A study of classroom acoustics and school teachers’ noise exposure, voice load and speaking time during teaching, and the effects on vocal and mental fatigue development

Measuring Vocal Fatigability in Teachers: The Vocal Fatigability Scale for Teachers (VFS-T)

OBJECTIVES

This study focuses on the distinction between vocal fatigability and vocal fatigue (VF), highlighting the importance of vocal fatigability when assessing teachers' quality of life. Vocal fatigability is more critical for quality of life than performance or perceived VF because it considers the accumulation and chronicity of fatigue over isolated tasks. The objectives are to develop and validate the Vocal Fatigability Scale for Teachers (VFS-T), to assess teachers' levels of vocal fatigability, and to analyze variations based on personal and occupational traits. The VFS-T construct encompasses items related to vocal sensations and performance, their connection to accumulated demanding vocal activity, descriptions of recovery strategies, necessary rest periods, and the impact of VF on daily activities.

STUDY DESIGN

A single cross-sectional study with an ex post facto design was conducted.

METHODS

The sample consisted of 184 active teachers with various vocal conditions. They completed the VFS-T questionnaire, provided personal and occupational data, and completed the VHI-10 questionnaire. The data collected were analyzed for item refinement, internal structure, reliability, validity, diagnostic capacity, cutoff values, and group differences.

RESULTS

The item refinement and internal structure analysis revealed a scale comprising 17 items grouped into two factors. The VFS-T shows good reliability and validity, with cutoffs at <15 for no fatigability, 15-27 for moderate fatigability, and >28 for high fatigability. Most teachers fall into the moderate fatigability range, with 72% experiencing vocal fatigability.

CONCLUSIONS

The VFS-T is a reliable tool for detecting vocal fatigability in teachers. This scale focuses on the construct of vocal fatigability, which is related to chronicity of VF and limitations in daily activities in teachers.

Student's Self-Reported Experience of Soundscape: The Link between Noise, Psychological and Physical Well-Being

Extensive research has shown that noise has detrimental effects on learning in classrooms, yet schools remain noisy environments. In addition, little is known about the students' insight into their subjective reaction to noise. Students' awareness of noise, as well as their perception of its effects on their affective and bodily states, remain unanswered. In the current study, the self-reported experience of noise and reaction towards noise, which was collected by way of a questionnaire, was assessed for 408 students in primary and secondary schools in Québec. Results suggest that about half of the students experience affective and bodily reactions to noise, and students who report having a negative affective reaction to noise are also more prone to report feeling this noise in their bodies. The results of this study offer a comprehensive picture of the students' subjective (affective and bodily) state in relation to noise in schools.

The Effects of Classroom Acoustic Conditions on Teachers' Health and Well-Being: A Scoping Review

PURPOSE

Teachers spend a significant amount of time in classrooms, which can be noisy environments. The aim of this scoping review was to determine what is known from the literature about the effect of classroom acoustic conditions on teachers' health and well-being.

METHOD

This scoping review followed the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews) protocol. Four bibliographic databases were searched: ERIC, PubMed, Scopus, and Web of Science.

RESULTS

Thirty-three articles were deemed relevant for the review. The most studied health aspect was teachers' vocal health. The majority of results showed higher noise levels or a higher number of students have a negative effect on teachers' health and well-being (61% and 60%, respectively), while 39% showed a negative effect of longer reverberation times. Most other results showed no effect.

CONCLUSIONS

These results show that poor classroom acoustic conditions can have a negative effect on teachers' health and well-being. Therefore, creating classrooms with good acoustic conditions and controlling noise is vital. Limitations are discussed, and future research to better understand the relationship between classroom acoustic conditions and teachers' health and well-being is proposed. This future research will help in understanding the acoustic conditions that are needed to optimize teachers' health and well-being in the classroom.

Social Vulnerability of Brazilian Metropolitan Schools and Teachers' Absence from Work Due to Vocal and Psychological Symptoms: A Multilevel Analysis

Teachers' voices and psychological symptoms are the main reasons for absence from work. The objectives of this study were: (i) to spatially represent, through a webGIS, the standardized rates of teachers' absences due to voice (outcome 1) and psychological symptoms (outcome 2) in each Brazilian Federative Unit (FU = 26 states plus Federal District) and (ii) to analyze the relationship between each national outcome rate and the Social Vulnerability Index (SVI) of the municipality where urban schools are located, adjusted for sex, age, and working conditions. This cross-sectional study comprised 4979 randomly sampled teachers working in basic education urban schools, of which 83.3% are women. The national absence rates were 17.25% for voice symptoms and 14.93% for psychological symptoms. The rates, SVI, and school locations in the 27 FUs are dynamically visualized in webGIS. The multilevel multivariate logistic regression model showed a positive association between voice outcome and high/very high SVI (OR = 1.05 [1.03; 1.07]), whereas psychological symptoms were negatively associated with high/very high SVI (OR = 0.86 [0.85 0.88]) and positively associated with intermediate SVI (OR = 1.15 [1.13; 1.16]), in contrast with low/very low SVI. Being a woman (voice: OR = 1.36 [1.35; 1.38]; psychological: 1.22 [1.21; 1.24]) and working in schools with various precarious conditions (17 variables) increased the odds of being absent due to voice and psychological symptoms. The results confirm the need for investments to improve working conditions in schools.

