Relationships between self-evaluations of voice and working conditions, background factors, and phoniatric findings in female teachers

Acoustic Characteristics of Voice in Teachers and Nonteachers

BACKGROUND

Teachers are professional voice users, and the vocal demands in the teaching profession can be considered unique. All teachers will wish to possess a voluminous, strongly-carrying voice that can be maintained for a prolonged time. This necessitated the need to understand and document the voice-acoustic characteristics of teachers.

OBJECTIVES

The specific objectives were to (a) investigate the acoustic characteristics of teachers' voices, (b) compare voice acoustic characteristics between female and male teachers, and (c) compare acoustic characteristics of voice between teachers and nonteachers.

PARTICIPANTS

Four hundred thirty-nine individuals congregated into two groups. Group 1 had 264 female teachers (mean age: 36.8 years) and 42 male teachers (mean age 36.8 years) with a minimum of 5 years of teaching experience. A hundred females (mean age: 37.3 years) and 33 males (mean age: 36.1 years) adults not indulging in additional, prolonged use of voice were in group 2.

MATERIALS AND METHOD

Sustenance of vowel /a/ for 3 seconds at a comfortable pitch and loudness followed by a monologue on "My school" for 1 minute were audio-recorded at the locations of the participants. Multidimensional Voice Profiles and Real Time Pitch were used to analyze the phonation and monologue samples, respectively.

RESULTS

Revealed that most F0 and its related measures, short- and long-term frequency perturbations were higher in female compared to the male participants. The majority of the acoustic parameters were higher in teachers compared to nonteachers of both sexes.

CONCLUSION

The results, in general, confirmed a few evinced findings in females and males, strengthening the nature-controlled biophysical influence on voice. A few acoustic measures discerned voices of teachers and nonteachers and also females and males in teachers. Nonteachers of both sexes showed better acoustic characteristics of voice against teachers signifying that the extended and prolonged voice use, an occupational demand of the teaching profession, led to vocal loading affecting the acoustic characteristics of teachers' voices.

Perception of Primary School Teachers Towards Voice Problems and Vocal Health-Seeking Behaviors: A qualitative study

OBJECTIVE

Teachers are the most common occupational group reporting to the voice clinics with dysphonia across the globe. However, less is known about teachers' perceptions about their voice and voice problems. Hence the present study aimed to explore teachers' perception about their teaching voice, voice problems and vocal health-seeking behaviors.

METHOD

A qualitative phenomenological research design using semi-structured interviews were conducted with fifteen female primary school teachers. Participants were asked to express their perception of teaching voice, vocal health care knowledge, and vocal hygiene practices. Using inductive analysis, the researchers converted the raw data into concepts or themes and discussed.

RESULT

The present study results showed that teachers perceive voice as the primary tool for their profession. However, teachers consider voice problems as part of their professional commitments. Despite knowing the harmful effects of voice problems, teachers' pay less attention to their voice problems and perceive them as usual, unavoidable and part of their profession. Due to their demanding work schedule and not getting enough support from the management, they hesitate to consult medical professionals unless it severely affects them.

CONCLUSIONS

The data obtained from this study can be used to improve the teachers' knowledge regarding vocal health and convince the school management to extend their support for the successful implementation of the vocal health training programs for teachers.

Clinical Findings among Patients with Respiratory Symptoms Related to Moisture Damage Exposure at the Workplace-The SAMDAW Study

BACKGROUND

Respiratory tract symptoms are associated with workplace moisture damage (MD). The focus of this observational clinical study was patients with workplace MD-associated symptoms, to evaluate the usefulness of different clinical tests in diagnostics in secondary healthcare with a special interest in improving the differential diagnostics between asthma and laryngeal dysfunction.

METHODS

In patients referred because of workplace MD-associated respiratory tract symptoms, we sought to systematically assess a wide variety of clinical findings.

RESULTS

New-onset asthma was diagnosed in 30% of the study patients. Laryngeal dysfunction was found in 28% and organic laryngeal changes in 22% of the patients, and these were common among patients both with and without asthma. Most of the patients (85%) reported a runny or stuffy nose, and 11% of them had chronic rhinosinusitis. Atopy was equally as common as in the general population.

