OBJECTIVE: To investigate the cross-sectional and longitudinal association between psychosocial work factors, assessed as work-unit averages, and headache. For comparison, we applied individual exposure measures.

METHODS: We used questionnaire-data on headache and psychosocial work factors (PWF). In total, 2247 employees were included in the cross-section analyses and 553 in the longitudinal analyses using work-unit averages. The corresponding numbers for the analyses using individual exposure measures were 4261 and 942 employees.

RESULTS: Low skill discretion and low decision authority were most consistently associated with higher odds of headache across all analyses. Role conflicts, bullying, and effort-reward imbalance were associated with headache in some analyses. All PWF were associated with headache in cross-sectional analyses with individual exposure measures.

CONCLUSION: This study partly supports the hypothesis of an effect of PWF, as a source of psychological stress, on the risk of headache.