The Effects of Room Acoustics on Self-reported Vocal Fatigue: A Systematic Review

PURPOSE

The main objective of the present systematic review is to quantify the relationship between the room acoustics and self-reported vocal fatigue.

METHODS

A comprehensive literature search and systematic review were conducted using PubMed/MEDLINE, Science Direct, Web of Science, EBSCO, and Scopus databases. Two inclusion criteria were defined: (1) description of a relationship between the room acoustics and self-reported vocal fatigue; and (2) reporting of raw data and/or a statistic of the association between the variables. Risk of bias in the included studies was assessed via the Quality Assessment Tool for Quantitative Studies Effective Public Health Practice Project. The occurrences and frequencies of the most common parameters in the literature are presented, and a quantitative summary of their relationships is reported.

RESULTS

In total, 12 publications met the inclusion criteria. The most relevant measures of self-reported vocal fatigue were the Vocal Fatigue Index (n = 3), Vocal Signs and Symptoms Questionnaire (n = 1), and vocal fatigue visual analog scales (n = 2). The most relevant room acoustic parameters include noise conditions (n = 6) and reverberation time (n = 2). The relationships between the room acoustic parameters and self-reported vocal fatigue are quantified and reported while maintaining the concepts stated in the original articles and outlining their similarities.

CONCLUSION

Overall, background noise and reverberation time were determined to be the most significant independent variables associated with self-reported vocal fatigue. A primary limitation of the evidence was inconsistent measures of self-reported vocal fatigue.

Vocal Behavior of Teachers Reading with Raised Voice in a Noisy Environment

(1) Objective: Teaching is a particularly voice-demanding occupation. Voice training provided during teachers’ education is often insufficient and thus teachers are at risk of developing voice disorders. Vocal demands during teaching are not only characterized by speaking for long durations but also by speaking in noisy environments. This provokes the so-called Lombard effect, which intuitively leads to an increase in voice intensity, pitch and phonation time in laboratory studies. However, this effect has not been thoroughly investigated in realistic teaching scenarios. (2) Methods: This study thus examined how 13 experienced, but vocally untrained, teachers behaved when reading in a noisy compared to quiet background environment. The quiet and noisy conditions were provided by a live audience either listening quietly or making noise by talking to each other. By using a portable voice accumulator, the fundamental frequency, sound pressure level of the voice and the noise as well as the phonation time were recorded in both conditions. (3) Results: The results showed that the teachers mainly responded according to the Lombard effect. In addition, analysis of phonation time revealed that they failed to increase inhalation time and appeared to lose articulation through the shortening of voiceless consonants in the noisy condition. (4) Conclusions: The teachers demonstrated vocally demanding behavior when speaking in the noisy condition, which can lead to vocal fatigue and cause dysphonia. The findings underline the necessity for specific voice training in teachers’ education, and the content of such training is discussed in light of the results.

Voice Problems Among School Teachers employing the Tele-teaching Modality

OBJECTIVES

To assess the prevalence of voice problems among teachers in Riyadh during tele-teaching and examine the relationship between the Voice Handicap Index 10 (VHI10) scores and a variety of risk factors believed to be related to voice problems. We also assessed awareness of voice hygiene and therapy among teachers.

STUDY DESIGN

An observational cross-sectional study conducted using a multistage random sampling method among Riyadh school teachers who taught by tele-teaching for a minimum of one year.

METHODS

A self-assessment questionnaire which included demographic information about teachers, factors related to their teaching backgrounds, tele-teaching settings, effects of tele-teaching on the voice, medical and social histories, reports of voice and reflux symptoms, VHI10, and general knowledge about voice hygiene. This was distributed to school teachers using an SMS link through the Ministry of Education's IT department.

RESULTS

A total 495 were included in the study after exclusions. The prevalence of teachers who had significant voice problems during tele-teaching (VHI10>11) was 21.6%. Multiple risk factors significantly increased the risk of voice problems during tele-teaching. These factors included being female, teacher age, the presence of background noise from both teachers and students, loud voices, using an open camera during the teaching, stress and anxiety, allergies, respiratory disease, reflux, hearing problems, and a family history of voice problems. Only 4.6% of respondents were familiar with voice hygiene and voice therapy, but 65% believe that it is important for teachers to be knowledgeable about them.

