Impacts of PM2.5 Air Pollution on Migraine Outcomes in Northern Thailand: A Pilot Comparison Study of Polluted and Non-Polluted Periods.

BACKGROUND

Emerging evidence suggests that air pollution, particularly fine particulate matter (PM2.5), may exacerbate migraine. Northern Thailand experiences severe seasonal air pollution, offering a unique context to investigate this association. This study aimed to evaluate the impact of seasonal PM2.5 exposure on migraine frequency, severity, emergency room (ER) visits, and medication use.

METHODS

This retrospective observational study included 42 adult migraine patients attending a university hospital's headache clinic from 2021 to 2023 who completed monthly headache diaries. PM2.5 data were obtained from national monitoring networks. "Polluted months" (January-May) were compared with "non-polluted months" (June-December). Study outcomes included headache frequency (days/month), pain severity (mild/moderate/severe), ER visits, and medication use.

RESULTS

Among 42 patients (mean age: 39.2 years; 57.1% female), headache frequency was higher during polluted months (6.4 vs 4.3 days/month, P < 0.001). All pain severity levels increased significantly during polluted periods. ER visits rose markedly (3.37 vs 0.65 visits/patient, P < 0.001). Use of both migraine-specific and non-specific medications per patient was significantly greater in polluted months.

CONCLUSION

PM2.5 exposure is associated with increased migraine burden. Seasonal air pollution may worsen headache frequency, severity, and healthcare utilization. Air quality should be considered in migraine management and environmental policy planning.