A human resource representative had migraines several times a month, which prevented her from working. As an accommodation, the employer provided unpaid flexible leave after all of her paid leave was exhausted.

An assembly line worker’s migraines were triggered by various fragrances. The employees around him often wore overwhelming perfumes that caused him to have a migraine. As an accommodation, the employer asked other employees to voluntarily refrain from wearing fragrances. The employee was also moved to a part of the assembly line where the fragrances were not as strong.

An accountant had a migraine headache about twice a week, which prevented him from coming to work. As an accommodation, the employer allowed this employee to work for home when he had a migraine headache. If his migraine was too severe to work from home, the employee was allowed to use comp time.



The above is an excerpt from the article, “Accommodation and Compliance Series:
Employees with Migraine Headaches.” For more information please visitwww.askjan.org.

Understanding Migraines

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What are migraine headaches?

Migraine headaches are the most common form of a vascular headache, which is an abnormal function of the brain’s blood vessels (UVA Health, 2004). There are several different types of migraines that have different symptoms associated with them. Examples of migraines include:

Classic Migraines: Classic Migraines are one of the most common types of migraines. They involve an aura 10-30 minutes before the migraine. Auras can consist of flashing lights, seeing zig-zag lines, or even temporary vision loss. Symptoms that may be associated with the Classic Migraine include throbbing or pounding felt in the forehead, temple, or jaw; difficulty with speech; weakness of an arm or leg; and confusion. A Classic Migraine attack could last up to 2 days.

Common Migraines: Common Migraines are another of the most common types of migraines. They differ from Classic Migraines because an aura does not precede the attack. However these symptoms may occur prior to the migraine: mental vagueness, mood changes, fatigue, retention of fluids, diarrhea and increased urination, and nausea and vomiting. Common Migraines may last up to 4 days.

Hemiplegic Migraines: Hemiplegic Migraines include symptoms such as temporary paralysis on one side of the body, vision deficits, and vertigo, which occur 10 – 90 minutes prior to the start of the Migraine.

Ophthal Moplegic: Ophthal Moplegic Migraines include vision problems, such as double vision.

Basilar Artery Migraines: Basilar Artery Migraines are characterized by a disturbance of a major brain artery. Symptoms may include vertigo, poor muscle coordination, and double vision.

Benign Exertional Headache: Benign External Headaches are migraines that are brought on by running, lifting, sneezing, or bending. The headache normally subsides after several minutes.

Status Migrainosus: Status Migrainosus is a severe migraine that can last 72 hours or longer and often results in hospitalization.

Headache-free Migraine: Headache-free Migraines are characterized by symptoms such as visual problems, nausea and vomiting, and constipation or diarrhea, but consist of no head pain (UVA Health, 2004).

What causes migraine headaches?

No one knows for certain what causes Migraine Headaches. Some doctors believe that they are due to changes in brain chemistry, which causes blood vessel dilation and inflammation. Research has shown that almost all individuals with migraines have a close relative who also has migraines (Mayo Clinic, 2005).

Although the direct cause of migraines is unknown, they are often a result of controllable and uncontrollable triggers. Examples of controllable triggers include lighting, smells, smoke, noise, disrupt in sleep patterns, and certain foods. Examples of uncontrollable triggers are weather, air pressure, and menstrual cycles. Often, when addressing accommodations it is important to talk with the employee about the triggers associated with the onset of the headache (Fackelmann, 2005).


The above is an excerpt from the article, “Accommodation and Compliance Series: Employees with Migraine Headaches.” For more information please visit www.askjan.org.

UV Index Scale: Sun Safety

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The UV Index scale used in the United States conforms with international guidelines for UVI reporting established by the World Health OrganizationExitLearn how to read the UV index Scale to help you avoid harmful exposure to UV radiation.

0 to 2: Low

UV Index Low - Green
A UV Index reading of 0 to 2 means low danger from the sun’s UV rays for the average person.
  • Wear sunglasses on bright days.
  • If you burn easily, cover up and use broad spectrum SPF 30+ sunscreen.
  • Watch out for bright surfaces, like sand, water and snow, which reflect UV and increase exposure.

3 to 5: Moderate

UV Index Moderate - Yellow

A UV Index reading of 3 to 5 means moderate risk of harm from unprotected sun exposure.

  • Stay in shade near midday when the sun is strongest.
  • If outdoors, wear protective clothing, a wide-brimmed hat, and UV-blocking sunglasses.
  • Generously apply broad spectrum SPF 30+ sunscreen every 2 hours, even on cloudy days, and after swimming or sweating.
  • Watch out for bright surfaces, like sand, water and snow, which reflect UV and increase exposure.