CONCLUSIONS

As laryngeal changes were rather common, we recommend proper differential diagnostics with lung function testing and investigations of the larynx and its functioning, when necessary, in cases of prolonged workplace MD-associated symptoms. Chronic rhinosinusitis among these patients was not uncommon. Based on this study, allergy testing should not play a major role in the examination of these patients.

Voice amplifier: effects on dose and vocal intensity of teachers without dysphonia

PURPOSE

Analyze the interference of using the voice amplifier in vocal dose of non-dysphonic teachers.

METHODS

This is an experimental study comparing people from the same ambience compound for 20 teachers from municipal elementary school in Belo Horizonte/MG. After consent, the participants were requested to answer the vocal symptom scale questionnaire (ESV) and later participated in two different moments of the study, for which they randomly selected. In the first moment, the participants used only the vocal dosimeter and in the second, they used the vocal dosimeter and the voice amplifier. The measurements were recorded by the device for 1h40m, in the classroom that the teachers taught. The time between the two measurements was one week, with the same room, the same time and the same discipline being taught, at both times.

RESULTS

The intensity parameter was the only one that showed difference with the use of the voice amplifier.

CONCLUSION

Use voice amplification while non-dysphonic teachers are teaching doesn't affect the fundamental frequency and vocal dose measure in the acoustics parameters. The vocal intensity is smaller when teacher uses the vocal amplification.

The Effectiveness of Rehabilitation of Occupational Voice Disorders in a Health Resort Hospital Environment

Background: The aim of this study was to present a rehabilitation program of occupational voice disorders for teachers, conducted in the form of health resort stays, and evaluate its effectiveness depending on job seniority. Methods: The study included 420 teachers who participated in a complex vocal prophylactic and rehabilitation program carried out during a 24-day stay at a health resort hospital. Employment time varied from 4 to 45 years (mean 28.3 years). The participants were divided into three groups: employment time < 21 years (57 teachers), 21–30 years (182 teachers) and > 30 years (181 teachers). All of the subjects underwent maximum phonation time assessment as well as jitter, shimmer and NHR (noise to harmonic ratio) parameters assessment before and after the program; they also underwent perceptual evaluation using the GRBAS scale and voice self-assessment using the VHI-30 scale. Results: The perceptual evaluation using the GRBAS scale and self-report measures of voice function assessed using the VHI scale revealed improvement (p < 0.001). The parameters of jitter, shimmer and NHR improved significantly: jitter p < 0.001, shimmer p < 0.001 and NHR p < 0.003. Maximum phonation time increased slightly but significantly (p < 0.001). For all of the studied groups regardless of their employment time, maximum phonation time increased (p < 0.001). Initially, the lowest values of maximum phonation time were observed in teachers with longer job seniority, which improved after the rehabilitation but remained <15 s. Conclusions: Voice care for teachers is crucial regardless of their job seniority. Early prophylaxis for voice disorders is effective, as the results of rehabilitation are better in teachers with a shorter employment time.

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.

Hoarseness and vocal tract discomfort and associated risk factors in air traffic controllers

Introduction

Objective

Methods

Results

Conclusion

Relationship Between Laryngeal Signs and Symptoms, Acoustic Measures, and Quality of Life in Finnish Primary and Kindergarten School Teachers

OBJECTIVE

This study investigated the relationship between the acoustic measure smoothed cepstral peak prominence (CPPS), teacher's quality of life as measured by the voice activity and participation profile (VAPP), laryngeal signs and symptoms, voice related health problems and laryngoscopic findings in Finnish teachers. The relationship between CPPS and sound pressure level (SPL) was also assessed.

METHODS

Vowel and text samples from 183 healthy Finnish teachers (99 kindergarten teachers [KT] and 84 primary school teachers [PST]) were analyzed for CPPS. Text reading was recorded in conversational loudness by PST, and KT were recorded wearing headphones, while listening to a masking noise of children talking to simulate their classroom voice and environment. CPPS values were correlated with the VAPP, self-reported laryngeal signs and symptoms, voice related health variables, and laryngoscopic findings.