CONCLUSIONS

Due to the lower prevalence of voice disorders among tele-teaching compared to traditional teaching methods, tele-teaching may be a viable option for teachers who have voice problems. There are still several factors influencing voice problems among tele-teachers. To attenuate potential risks, it is crucial that teachers are aware of the concepts of voice hygiene and voice therapy.

Indoor environmental quality in naturally ventilated schools of a dusty region: Excess health risks and effect of heating and desert dust transport

Indoor air quality (IAQ) is impacted by polluted outdoor air in naturally ventilated schools, especially in places where both anthropogenic and natural sources of ambient air pollution exist. CO₂ , PM_2.5 , PM₁₀ , temperature, relative humidity (RH), and noise were measured in five naturally ventilated primary schools in City of Sanliurfa, in a dusty region of Turkey, Southeast Anatolia. Excess risk levels were estimated for particulate matter. Investigation was conducted through an educational year including two seasons in terms of anthropogenic effect, that is, heating/non-heating, and natural effect, that is, desert dust transport/non-dust transport. The median CO₂ concentration was measured to be >1000 ppm in all seasons/schools. Temperature and RH fell out of the comfort zone in October-December, during which pollutant concentrations were considerably increased, specifically in November, that heating and dust transport periods coincide. The overall mean indoor PM₁₀ and PM_2.5 levels were 58 and 31.8 μg/m³ , respectively. Risk assessment indicate that both short (incidence of asthma symptoms in asthmatic children) and long-term (prevalence of bronchitis) effects are considerable with 10.9 (2.4-19.6)% and 19.5 (2.2-38.8)%, respectively. The findings suggest that mechanical ventilation retrofitting with particle filtration is needed to mitigate potential negative health consequences on children.

Self-Perception of Vocal Effort in Response to Modeled Communication Demands

OBJECTIVES

The optimization of vocal effort given a response to a voice demand is a common clinical and vocal performance goal. Increases in vocal effort are often in response to communication limitations from both the interlocutors and the communication environment. This study investigates the relationship between vocal effort and vocal demands from changes and limitations imposed by the communication environment.

METHODS

Thirty-seven participants rated their vocal effort associated with a map description task in a range of communication demands. These demands included communication distance (from 1 m to 4 m), loudness goal (54 dB-66 dB), and excess background noise (53 dBA-71 dBA). The vocal effort ratings were compared across the different types and extents of vocal demand conditions.

RESULTS

As would be expected, there were significant increases in vocal effort levels from the control condition to the extremes of the distance and loudness goal vocal demands. Each increase in background noise resulted in distinct increases in vocal effort level. Participants were able to use the vocal effort scale to efficiently quantify expected increases in vocal demands.

CONCLUSIONS

Increases of vocal effort level accompany increases to vocal demands that exceed the habitual or expected communication. While voice training and vocal therapy are essential for reducing internal vocal demands, clients with a goal to reduce vocal effort should also consider external vocal demands such as communication distance and background noise.

Videoconference Fatigue: A Conceptual Analysis

Videoconferencing (VC) is a type of online meeting that allows two or more participants from different locations to engage in live multi-directional audio-visual communication and collaboration (e.g., via screen sharing). The COVID-19 pandemic has induced a boom in both private and professional videoconferencing in the early 2020s that elicited controversial public and academic debates about its pros and cons. One main concern has been the phenomenon of videoconference fatigue. The aim of this conceptual review article is to contribute to the conceptual clarification of VC fatigue. We use the popular and succinct label "Zoom fatigue" interchangeably with the more generic label "videoconference fatigue" and define it as the experience of fatigue during and/or after a videoconference, regardless of the specific VC system used. We followed a structured eight-phase process of conceptual analysis that led to a conceptual model of VC fatigue with four key causal dimensions: (1) personal factors, (2) organizational factors, (3) technological factors, and (4) environmental factors. We present this 4D model describing the respective dimensions with their sub-dimensions based on theories, available evidence, and media coverage. The 4D-model is meant to help researchers advance empirical research on videoconference fatigue.

Sustainable employability of teachers with hearing loss

OBJECTIVE

In many countries the retirement age is rising. Consequently, age-related hearing loss is an increasing occupational health problem. This study examined the association between hearing loss and sustainable employability of teachers.

DESIGN

For this cross-sectional study a survey and an online hearing screening test were used. Sustainable employability was measured with the Capability Set for Work Questionnaire (CSWQ), examining seven work values. CSWQ-scores of teachers with poor, insufficient, and good hearing were investigated with ordinal regression analyses. Work values and discrepancies between the importance and achievement of the values were examined by chi-square tests.

STUDY SAMPLE

Dutch teachers (N = 737) of whom 146 (20%) had insufficient and 86 (12%) poor hearing.