6 to 7: High

UV Index High - Orange

A UV Index reading of 6 to 7 means high risk of harm from unprotected sun exposure. Protection against skin and eye damage is needed.

  • Reduce time in the sun between 10 a.m. and 4 p.m.
  • If outdoors, seek shade and wear protective clothing, a wide-brimmed hat, and UV-blocking sunglasses.
  • Generously apply broad spectrum SPF 30+ sunscreen every 2 hours, even on cloudy days, and after swimming or sweating.
  • Watch out for bright surfaces, like sand, water and snow, which reflect UV and increase exposure.

8 to 10: Very High

UV Index Very High - Red

A UV Index reading of 8 to 10 means very high risk of harm from unprotected sun exposure. Take extra precautions because unprotected skin and eyes will be damaged and can burn quickly.

  • Minimize sun exposure between 10 a.m. and 4 p.m.
  • If outdoors, seek shade and wear protective clothing, a wide-brimmed hat, and UV-blocking sunglasses.
  • Generously apply broad spectrum SPF 30+ sunscreen every 2 hours, even on cloudy days, and after swimming or sweating.
  • Watch out for bright surfaces, like sand, water and snow, which reflect UV and increase exposure.

11 or more: Extreme

UV Index Extreme - Purple

A UV Index reading of 11 or more means extreme risk of harm from unprotected sun exposure. Take all precautions because unprotected skin and eyes can burn in minutes.

  • Try to avoid sun exposure between 10 a.m. and 4 p.m.
  • If outdoors, seek shade and wear protective clothing, a wide-brimmed hat, and UV-blocking sunglasses.
  • Generously apply broad spectrum SPF 30+ sunscreen every 2 hours, even on cloudy days, and after swimming or sweating.
  • Watch out for bright surfaces, like sand, water and snow, which reflect UV and increase exposure.

The Shadow Rule

An easy way to tell how much UV exposure you are getting is to look for your shadow:

  • If your shadow is taller than you are (in the early morning and late afternoon), your UV exposure is likely to be lower.
  • If your shadow is shorter than you are (around midday), you are being exposed to higher levels of UV radiation. Seek shade and protect your skin and eyes.


  • The above is an excerpt from the article, “UV Index Scale | Sun Safety.” For more information, please visit, www.epa.gov.

Clear the Clutter

clean-backroom-ThinkstockPhotos-97430553.jpgA cluttered workplace can lead to ergonomics issues and possible injuries because workers have less space to move, Gray said.

“When an area is cluttered, you’re going to likely have a cut or laceration injury,” she said. “You’re not going to have as much room to set up your workstation like you should and move around. You’re going to be twisting your body rather than moving your whole body.”

The Ohio Bureau of Workers’ Compensation recommends that workers return tools and other materials to storage after using them, and dispose of materials that are no longer needed.

Keep aisles, stairways, emergency exits, electrical panels and doors clear of clutter, and purge untidy areas. Empty trash receptacles before they overflow.


The above is an excerpt from the article, “11 tips for effective workplace housekeeping.” For more information visit http://www.safetyandhealthmagazine.com/.

Prevent Falling Objects

To some people, the word “housekeeping” calls to mind cleaning floors and surfaces, removing dust, and organizing clutter.

But in a work setting, it means much more. Housekeeping is crucial to safe workplaces. It can help prevent injuries and improve productivity and morale, as well as make a good first impression on visitors, according to Cari Gray, safety consultant for the Ohio Bureau of Workers’ Compensation. It also can help an employer avoid potential fines for non-compliance.

The practice extends from traditional offices to industrial workplaces, including factories, warehouses and manufacturing plants that present special challenges such as hazardous materials, combustible dust and other flammables. Experts agree that all workplace safety programs should incorporate housekeeping, and every worker should play a part. In addition, housekeeping should have management’s commitment so workers realize its importance

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Gray noted that protections such as a toe board, toe rail or net can help prevent objects from falling and hitting workers or equipment.

Other tips include stacking boxes and materials straight up and down to keep them from falling, said Paul Errico, a Fairfield, CT-based safety consultant. Place heavy objects on lower shelves, and keep equipment away from the edges of desks and tables. Also, refrain from stacking objects in areas where workers walk, including aisles.

Keep layout in mind so workers are not exposed to hazards as they walk through areas, Norton added.


The above is an excerpt from the article, “11 tips for effective workplace housekeeping.” For more information visit http://www.safetyandhealthmagazine.com/.