RESULTS

There was a significant difference between the two groups for CPPS text, PST showed significantly lower CPPS values (10.44) than KT (11.52). There was no difference between the two groups for CPPS vowel phonation. There was a significant correlation between SPL text and CPPS text for KT (P < 0.001, r = 0.43) but not for PST (P < 0.10, r = 0.16). There was a significant correlation between SPL vowel and CPPS vowel for both PST (P < 0.001, r = 0.47) and KT (P < 0.001, r = 0.45). CPPS did not correlate with the VAPP, laryngeal signs and symptoms, health variables or laryngeal findings. Factorial analysis of variance resulted in a significant relationship between the VAPP, laryngeal signs and symptoms, and teacher type. Teacher type and symptoms had a significant effect on VAPP scores.

CONCLUSIONS

In the present work CPPS does not correlate with vocal health indicators of functionally healthy teachers. CPPS was significantly influenced by differences in speaking voice SPL, emphasizing the impact of recording conditions and technique. There was a significant relationship between laryngeal signs and symptoms, teacher type and the VAPP. Laryngeal signs and symptoms and teacher type are important variables and should be included in the clinical evaluation of occupational voice users, and voice problems.

Amplificación vocal en el ámbito ocupacional educativo: una revisión de la literatura

Introducción. La amplificación vocal se ha utilizado como una herramienta para prevenir desórdenes de voz en profesores.Objetivos. Conocer los cambios reportados sobre el comportamiento vocal cuando los profesores utilizan sistemas de amplificación vocal y hacer una comparación entre el antes y el después de su uso.Materiales y métodos. Se realizó una revisión de artículos en cuatro bases de datos y se seleccionaron 11 bajo criterios de inclusión y exclusión: 3 presentaron un nivel de evidencia IIb, mientras que 8, IV. Se analizó la información de los artículos para recolectar datos sobre los efectos en el comportamiento vocal a nivel perceptivo y acústico frente al uso de amplificación vocal.Resultados. Los participantes tuvieron una reducción en la intensidad y en la frecuencia fundamental con mayores efectos en la población sin desorden de voz. Hubo una disminución significativa de la dosis de distancia a diferencia de la dosis de ciclo. En los cuestionarios se infirió un descenso en síntomas, reducción de la carga vocal y mejora en la comunicación.Conclusión. Los amplificadores de voz sirven para prevenir trastornos de la voz. Investigaciones futuras deberán manejar un rigor investigativo en los niveles de evidencia y un diseño de estudio que permita obtener resultados consistentes en diferentes usuarios de la 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.

Associations between self-perceived voice disorders in teachers, perceptual assessment by speech-language pathologists, and instrumental analysis

PURPOSE

The three aims of this study were to assess agreement between self-perceived voice disorders, perceptual and instrumental assessment; to determine factors associated with perceptual voice assessment; and to determine which associated factors would serve as an initial screening tool for ascertainment of the presence or absence of voice disorders among teachers.

METHOD

A cross-sectional study was conducted among 574 Colombian teachers. Participants filled in a questionnaire and recorded a voice sample. The voice samples were perceptually evaluated by a speech-language pathologist with the Grade, Roughness, Breathiness, Asthenia, and Strain (GRBAS) scale and objectively with an automated voice analysis for fundamental frequency, jitter, shimmer and maximum phonation time. Agreements between GRBAS scale, self-reported voice disorders and instrumental analysis were determined by unweighted Coheńs Kappa coefficients and receiver operating characteristic curves. Multivariate logistic regression analysis was used to identify variables associated with the perceptual assessment. Diagnostic performance of these variables was assessed by the area under the curve.

RESULT

There was no agreement between self-reported voice disorders and GRBAS assessments. Maximum phonation time showed a slight agreement with perceptual assessment of voice disorders.

CONCLUSION

Since these three methods offer different information, it is advisable to include all methods in ascertainment of voice disorders among teachers at work.

Four-day Follow-up Study on the Self-reported Voice Condition and Noise Condition of Teachers: Relationship Between Vocal Parameters and Classroom Acoustics

OBJECTIVES

This study aimed to determine the changes in self-reported voice and noise condition over a follow-up of 4 days (equivalent to one working week), to define the relationship between the objective voice parameters and the self-reported voice condition, as well as to characterize the relationship between classroom acoustics and the self-reported noise condition.

STUDY DESIGN

This is a cohort study.

METHODS

We performed voice monitoring of 27 teachers for four working days using the Voice-Care device, which provides information on the fundamental frequency, vocal sound pressure level, and phonation time percentage. The participants performed a pre-monitoring, which consisted of a brief conversation, before each monitoring session, and filled in a questionnaire after each monitored lesson, in which they indicated their opinions about their voice condition and the classroom noise conditions.