RESULTS

Teachers with insufficient (OR = 0.64; 95% CI 0.46-0.89) and poor (OR = 0.55; 95% CI 0.36-0.83) hearing had lower CSWQ-scores compared with good hearing teachers. Adjustment for covariates, in particular for self-rated health, attenuated the associations. Compared with good hearing teachers, teachers with poor hearing reported more discrepancies in using their knowledge and skills and setting their own goals at work.

CONCLUSIONS

Hearing loss was negatively associated with sustainable employability of teachers. This emphasises the importance of assessing the hearing status of teachers.

Psychische Gesundheit bei Referendaren

Hintergrund

Lehrkräfte sind in ihrem Beruf verschiedenen Belastungen ausgesetzt, aufgrund derer es zu Fehlbeanspruchungen kommen kann. Weniger bekannt ist dagegen die gesundheitliche Situation bei Referendaren.

Ziel der Studie

Es war zu klären, ob und inwieweit die psychische Gesundheit in Abhängigkeit der Referendariatsphase bei Referendaren beeinträchtigt ist, um den Bedarf an Präventionsmaßnahmen einschätzen zu können.

Methodik

Für die Studie wurden 131 Referendare im Alter von 28,1 ± 3,7 Jahren aus Magdeburg und Umgebung befragt. 72 von ihnen befanden sich in der Einstiegsphase des Referendariats, 51 in der Qualifizierungsphase und 8 in der Prüfungsphase. Die psychische Gesundheit wurde mit der Kurzversion des „General Health Questionnaire 12“ (GHQ-12), die Anstrengungsbereitschaft mit einem Teil des Effort-reward-imbalance(ERI)-Fragebogens und das Burnout-Risiko mit dem Maslach-Burnout-Inventar (MBI) erhoben. Zusätzlich wurden arbeitsbezogene Verhaltens- und Erlebensmuster (AVEM) erfasst.

Ergebnisse

Bei 41 (31,3 %) Referendaren war die psychische Gesundheit bereits beeinträchtigt, sie wiesen auch einige Burnout-Symptome auf. In der Qualifizierungsphase war die emotionale Erschöpfung stärker als in der Einstiegsphase. Mehrheitlich waren gesundheitsförderliche Muster G und S vertreten, bei etwa einem Drittel der Referendare überwogen die gesundheitsgefährdenden Verhaltensmuster A und B.

Schlussfolgerung

Da sich die psychische Gesundheit bereits im Referendariat bei etwa einem Drittel der Referendare beeinträchtigt gezeigt hat, müssen präventive Maßnahmen als Pflichtveranstaltung in das Studium integriert werden, um die Gesundheit der Referendare zu erhalten.

Noise exposure among teachers in technology educational shops in selected British Columbia, Canada, high schools

Teachers in technology education shops (TESs) in high schools are at risk from exposure to occupational hazards, including physical work demands and chemicals, particulate matter and noise, as well as non-optimal working conditions negatively affected by temperature, humidity, and lighting. This study evaluated the exposure to noise of 17 TES teachers working in 17 wood-working, metal-working, and automotive shops in selected high schools in British Columbia, Canada, and examined the quality of the acoustical teaching environments due to background noise. This study characterized noise control measures in the sampled TESs and observed the safety practices of teachers during TES classes. The results of this investigation indicated that almost 60% of the participating teachers were exposed to unacceptable levels of noise during teaching and working in TESs. It also showed that TES acoustical environmental quality was adversely affected by high background noise levels due to poor room designs and settings. Practical recommendations were provided to reduce and control the exposure to noise in TESs and to enhance the quality of health, safety, and quality of teaching environment in these TESs.

Are classroom thermal conditions, lighting, and acoustics related to teacher health symptoms?

Over half of schools surveyed in the United States reported one environmental problem affecting Indoor Air Quality. This study investigated environmental concerns in schools, teacher-reported symptoms, and performance in relation to thermal environment, lighting, and noise conditions in New York State classrooms. This cross-sectional study consisted of telephone surveys among teachers from 428 NYS public schools. Survey contents included teacher demographics, employment characteristics, and environmental factors. Unconditional logistic regression analyses were used to estimate odds ratios (OR) of health symptoms for classroom conditions including thermal environment, lighting, and acoustics. Although too dry, too hot, or cold were major thermal concerns, 78% of the teachers reported that they cannot control temperature through thermostat. Over 50% of NYS teachers reported almost all health symptoms worsening during workdays. We found the top five most common health symptoms reported by NYS teachers are all allergy-related symptoms. Additionally, all extreme thermal factors were significantly associated with work-related symptoms in teachers. "Too dry" had the highest risk for allergic symptoms (OR: 2.49, 95% CI: 2.01-3.10), and then followed by any noise (OR: 2.46, 95% CI: 1.80-3.36) associated with voice-related health, and "lighting too dim" (OR: 2.38, 95% CI: 1.77-3.19). Future studies are needed to confirm these findings.