Control Dust for Cleaner Workspace

sander-concentrate-ThinkstockPhotos-520165591.jpgDust accumulation of more than 1/32 of an inch – or 0.8 millimeters – covering at least 5 percent of a room’s surface poses a significant explosion hazard, according to the Quincy, MA-based National Fire Protection Association. This dust accumulation is about as thick as a dime or paper clip.

An industrial hygienist should test the workplace for exposures if air quality and dust are concerns, Gray said.

NFPA 654 – a standard on preventing fire and dust explosions – addresses identifying hazard areas, controlling dust and housekeeping. The standard states that vacuuming is the “preferred” method of cleaning. Sweeping and water wash-down are other options. “Blow-downs” using compressed air or steam is allowed for inaccessible or unsafe surfaces.

Industrial vacuums can clean walls, ceilings, machinery and other places, CCOHS notes.

“You want to use wet methods or have high-efficiency vacuum systems,” said Steve Ahrenholz, senior industrial hygienist at NIOSH’s Division of Surveillance, Hazard Evaluations and Field Studies. “You don’t want to use just a shop vac or dry-sweep it – definitely not using compressed air to blow it. [Then] you’re just re-suspending the dust and distributing it all over.”

Dust also can affect equipment’s length of life and quality of products, Ahrenholz added.


The above is an excerpt from the article, “11 tips for effective workplace housekeeping.” For more information visit http://www.safetyandhealthmagazine.com/.

Eliminate fire hazards

hvac-fb-shutterstock_160580267Employees are responsible for keeping unnecessary combustible materials from accumulating in the work area. Combustible waste should be “stored in covered metal receptacles and disposed of daily,” according to OSHA’s Hazardous Materials Standard (1910.106).

The National Safety Council “Supervisors’ Safety Manual” includes these precautionary measures for fire safety:

  • Keep combustible materials in the work area only in amounts needed for the job. When they are unneeded, move them to an assigned safe storage area.
  • Store quick-burning, flammable materials in designated locations away from ignition sources.
  • Avoid contaminating clothes with flammable liquids. Change clothes if contamination occurs.
  • Keep passageways and fire doors free of obstructions. Stairwell doors should be kept closed. Do not store items in stairwells.
  • Keep materials at least 18 inches away from automatic sprinklers, fire extinguishers and sprinkler controls. The 18-inch distance is required, but 24 to 36 inches is recommended. Clearance of 3 feet is required between piled material and the ceiling. If stock is piled more than 15 feet high, clearance should be doubled. Check applicable codes, including Life Safety Code, ANSI/NFPA 101-2009.
  • Hazards in electrical areas should be reported, and work orders should be issued to fix them.

The above is an excerpt from the article, “11 tips for effective workplace housekeeping.” For more information visit http://www.safetyandhealthmagazine.com/.

Prevent slips, trips and falls

fall-office-fb--shutterstock_236390041Slips, trips and falls were the second leading cause of nonfatal occupational injuries or illnesses involving days away from work in 2013, according to data from the Bureau of Labor Statistics.

OSHA’s Walking-Working Surfaces Standard (1910.22(a)) states that all workplaces should be “kept clean and orderly and in a sanitary condition.” The rule includes passageways, storerooms and service rooms. Floors should be clean and dry. Drainage should be present where “wet processes are used.”

Employers should select adequate flooring (e.g., cement, ceramic tile or another material), as different types of flooring hold up better under certain conditions, said Fred Norton, technical director of ergonomics and manufacturing technology for Risk Control Services, Liberty Mutual Insurance in Walnut Creek, CA. Then, develop and implement housekeeping procedures using appropriate cleaners.

“Things like oils and grease – if you don’t use the right kind of cleaning protocols, you’ll just spread slipperiness around rather than getting it up and off the floor,” Norton said.

To help prevent slip, trip and fall incidents, the Canadian Center for Occupational Health and Safety recommends the following:

  • Report and clean up spills and leaks.
  • Keep aisles and exits clear of items.
  • Consider installing mirrors and warning signs to help with blind spots.
  • Replace worn, ripped or damage flooring.
  • Consider installing anti-slip flooring in areas that can’t always be cleaned.
  • Use drip pans and guards.

In addition, provide mats, platforms, false floors or “other dry standing places” where useful, according to OSHA. Every workplace should be free of projecting nails, splinters, holes and loose boards.

Gray added that employers should audit for trip hazards, and encourage workers to focus on the task at hand.


The above is an excerpt from the article, “11 tips for effective workplace housekeeping.” For more information visit http://www.safetyandhealthmagazine.com/.