RESULTS

The teachers who, during the pre-monitoring, showed a higher standard deviation of the vocal sound pressure level and a greater phonation time percentage difference between the entire monitoring and the pre-monitoring sessions, reported fewer voice complaints. Decay time (DT_40ME), a reverberation measure from the speakers' perspective, resulted to be associated with the self-reporting of the noise condition.

CONCLUSION

Voice disorders at work prevention programs should include strategies to exercise the respiratory and laryngeal components of voice production, because these elements may influence the variation in the vocal sound pressure level, which was found to be significantly associated with the self-reported voice condition. This study also highlights the importance of including reverberation measures, from the speakers' perspective, in the design of schools.

Dysphonia risk screening protocol

OBJECTIVE

To propose and test the applicability of a dysphonia risk screening protocol with score calculation in individuals with and without dysphonia.

METHOD

This descriptive cross-sectional study included 365 individuals (41 children, 142 adult women, 91 adult men and 91 seniors) divided into a dysphonic group and a non-dysphonic group. The protocol consisted of 18 questions and a score was calculated using a 10-cm visual analog scale. The measured value on the visual analog scale was added to the overall score, along with other partial scores. Speech samples allowed for analysis/assessment of the overall degree of vocal deviation and initial definition of the respective groups and after six months, the separation of the groups was confirmed using an acoustic analysis.

RESULTS

The mean total scores were different between the groups in all samples. Values ranged between 37.0 and 57.85 in the dysphonic group and between 12.95 and 19.28 in the non-dysphonic group, with overall means of 46.09 and 15.55, respectively. High sensitivity and specificity were demonstrated when discriminating between the groups with the following cut-off points: 22.50 (children), 29.25 (adult women), 22.75 (adult men), and 27.10 (seniors).

CONCLUSION

The protocol demonstrated high sensitivity and specificity in differentiating groups of individuals with and without dysphonia in different sample groups and is thus an effective instrument for use in voice clinics.

Survey of Voice Acoustic Parameters in Iranian Female Teachers

Objectives

Teachers are one of the professional voice users. Voice problems are common among them. Female teachers are known to have more voice problems than male ones. Furthermore, there are only few studies on the voice of Iranian female teachers. The present study investigated the acoustic parameters of voice in Iranian female teachers and compares them with nonteachers.

Methods

In this cross-sectional study, 90 Iranian female elementary teachers, 30–50 years old, and 90 Iranian female nonteachers in the same age were assessed between May 2010 and October 2011. Data collection was carried out, using the Dr. Speech software (subprogram: vocal assessment Version 4.0 from Tiger Electronics) at the speech therapy clinic under a comfortable phonation. Normal voice in practitioners was judged by the perceptual evaluation by a voice therapist and indirect laryngoscopy examination by an otorhinolaryngologist. Voice characteristics were assessed with GRBAS scale. The speech sample was sustained /â/ using habitual and constant vocal for 10 seconds. Three tokens from each subject were obtained. Then, each subject was asked to read a standard passage in Farsi. Eventually, the difference measures of F₀, jitter, shimmer, harmonic to noise ratio (HNR), and maximum of phonation time (MPT) between two groups were investigated by statistics software SPSS 19.0 (IBM corp.2010).

Results

Results showed that the values of F₀ were higher in teachers (210.03 Hz) than in nonteachers (194.11 Hz; P < 0.001). In addition, the values of perturbation measures were greater in teachers (jitter 0.32% and shimmer 4.63%) than those in the control group (jitter 0.22% and shimmer 3.15%; P < 0.001), but in HNR and MPT values, nonteachers showed higher levels (P < 0.001). The value of HNR in teachers was (18.84±1.56) but it was (21.3±1.73) in non-teachers and MPT value in teachers was (16.83±3.65) and in non-teachers was (22.5±5.2).

Conclusions

It can be concluded that vocal overuse, abuse, or misuse during teaching over a period of time result in achievement of inadequate phonatory pattern with excessive musculoskeletal tension, and the possible result is tissue changes in teacher's voice. In addition, acoustic analysis of voice parameters for teachers may significantly contribute to the objective voice examination of this group.