A Pilot Study on the Relationship between Primary-School Teachers' Well-Being and the Acoustics of their Classrooms

Although teachers’ well-being and vocal health are affected by noise, research on classroom sound environment from the teachers’ perspective is scarce. This study investigated the relationship between teachers’ well-being and classroom acoustics. The possible influence of teachers’ age, experience, teaching grade and class size on the relationship was also investigated. In this study, well-being refers to self-reported vocal health, stress, burnout and self-efficacy. Twenty-three primary-school teachers answered questionnaires on well-being. In each teacher’s classroom, the acoustical properties were measured with the variables reverberation time, clarity of speech (C₅₀) and ventilation system noise (VSN). A series of non-parametric correlations were run to determine the relationship between teachers’ well-being and classroom acoustics. Initially, there was a significant bivariate correlation between burnout and VSN, as well as voice symptoms correlated with VSN and teaching grade. Although the results became not significant after correction for multiple tests, the findings indicate that higher degree of burnout is associated with higher levels of VSN in classrooms, and voice symptoms increase with higher VSN. Teachers working in lower grades had more voice symptoms than those working in higher grades.

Factors associated with perception of loud occupational noise by school teachers in basic education in Brazil

OBJECTIVE

To determine the prevalence of the perception of loud noise in basic education schools in Brazil and the associated factors.

METHODS

A cross-sectional study with a representative national sample of teachers. The data collection was conducted with 6,510 teachers from October 2015 to March 2016. All teachers answered a telephone questionnaire with questions related to health and working conditions. The measure of association was prevalence ratio, estimated using Poisson regression.

RESULTS

The prevalence of reported loud occupational noise was 33.0%. There was a positive association in the outcome of classroom disturbance reports (PR = 3.41; 95%CI 3.07 - 3.75), feeling of working under high-pressure levels (PR = 1.33; 95%CI 1.22-1.45), having suffered verbal abuse from students (PR = 1.21; 95%CI 1.11-1.31), teaching in different teaching modalities (PR = 1.21; 95%CI 1.02-1.42), more than 30 active teachers in the school (PR = 1.28; 95%CI 1.07-1.54). The teachers who reported a pleasant school environment (PR = 0.81; 95%CI 0.75-0.87), along with the teachers who worked in rural areas (PR = 0.84; 95%CI 0.75-0.95), experienced less noise at work.

CONCLUSION

The prevalence of loud noise perception in Brazilian schools reached high levels and showed statistical significance with the characteristics of schools and teacher's work environment. These results demonstrate the need for developing public policies that take into consideration the reduction of noise levels in schools.

Teachers' and Children's Experiences after an Acoustic Intervention and a Noise-Controlling Workshop in Two Elementary Classrooms

INTRODUCTION

Treating sources of noise is a novel aspect of voice ergonomics intended to enhance the preconditions for good voice production and easy listening.

OBJECTIVE

To improve experiences of listening and voice ergonomics in classrooms.

METHODS

Participants were two female elementary school teachers with voice symptoms and their pupils (n = 50). Two interventions were performed: the acoustic intervention and then the workshop intervention where the teachers and pupils were active. Teachers' voice symptoms and pupils' and teachers' experiences of the interventions were elicited by questionnaire.

RESULTS

The teacher with many voice symptoms experienced more annoyance from sounds and benefitted more from the interventions. After the interventions both teachers suffered fewer voice breaks and voice symptoms such as lump and mucus in the throat. The pupils reported improvement in the teachers' voice clarity and audibility (p = 0.001). Pupils aged 12-13 years were more annoyed by sounds than those aged 8-9 years (p = 0.003). The older pupils experienced less sound annoyance after both interventions and the younger ones after the workshop intervention.

CONCLUSIONS

The importance of good acoustics and individuals' ability to improve voice ergonomics and listening conditions was demonstrated.

Prevalence and Risk Factors of Voice Disorders in French Tour Guides

OBJECTIVE/HYPOTHESIS

Voice disorders are frequently observed among professionals using their voice as their main working tool (ie, occupational voice users). The objective of this study is to establish the prevalence of voice disorders in tour guides and to evaluate the risk factors associated with these disorders.

STUDY DESIGN

An online survey, containing the VHI-10 test, was sent to the metropolitan France guides in November 2017. The results were analyzed using answers of tour guides dispatched in all metropolitan French departments.

RESULTS

We received 465 replies. Voice disorders were highly prevalent (up to 21.29%) according to the VHI-10 and were comparable to observed rates in other professional categories (teachers and telecommunicators). The proportion of guides complaining about voice disorders episodes (44.94%) is greater than in the overall general population. Specific work-related factors emerged in this study. First, the use of a high-intensity voice for more than 6 hours a week is a factor significantly associated with a higher risk of having a pathological score at VHI-10. Second, a significant proportion of the guides noted that noise pollution and changes in temperature affected their vocal quality.

