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Abstract Details

Air pollution, methane super-emitters, and oil and gas wells in Northern California: the relationship with migraine headache prevalence and exacerbation
Headache
Headache Posters (7:00 AM-5:00 PM)
075

Prior studies report associations between fine particles (PM2.5), nitrogen dioxide (NO2), and ozone and migraine-related emergency department (ED) visits. To our knowledge, none have evaluated the importance of methane super-emitters or oil and gas wells, nor have any considered alternative proxies for migraine exacerbation beyond ED visits.

Examine the implications of environmental exposures for migraine headache among Sutter Health patients in Northern California. 
We identified 89,575 migraine cases between 2014–2018 using a migraine probability algorithm (MPA) score and 270,564 frequency-matched controls. Exposures included 2015 annual average block group-level PM2.5 and NO2 concentrations, inverse-distance weighted (IDW) methane emissions from super-emitters within 10km of participant residences between 2016–2018, and 2015 IDW active oil and gas wells within 10km of participant residences. We used logistic and negative binomial mixed models to evaluate the association between environmental exposures and (1) migraine case status; and (2) migraine severity (i.e., MPA score >100, triptan prescriptions, neurologist visits, urgent care migraine visits, and ED migraine visits). Models controlled for age, sex, race/ethnicity, Medicaid eligibility, primary care visits, population density, and community poverty.
For each 5 ppb increase in NO, we observed 2% increased odds of migraine case status (95% CI: 1.00, 1.05) and for each 100,000 kg/hour increase in IDW methane emissions, the odds of case status also increased (OR = 1.04, 95% CI: 1.00, 1.08). PM2.5 was linearly associated with neurology visits, migraine-specific urgent care visits, and MPA score >100, but not triptans or ED visits. NOwas associated with migraine-specific urgent care and ED visits, but not other severity measures. We observed limited associations between continuous measures of methane emissions and proximity to oil and gas wells and migraine severity.

Our findings illustrate the potential role of multiple ambient air pollutants for prevalent migraine and migraine severity.

Authors/Disclosures
Holly Elser, MD, PhD (Hospital of the University of Pennsylvania)
PRESENTER
Dr. Elser has nothing to disclose.
Rachel Morello-Frosch (University of California, Berkeley) The institution of Rachel Morello-Frosch has received research support from NIH. The institution of Rachel Morello-Frosch has received research support from Cal-EPA. The institution of Rachel Morello-Frosch has received research support from US-EPA.
Alice Jacobson (Sutter Health) Alice Jacobson has nothing to disclose.
Alice Pressman No disclosure on file
Marianthi-Anna Kioumourtzoglou, 7882 Marianthi-Anna Kioumourtzoglou, 7882 has nothing to disclose.
Richard Reimer No disclosure on file
Joan Casey (Columbia University Mailman School of Public Health) Joan Casey has nothing to disclose.