Prevalence of and Risk Factors for Self-reported Voice Problems Among Hindu Temple Priests

Prevalence of and Risk Factors for Self-Reported Voice Problems in Tibetan Monks

BACKGROUND

It is observed that Tibetan monks pray for a long duration with inappropriate pitch and loudness. Hence, they may be prone to developing voice problems (VPs). However, the monks are not stressed and do not miss praying in the monastery (which is quite different from many other professional voice users in Western countries). Moreover, no studies have investigated the nature of VPs among Tibetan monks. Such a study may provide insight into the prevalence of and risk factors for VPs and may help enhance our knowledge of the VPs in Tibetan monks.

STUDY DESIGN

Cross-sectional survey.

METHOD

A self-reporting questionnaire was distributed among 300 Tibetan monks residing in Namdroling Nyingmapa Monastery, Karnataka, India, from February 2023 to June 2023.

RESULTS

39% of Tibetan monks experienced VPs in their careers; hoarseness, momentary voice loss/sudden voice changes, and dryness were the most frequently reported symptoms. Monks reporting the presence of VPs also exhibited significantly higher frequencies of different phonotraumatic behaviors like speaking with a loud voice, constantly altering the voice, frequent throat clearing, speaking/chanting during throat infections, or VPs than those who did not report VPs. The results of bivariate regression analysis identified factors such as more than 8hours of prayer duration per day, praying in the presence of musical instruments, not sipping water in between prayers, less than three liters of water intake, and the presence of acid reflux and dry throat, as significant risk factors responsible for VPs in Tibetan monks.

CONCLUSIONS

Current results suggest that monks are at a high risk of developing VPs, and several factors (vocational, environmental, lifestyle, and health-related) contribute to the development of VPs. Further, VPs in monks also affect them in terms of missing prayers, interacting less with family/friends, and avoiding social gatherings. Overall, there is a great need to educate the monks about vocal health and preventing VPs.

Is Cepstral Peak Prominence a Measure of Vocal Fatigue in Temple Priests: A Pilot Study

PURPOSE

Considering cepstral analysis of voice as a measure of overall severity of dysphonia, we tried to investigate if these measures could be considered as a metric of vocal fatigue as well. Since voice quality changes are seen as a result of vocal fatigue, we wanted to find out if there were any correlations between the cepstral measures, vocal fatigue symptoms, and auditory perceptual evaluation of voice in professional voice users.

METHOD

The pilot study was conducted on 10 temple priests belonging to the Krishna Consciousness Movement. We conducted a pre-post voice evaluation, which included recording voices before the beginning of any temple preaching in the morning and after all the preaching sessions in the evening. The priests also filled in the Vocal Fatigue Index (VFI) questionnaire twice (morning and evening), and all the voice samples were analyzed for GRBAS (Grade, Roughness, Breathiness, Asthenia, and Strain voice quality) rating by speech language pathologists with voice expertise. Correlations were obtained between the acoustic measures, VFI responses, and auditory perceptual evaluations.

RESULT

The findings of our pilot study didn't show any correlations between the cepstral measures and the questionnaire responses or with the perceptual ratings. However, the cepstral measures were slightly higher for evening recordings than the morning recordings. Our participants did not experience or perceive any voice symptoms or vocal fatigue.

CONCLUSION

Despite more than 10 hours of voice use per day for over 10 years, our participants did not experience any voice symptoms or vocal fatigue. This finding indicates that there may be diverse reasonings and opinions about the occurrence of voice problems in various professional voice users. This is particularly because the participants' responses to vocal fatigue symptoms had more of a psychological explanation (faith, self-power, etc.) rather than any physiological changes in the vocal apparatus.

Prevalence of Voice Problems and Associated Risk Factors Among Tamil-Speaking Imams

PURPOSE

Voice of Professional Voice Users (PVUs) are of particular interest to practicing Speech-Language Pathologists. There is a dearth of studies concerning the prevalence of voice disorders and the associated risk factors among Tamil-speaking Imams. We address this research gap using non-experimental survey research.

METHODS

A questionnaire was framed by reviewing earlier literature. The derived questionnaire was administered to one hundred Tamil-speaking Imams actively involved in religious service in Tamil Nadu. We analyzed the obtained responses quantitatively and qualitatively. We also examined the effect of age on the prevalence of voice disorders and associated risk factors.

RESULTS

Based on survey responses, the career prevalence of voice problems among Tamil-speaking Imams was as high as 89%, and the point prevalence was 64%. The general health status of the Imams were good. However, vocal health was not satisfactory. This study identified several factors that contribute to voice problems, such as constant use of loud voice, acid reflux, unhealthy vocal habits, and insufficient hydration. A positive aspect observed during this study was the absence of smoking and consumption of alcohol among Imams. Even though the Imams presented good awareness of the voice production mechanism, they reported not seeking medical help when facing a voice problem. Current findings report a minimal impact of age-related differences on associated risk factors for voice disorders among the Imams.