CONCLUSIONS

In light of these results, we can conclude that the tour guide profession is subject to voice-related risks. The prevalence of voice disorders is particularly higher than in the general population and risk factors specific to tour guide population exist.

Preschool teachers' perspective on how high noise levels at preschool affect children's behavior

Early-age exposure to noise may have long-term health implications of which we have little knowledge of today. Age-specific hearing, learning inadequate coping strategies, and alterations in biological stress regulatory responses could play a role in the long-term health impacts. In Sweden about half a million children in the age between 1–5 years attend preschool. The noise exposure at preschools is intermittent and unpredictable and levels reach up to 84 dB LAeq (time indoors) with maximum levels of 118 dB LA_F, mostly due to child activity. To increase the overall understanding of the possible implications of preschool noise environments for children, this paper describes children’s behavioral and emotional reactions to and coping with their everyday sound environment from a teachers perspective. A postal questionnaire study performed in 2013–2014 with answers from 3,986 preschool teachers provided the data. Content analysis was combined with quantitative analysis. Eighty-two percent of the personnel considered that children’s behavior was affected rather or very much by preschool noise. The most prevalent behaviors were categorized into: be heard, be distracted, show negative internal emotions, crowd, avoid, withdraw, be exhausted, and learning. The quantitative analyses confirmed an association between the perceived loudness and noise annoyance at preschool and affirmative reporting on noise affecting the children´s behavior. Age of the personnel, with the youngest age group reporting noise related behavior less often, and age distribution of the class, with 1–5 years old seeming less affected by noise, were also indicated, while pedagogic orientation was not a significant factor. Future studies should address the long-term health effects of these behaviors.

Condições de trabalho e de voz em professores de escolas públicas e privadas

RESUMO Objetivo Identificar se existe correlação entre o Índice de Triagem para Distúrbio de Voz e as condições de trabalho de professores das escolas públicas e privadas e compará-las entre os professores das duas redes de ensino. Métodos Participaram 183 professores, sendo 122 de escolas públicas e 61 de uma escola privada, que responderam ao questionário Condição de Produção Vocal do Professor, composto por 81 questões. Destas, entretanto, foram analisadas as questões referentes à identificação pessoal, funcional, condições vocais e de trabalho. Foi realizada análise estatística descritiva e inferencial. Resultados Quando analisados em relação às condições vocais, a maioria dos professores das escolas públicas relatou queixa vocal. O Índice de Triagem para Distúrbio de Voz dos professores das escolas públicas correspondeu a mais sintomas vocais do que os da escola privada. Além disso, os docentes das escolas públicas relataram piores condições de trabalho, em relação aos docentes da escola privada. Conclusão Existe uma correlação negativa entre o Índice de Triagem para Distúrbio de Voz e as condições de trabalho dos professores de escola pública e particular. Os professores das escolas públicas relataram piores condições de trabalho do que os da escola privada, bem como referiram maior ocorrência de distúrbio da voz e apresentaram maior pontuação no Índice de Triagem para Distúrbio de Voz.

Influence of Noise Resulting From the Location and Conditions of Classrooms and Schools in Upper Egypt on Teachers' Voices

PURPOSE

Teachers are professional voice users, always at high risk of developing voice disorders due to high vocal demand and unfavorable environmental conditions. This study aimed at identifying possible correlations between teachers' voice symptoms and their perception of noise, the location of schools, as well as the location and conditions of their classrooms.

METHOD

One hundred forty teachers (ages 21-56) from schools in Upper Egypt participated in this study. They filled out a questionnaire including questions about the severity and frequency of their voice symptoms, noise perception, and the location and conditions of their schools and classrooms. Questionnaire responses were statistically analyzed to identify possible correlations.

RESULTS

There were significant correlations (P < 0.05) between voice symptoms, teachers' noise perception, and noise resulting from the location and conditions of schools and classrooms. Teachers experienced severe dysphonia, neck pain, and increased vocal effort with weekly or daily recurrence. Among the teachers who participated in the study, 24.2% felt they were always in a noisy environment, with 51.4% of the total participants reporting having to raise their voices. The most common sources of noise were from student activities and talking in the teachers' own classrooms (61.4%), noise from adjacent classrooms (52.9%), and road traffic (40.7%).

CONCLUSIONS

Adverse effect on teachers' voices due to noise from poor school and classroom conditions necessitates solutions for the future improvement of conditions in Egyptian schools. This study may help future studies that focus on developing guidelines for the better planning of Egyptian schools in terms of improved infrastructure and architecture, thus considering the general and vocal health of teachers.