Estratégias de enfrentamento e perfil de participação e atividades vocais em professoras da rede pública de ensino com e sem distúrbios de voz

Resumo:OBJETIVO:verificar a associação entre o distúrbio vocal com as características sociodemográficas, os aspectos vocais, os tipos de estratégias de enfrentamento e o impacto vocal nas atividades diárias em professoras da rede estadual de ensino de Alagoas.MÉTODOS:cento e dez professoras foram submetidas à análise perceptivo-auditiva, aos protocolos Condição de Produção Vocal do Professor, Protocolo de Estratégias de Enfrentamento das Disfonias e Perfil de Participação e Atividades Vocais. Por meio da Escala Analógico-Visual avaliou o grau de distúrbio vocal: até 35,5mm sem distúrbio e acima de 35,5mm com distúrbio. Foram utilizados para as análises estatísticas média, desvio padrão, mediana, Qui-quadrado de Pearson e Exato de Fisher.RESULTADOS:os percentuais com distúrbio vocal foram mais elevados entre as que lecionavam entre 11 e 20 anos (44,6%) e as que lecionavam em duas a três escolas (49,1%). "Já faltou ao trabalho por alterações vocais e secreção/catarro na garganta" apresentaram associação com a presença do distúrbio vocal. Professoras dos dois grupos apresentaram uma tendência para a utilização das estratégias com foco no problema e não diferiram quanto à percepção do impacto vocal na realização de atividades diárias.CONCLUSÃO:professoras que possuem mais de 11 anos de docência; lecionavam em duas ou mais escolas; faltavam sempre ao trabalho por alterações vocais e apresentavam como sintoma vocal catarro/secreção na garganta apresentaram maiores chances de ter distúrbio vocal. A presença do distúrbio vocal não se mostrou significante para as dimensões do protocolo PPAV, assim como para os tipos de estratégias de enfrentamento.

Conhecimento vocal e a importância da voz como recurso pedagógico na perspectiva de professores universitários

OBJETIVO: investigar o conhecimento vocal e sua importância como recurso pedagógico em professores universitários. MÉTODOS: participaram 112 docentes, média de 46,60 anos, 35,7% do sexo masculino e 64,3% do feminino, 66,1% doutores. Utilizou-se o questionário Condições de Produção Vocal-Professor, adaptado pela pesquisadora, além da inserção de novas questões abertas e fechadas de interesse para o estudo, as quais foram assinaladas em uma escala analógica de zero a dez. Foram coletadas amostras de voz dos professores e analisadas por avaliação fonoaudiológica. As questões fechadas receberam tratamento estatístico, considerando-se a média das notas autorreferidas, em cada variável pesquisada. Os resultados foram correlacionados a partir das variáveis: sexo e presença/ausência de alteração vocal. Organizaram-se as respostas das questões abertas por similaridade de conteúdo e frequência de ocorrência. RESULTADOS: constatou-se associação significante entre sexo feminino e voz fina, fadiga e perda da voz; presença de distúrbio de voz e autorreferência à voz fraca, rouquidão, voz insuficiente para o trabalho e fadiga vocal. Os professores participaram da pesquisa para colaborar e melhorar a voz na docência; mudariam suas vozes nos aspectos de intensidade, tom e modulação; os recursos vocais mais utilizados em sala de aula foram variação de tom e intensidade, modulação e pausas; e quando a voz está alterada, recorrem ao repouso vocal e à hidratação. Atribuiu-se a média de 9,42 para a voz como recurso pedagógico. CONCLUSÃO: o conhecimento vocal dos participantes foi apropriado e eles avaliaram a voz como recurso pedagógico essencial.

Associations between voice ergonomic risk factors and acoustic features of the voice

The associations between voice ergonomic risk factors in 40 classrooms and the acoustic parameters of 40 schoolteachers' voices were investigated. The risk factors assessed were connected to participants' working practices, working postures, and the indoor air quality in their workplaces. The teachers recorded spontaneous speech and sustained /a/ before and after a working day. Fundamental frequency, sound pressure level, the slope of the spectrum, perturbation, and harmonic-to-noise ratio were analysed. The results showed that the more the voice ergonomic risk factors were involved, the louder the teachers' voices became. Working practices correlated most often with the acoustic parameters; associations were found especially before a working day. The results suggest that a risky voice ergonomic environment affects voice production.

