Prevalence, Characterization, and Impact of Voice Disorders in Fado Singers

Prevalence of voice handicap among nurses in intensive care units due to occupational noise during pandemic

Background

Healthcare workers have been identified as being at risk of occupational voice disorders. Among them, nurses working in intensive care units (ICUs) are particularly vulnerable due to the risk factors that are associated with their exposure to high levels of noise. Thus, this study aimed to determine the prevalence of voice disorders among ICU nurses.

Methods

A questionnaire was administered to 100 ICU nurses from four hospitals in China. The questionnaire assessed vocal-related symptoms, perceived voice handicap, frequently heard noise sources, and the quality of communications.

Results

Results indicate that the most frequently reported voice symptoms were 'voice tiredness' and 'voiceless'. Nurses working more than 50 h per week experienced voice symptoms more frequently than nurses working for 40-50 h per week. The median value of the perceived voice handicap score (VHI-30) was 23, indicating mild voice handicap, while 24% of the nurses reported severe voice handicap. Longer working hours and working at patient wards were significantly associated with higher VHI-30 scores. The nurses also reported that the quality of verbal communication with patients and colleagues and voice problems worsened during the COVID-19 pandemic.

Conclusion

More than 20% of nurses reported severe voice handicap, however, voice handicap among ICU nurses did not appear universally to all nurses. Further research is necessary to identify the risk factors associated with voice disorders and the mechanism behind such heterogeneity among ICU nurses.

Immediate Effects of Straw Phonation in Water Exercises on Parameters of Vocal Loading in Carnatic Classical Singers

OBJECTIVE

The present study aimed to investigate the effect of vocal loading and the immediate effects of straw phonation in water exercises on parameters of vocal loading in Carnatic classical singers.

STUDY DESIGN

A within-subject pretest-posttest design.

METHODS

Twelve healthy Carnatic classical singers participated in the vocal loading experiment for 2 days, referred to as no-treatment and treatment conditions. The vocal loading task consisted of 1 hour of continuous singing in the presence of background noise. For the treatment condition, the participants followed a 10-minute straw phonation in water exercises before the vocal loading task. Acoustic, electroglottographic, and self-rated perceptual voice measures were recorded before and after the vocal loading task on both days.

RESULTS

Pretest and posttest comparison of various outcome measures during no-treatment day suggested a significant increase in shimmer percent, decrease in maximum phonation duration of vowel /a/, and increase in perceived phonatory effort, perceived vocal effort, and Evaluation of Ability to Sing Easily scores. Pretest and posttest comparisons during treatment day showed a significant increase in Mean F0, Highest F0, and Lowest F0, perceived phonatory effort, and perceived vocal effort scores. However, changes in Mean F0, Highest F0, and Lowest F0 measures were small in the posttest condition compared to pretest.

CONCLUSION

The present results suggest that vocal loading did induce changes in Carnatic classical singers' voices. However, there is no substantial evidence that straw phonation is effective in reducing the vocal loading in Carnatic classical singers. Further studies are required to corroborate the current findings.

Cepstral Measures in the Fado Voice: Gender, Age and Phonatory Tasks

Cepstral measures are sensitive to gender, age and phonatory tasks. With a cepstral measure designated as the CPP, it was possible to confirm the vulnerability of the Fado singers' voice. These were established at the vocal pathological threshold, which suggests a need for a direct clinical approach for these voice users.

OBJECTIVES/HYPOTHESIS

This study aimed to characterize cepstral peak prominence (CPP) and cepstral peak prominence smoothed (CPPS) in the Fado singing voice and to determine if there were significant differences in CPP and CPPS measures between spoken and sung tasks, as well as due to singers' gender and age.

METHODS

Forty seven males and 57 females Fado singers, ranging from 18 to 70 years participated in this study. Spoken voice tasks were sustained [a] and reading aloud the phonetically balanced text "O Sol". Sung tasks were sustained [a] of the word [ɐfinaɫ] and the Fado chorus song "Nem às paredes confesso". Acoustic measures included CPP and CPPS. CPP was measured using Analyses of Dysphonia in Speech and Voice software, of Multi-Speech program, Model 3700, by KayPENTAX. CPPS was measured using Praat software (4.2.1/2003). Statistical analysis was performed with an IBM SPSS Statistics version 22 program. CPP and CPPS mean differences of spoken and sung tasks were analyzed using paired samples t-test, with α at .05.

RESULTS

CPP and CPPS values of singers' voice changed according to the gender, age and phonatory tasks. There were significant differences between CPP and CPPS measures (P < 0.05). Generally, young male singers, in their sung task, presented the highest CPP and CPPS values. The highest CPP mean was obtained by older males in sustained spoken [a] and the lowest was obtained by younger males in their reading aloud task. For CPPS, the highest mean value was obtained by younger males during sung [a] and the lowest was by younger males in the reading aloud task.

CONCLUSION

Males presented higher cepstral measures than females. Young singers presented higher cepstral measures than older. Sung tasks had higher cepstral measures than spoken tasks. CPPS means are overall higher than CPP means. This study reinforces the need for a clinical prevention approach directed at potential vocal disorders in Fado singers.

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.

A survey of vocal health in church choir singers

Purpose

Choir singing is an important tradition of Christian worship across India. However, vocal health issues related to the church choir singers are less addressed in the literature. Hence, this study aimed to investigate the prevalence of vocal symptoms, identify the variables associated with increased risk of voice problems and knowledge of factors influencing vocal health in church choir singers.

Method

One hundred and forty-eight church choir singers (61 males and 85 females) between the age range of 18 and 70 years participated in the study. They completed a self-reported questionnaire addressing demographic and singing-related details, vocal symptoms, variables associated with increased risk reporting voice problems and knowledge about factors influencing vocal health.

Result

Eighty-four percent of the choir singers reported two or more vocal symptoms sometimes or more frequently while or after singing. More than half of the church choir singers had experienced vocal symptoms such as accessing notes in the upper range, loss of vocal endurance, pitch breaks, hoarseness, dryness in the throat, and discomfort in the throat. Among the different variables, systemic hydration found to have a significant association with reporting of voice problems in church choir singers. The overall knowledge regarding the factors influencing vocal health was found to be limited among the choir singers.

Conclusion

Choir singers like other professional singers experienced a higher prevalence of vocal symptoms during or after singing and exhibited limited knowledge about factors that negatively influence vocal health. Hence, there is a need to look into these singer’s vocal requirements, who usually go unnoticed.

Occupational voice is a work in progress: active risk management, habilitation and rehabilitation

The current article reviews recent literature examining occupational voice use and occupational voice disorders (January 2018–July 2019).