Presenting and processing information in background noise: A combined speaker-listener perspective

Transferring information orally in background noise is challenging, for both speaker and listener. Successful transfer depends on complex interaction between characteristics related to listener, speaker, task, background noise, and context. To fully assess the underlying real-life mechanisms, experimental design has to mimic this complex reality. In the current study, the effects of different types of background noise have been studied in an ecologically valid test design. Documentary-style information had to be presented by the speaker and simultaneously acquired by the listener in four conditions: quiet, unintelligible multitalker babble, fluctuating city street noise, and little varying highway noise. For both speaker and listener, the primary task was to focus on the content that had to be transferred. In addition, for the speakers, the occurrence of hesitation phenomena was assessed. The listener had to perform an additional secondary task to address listening effort. For the listener the condition with the most eventful background noise, i.e., fluctuating city street noise, appeared to be the most difficult with markedly longer duration of the secondary task. In the same fluctuating background noise, speech appeared to be less disfluent, suggesting a higher level of concentration from the speaker's side.

The Effect of Classroom Capacity on Vocal Fatigue as Quantified by the Vocal Fatigue Index

OBJECTIVE

Previous research has concluded that teachers are at a higher-than-normal risk for voice issues that can cause occupational limitations. While some risk factors have been identified, there are still many unknowns.

PATIENTS AND METHODS

A survey was distributed electronically with 506 female teacher respondents. The survey included questions to quantify three aspects of vocal fatigue as captured by the Vocal Fatigue Index (VFI): (1) general tiredness of voice (performance), (2) physical discomfort associated with voicing (pain), and (3) improvement of symptoms with rest (recovery). The effect of classroom capacity on US teachers' self-reported experience of vocal fatigue was analyzed.

RESULTS

The results indicated that a classroom's capacity significantly affected teachers' reported amounts of vocal fatigue, while a teacher's age also appeared to significantly affect the reported amount of vocal fatigue. A quadratic rather than linear effect was seen, with the largest age effect occurring at around 40-45 years in all three factors of the VFI.

CONCLUSION

Further factors which may affect vocal fatigue must be explored in future research. By understanding what increases the risk for vocal fatigue, educators and school administrators can take precautions to mitigate the occupational risk of short- and long-term vocal health issues in school teachers.

Analysing the vocal behaviour of teachers during classroom teaching using a portable voice accumulator

PURPOSE

Teachers are at a considerable risk of developing vocal health problems due to intensive voice use during teaching. This study investigated factors related to the teacher's voice during a teaching situation.

METHODS

Overall, 113 teachers were recorded during a typical class lesson, lasting on average 48 min. A portable voice dosimeter (VoxLog System) was used to measure the sound pressure level (SPL) of the noise in the classroom, the teacher's voice SPL, the fundamental frequency (f_o) and the phonation time. General conditions of each lesson such as number of pupils, lesson subject and the educational level of the class were also collected. For the analysis, vocal loading doses and correlations between teacher's voice and noise SPL were calculated.

RESULTS

Voice and noise SPL values varied across the lesson subjects, with highest levels measured in sports lessons. The mean noise SPL changed throughout a lesson with highest values at the beginning and at the end of the lessons. The correlation analysis of voice and noise SPL identified two groups of teachers with different vocal SPL behaviours. For some teachers, the voice SPL varied with the noise SPL. For others, voice SPL was constantly high. A regression model on the teacher's voice SPL yielded a strong correlation with f_o, the classroom noise SPL, and the individual vocal SPL behaviour.

CONCLUSIONS

Classroom noise SPL and individual vocal SPL behaviour were significantly associated with teachers' voice SPL during teaching. Addressing these factors could be important steps in reducing the vocal load in teachers.

Validating self-reporting of hearing-related symptoms against pure-tone audiometry, otoacoustic emission, and speech audiometry

OBJECTIVE

To validate self-reported hearing-related symptoms among personnel exposed to moderately high occupational noise levels at an obstetrics clinic.

DESIGN

Sensitivity, specificity, and predictive values were calculated for questionnaire items assessing hearing loss, tinnitus, sound sensitivity, poor hearing, difficulty perceiving speech, and sound-induced auditory fatigue. Hearing disorder was diagnosed by pure-tone audiometry, distortion product otoacoustic emissions, and HINT (Hearing In Noise Test).

STUDY SAMPLE

Fifty-five female obstetrics personnel aged 22-63 participated; including 26 subjects reporting hearing loss, poor hearing, tinnitus, or sound sensitivity, and 29 randomly selected subjects who did not report these symptoms.

RESULTS

The questionnaire item assessing sound-induced auditory fatigue had the best combination of sensitivity ≥85% (95% CIs 56 to 100%) and specificity ≥70% (95% CIs 55 to 84%) for hearing disorder diagnosed by audiometry or otoacoustic emission. Of those reporting sound-induced auditory fatigue 71% were predicted to have disorder diagnosed by otoacoustic emission. Participants reporting any hearing-related symptom had slightly worse measured hearing.

