Milde-Busch A, von Kries R, Thomas S, Heinrich S, Straube A, Radon K. The association between use of electronic media and prevalence of headache in adolescents: results from a population-based cross-sectional study. BMC Neurol. Feb 9, 2010. 10(1):12. Ahead of print.

Headache is one of the most frequent health complaints worldwide, and it is commonly reported by adolescents. Whether or not health problems in general and headaches in particular are associated with frequent use of electronic media, is currently the matter of debate. Most studies on this subject have focused on mobile phones, have been conducted among adults, and their results are controversial.

The objectives of these investigations conducted in Bavaria, Germany, were “to assess the association between use of different types of electronic media (mobile phones, computer, playing with game consoles, watching television, listening to music) and prevalence of headache and to differentiate associations between different types of headache (migraine, tension-type headache, miscellaneous headache)”.

This study was part of a larger epidemiological study of possible effects of exposure to radiofrequency radiation on well-being of children and adolescents. A population-based sample of adolescents was personally interviewed on a broad range of health conditions and on type and duration of electronic media use. Of 1,025 adolescents aged 13-17 years with completed interview, conclusive information and non-missing values of potentially confounding socio-demographic variables, 489 reported episodes of headache at least once a month during the last six months. They responded to a detailed standardized questionnaire to ascertain the type of headache. All the other subjects (n=536) were included in the “no headache” group.

The use of mobile phones was relatively low in this sample: 77% of the participants reported less than 5 minutes or no use per day. Most participants reported daily use of computer/internet (85%), television (90%) and listening to music (90%). Only 27% of adolescents daily played with game consoles. There was a significant increasing trend in prevalence of headache (any type) with increasing duration of listening to music. This association remained significant after adjustment for age, sex, family condition and socio-economic status. However, it was no longer significant when cross-adjustment for all other electronic media use was made. In the analyses stratified by type of headache, few and inconsistent significant results were obtained. Significant associations were observed with socio-demographic factors, particularly with sex.

The authors discussed limitations of their study, including classification of exposure and outcome based solely on self-reports and lack of statistical power in analyses of separate types of headache. They also note the possibility of a “reverse causation” (for example, subjects suffering from headache may reduce electronic media use) and suggest that the temporal sequence of electronic media use and onset of headache be addressed in a longitudinal study.

The authors concluded that, based on their results, they “cannot point to systematic effect of single media types nor on specific types of headache which might predominantly be caused by the use of electronic media.”

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