CONCLUSIONS

Voice disorders are prevalent among Tamil-speaking Imams. Several risk factors leading to voice disorders among these individuals need to be addressed.

Prevalence of Work-Related Voice Disorders in Voice Professionals: Systematic Review and Meta-Analysis

OBJECTIVE

To analyze the prevalence of work-related voice disorders (WRVD) among the voice professionals.

METHODS

The study protocol was registered in PROSPERO (CRD42021250121). The search was performed in the Embase, Lilacs, Medline, SCOPUS, and Web of Sciences databases. There were no limitations to the year of publication and the search included observational studies which reported data on the prevalence of dysphonia in voice professionals measured through vocal complaints, vocal self-assessment, the auditory-perceptual judgment of the voice, and laryngoscopy examinations. The critical appraisal instrument for studies reporting prevalence data was used to analyze the risk of bias of the studies. Data analysis was performed using Jamovi and R software with a significance level of 5%.

RESULTS

The initial search identified 561 articles, 73 of which were finally included and analyzed. The total number of participants was 63,126. Dysphonia was diagnosed in 45,996 participants based on a vocal complaint, 12,843 using vocal self-assessment, 1,254 using the auditory-perceptual judgment, and 1,683 using laryngoscopies. The prevalence of total dysphonia was 44.0 (95% CI 38.47; 49.69). The prevalence of vocal complaints was 43.9% (95% CI 37.37; 50.52), 42.5% (95% CI 28.57; 57.08) for self-assessment, 53.0% (95% CI 29.87; 77.19) for auditory-perceptual judgment, and 36.9% (95% CI 18.62; 57.08) for laryngoscopic examination. In the auditory-perceptual judgment, voice professionals in class 3 (moderate quality, high demand) had a higher prevalence of dysphonia than those in class 4 (moderate quality, moderate demand) (P = 0.04). In the auditory-perceptual judgment (P = 0.04), there was a higher prevalence of dysphonia in teachers than among other voice professionals non-teachers, and in the laryngeal evaluation, no differences were found between professionals (P = 0.8).

CONCLUSION

There was a high prevalence of dysphonia in voice professionals, especially in the detection by auditory-perceptual judgment. High vocal demand and being a teacher influenced the increase in the prevalence of WRVD.

Systems Approaches to Occupational Vocal Health: Considerations for Community Faith Leaders

Systems thinking approaches can benefit the occupational vocal health of vocally reliant workers. This paper explores community faith leaders as an example of a highly vocally reliant occupation, who may benefit from systems thinking being used to support their vocal occupational health and safety. A scoping review of the current literature regarding faith leaders' occupational voice use and vocal health is detailed, including recognised occupational hazards. This article then discusses the unique and potential use of systems thinking for facilitating faith leaders' vocal occupational health and safety. Rather than using a solely clinical perspective, the sociotechnical systems approach and the biopsychosocial-spiritual approach are noted as particularly pertinent for this occupational group.

Vocal and Nonvocal Habits among Vedic Chanters

<b><i>Objectives:</i></b> The objective of the present study was to explore the voice concerns and vocal and nonvocal habits of Vedic chanters. <b><i>Participants and Method:</i></b> A cross-sectional design was used to study 200 Vedic chanters using a 36-item questionnaire. This questionnaire was developed and administered to explore their voice concerns and vocal and nonvocal habits. Descriptive statistics were used to summarize the findings and K-means cluster analysis was carried out to identify clusters concerning voice quality and influence of habits. <b><i>Results:</i></b> The majority of Vedic chanters were involved in certain vocal habits such as use of loud voice while chanting and frequent throat clearing. Further, approximately half of the chanters expressed a concern towards their voice, while a vast majority experienced vocal fatigue. Cluster analysis helped in identification of 4 clusters: Vedic chanters with (1) good lifestyle and good voice characteristics (<i>n</i> = 107), (2) good lifestyle but bad voice characteristics (<i>n</i> = 15), (2) poor lifestyle and good voice characteristics (<i>n</i> = 51), and (4) poor lifestyle leading to bad voice characteristics (<i>n</i> = 27). <b><i>Conclusion:</i></b> The findings of the present study provide useful information on voice concern and vocal and nonvocal habits among a unique population of individuals. The current study of Vedic chanters highlights the need to have a detailed understanding of their specific voice usage, demands, and voice characteristics.