CONCLUSIONS

We suggest including sound-induced auditory fatigue in questionnaires for identification of hearing disorder among healthcare personnel, though larger studies are warranted for precise estimates of diagnostic performance. Also, more specific and accurate hearing tests are needed to diagnose mild hearing disorder.

Classroom Noise and Teachers' Voice Production

PURPOSE

The aim of this study was to research the associations between noise (ambient and activity noise) and objective metrics of teachers' voices in real working environments (i.e., classrooms).

METHOD

Thirty-two female and 8 male teachers from 14 elementary schools were randomly selected for the study. Ambient noise was measured during breaks in unoccupied classrooms and, likewise, the noise caused by pupils' activity during lessons. Voice samples were recorded before and after a working day. Voice variables measured were sound pressure level (voice SPL), fundamental frequency, jitter, shimmer, and the tilt of the sound spectrum slope (alpha ratio).

RESULTS

The ambient noise correlated most often with the fundamental frequency of men and voice SPL, whereas activity noise correlated with the alpha ratio and perturbation values. Teachers working in louder ambient noise spoke more loudly before work than those working in lower noise levels. Voice variables generally changed less during work among teachers working in loud activity noise than among those working in lower noise levels.

CONCLUSIONS

Ambient and activity noises affect teachers' voice use. Under loud ambient noise teachers seem to speak habitually loudly, and under loud activity noise teachers' ability to react to loading deteriorates.

The effects of acoustical refurbishment of classrooms on teachers' perceived noise exposure and noise-related health symptoms

OBJECTIVES

To investigate whether acoustical refurbishment of classrooms for elementary and lower secondary grade pupils affected teachers' perceived noise exposure during teaching and noise-related health symptoms.

METHODS

Two schools (A and B) with a total of 102 teachers were subjected to an acoustical intervention. Accordingly, 36 classrooms (20 and 16 in school A and school B, respectively) were acoustically refurbished and 31 classrooms (16 and 15 in school A and school B, respectively) were not changed. Thirteen classrooms in school A were interim "sham" refurbished. Control measurements of RT and activity sound levels were measured before and after refurbishment. Data on perceived noise exposure, disturbance attributed to different noise sources, voice symptoms, and fatigue after work were collected over a year in a total of six consecutive questionnaires.

RESULTS

Refurbished classrooms were associated with lower perceived noise exposure and lower ratings of disturbance attributed to noise from equipment in the class compared with unrefurbished classrooms. No associations between the classroom refurbishment and health symptoms were observed. Before acoustical refurbishment, the mean classroom reverberation time was 0.68 (school A) and 0.57 (school B) and 0.55 s in sham refurbished classrooms. After refurbishment, the RT was approximately 0.4 s in both schools. Activity sound level measurements confirmed that the intervention had reduced the equivalent sound levels during lessons with circa 2 dB(A) in both schools.

CONCLUSION

The acoustical refurbishment was associated with a reduction in classroom reverberation time and activity sound levels in both schools. The acoustical refurbishment was associated with a reduction in the teachers' perceived noise exposure, and reports of disturbance from equipment in the classroom decreased. There was no significant effect of the refurbishment on the teachers' voice symptoms or fatigue after work.

Effects of Adventitious Acute Vocal Trauma: Relative Fundamental Frequency and Listener Perception

OBJECTIVE

High voice users (individuals who demonstrate excessive or loud vocal use) are at risk for developing voice disorders. The objective of this study was to examine, both acoustically and perceptually, vocal changes in healthy speakers after an acute period of high voice use.

METHODS

Members of a university women's volleyball team (n = 12) were recorded a week before (pre) and week after (post) the 10-week spring season; n = 6 control speakers were recorded over the same time period for comparison. Speakers read four sentences, which were analyzed for relative fundamental frequency (RFF). Eight naïve listeners participated in an auditory-perceptual visual sort and rate (VSR) task, in which they rated each voice sample's overall severity and strain.

RESULTS

No significant differences were found as a function of time point in the VSR ratings for the volleyball group. Onset cycle 1 RFF values were significantly lower (P = 0.04) in the postrecordings of the volleyball participants compared with prerecordings, but there was no significant difference (P = 0.20) in offset cycle 10 RFF values. Receiver operating characteristic analyses indicated moderate sensitivity and specificity of onset cycle 1 RFF for discrimination between the volleyball and control participants. Changes were not apparent in the control group as a function of time for either, onset cycle 1 RFF, offset cycle 10 RFF, or either vocal attribute.

CONCLUSIONS

Onset cycle 1 RFF may be an effective marker for detecting vocal changes over an acute high voice use period of time before perceptual changes are noted.