Voice use in professional soccer management

Vocal load related to heavy voice use in particular professions increases the risk of occupational voice disorders. Research on professional voice use has primarily focused on educators, singers, and call-centre advisors. This paper describes the daily experiences of professional soccer managers' occupational voice use through qualitative methods. Four global themes were identified: 1) voice uses, 2) factors affecting voice change, 3) impact of voice use, and 4) the importance of voice in soccer management. All describe the nature of soccer managers' vocal demands. Risk factors for voice disorders include intense and prolonged voice use in environments with adverse acoustic properties for speakers and poor phonation methods. Research on vocal behaviours and early prevention programmes for this population group is warranted.

Voice disorders in teachers and their associations with work-related factors: a systematic review

PURPOSE

To provide a quantitative assessment of the occurrence of voice disorders among teachers and to identify associated work-related and individual factors in the teaching profession.

METHOD

A systematic review was conducted using three computerized databases on the occurrence of voice disorders among teachers and their associations with work-related and individual factors. Some of the keywords used were: "teacher", "voice disorder", "voice problem", and "dysphonia". Information regarding the occurrence of voice disorders and associations between work-related and individual factors and voice disorders were extracted from each paper. Occurrence and associations were expressed in prevalence and odds ratios, respectively.

RESULTS

In total, 23 publications met the criteria for inclusion. All publications were cross-sectional studies. Prevalence estimates varied widely, reflecting disparity in definitions of "voice problem". Teachers had a significantly increased occurrence of voice disorders compared to other occupations. Several work-related and individual factors were consistently associated with voice disorders, most notably high levels of noise in classrooms, being a physical education instructor, and habitual use of a loud speaking voice.

CONCLUSION

This review shows that teachers report voice disorders more often than non-teachers. Various work-related and individual factors are associated with reported voice disorders. Longitudinal studies are urgently required to get more insight into the development of voice disorders, their work-related determinants, and the consequences of these voice disorders for functioning and work performance among teachers.

LEARNING OUTCOMES

Describe the occurrence of voice disorders among teachers. Identify some work-related factors of voice disorders among teachers. Interpret the quality of the publications to describe or analyze the relationship between working conditions and voice disorders among teachers.

Occupational and individual risk factors for dysphonia in teachers

BACKGROUND

In recent decades several groups of researchers have been interested in describing and understanding vocal morbidity in teachers in order to explain the large number of teachers diagnosed with dysphonia and account for the absenteeism attributed to vocal disability.

AIMS

To determine the proportion of teachers who reported a diagnosis of dysphonia and measure associations between individual and contextual factors and the event of interest.

METHODS

Teachers were recruited from the city of Belo Horizonte and invited to complete a web-based institutional intranet questionnaire.

RESULTS

In total, 649 teachers responded; 32% (CI 28.5-35.5) reported that they had received a physician diagnosis of dysphonia. This prevalence was significantly higher among female teachers (prevalence ratio (PR) 2.33; CI 1.41-3.85), and groups who reported limited technical resources and equipment (PR 1.56; CI 1.14-2.15), a diagnosis of gastritis (PR 1.59; CI 1.28-1.98), not being summoned for an annual physician examination (PR 0.47; CI 0.32-0.68), or absenteeism (PR 1.39; CI 1.06-1.81).

CONCLUSIONS

The high prevalence of dysphonia in teachers was not associated with any individual variables, except for sex and comorbidity (diagnosis of gastritis). Limited technical resources and equipment were associated with dysphonia and suggests policy change is important in preventing dysphonia.

Percepção de ruído no ambiente de trabalho e sintomas auditivos e extra-auditivos autorreferidos por professores universitários

OBJETIVO: Investigar a correlação entre ruído no ambiente de trabalho e sintomas auditivos e extra-auditivos mencionados por professores universitários. MÉTODOS: Oitenta e quatro professores responderam a um questionário com questões sobre identificação, situação funcional e saúde. A relação entre ruído no trabalho e sintomas extra-auditivos e auditivos foi pesquisada. Foi realizada análise estatística, considerando o nível de significância de 5%. RESULTADOS: Nenhum professor indicou ausência de ruído. As respostas foram agrupadas em Sempre (S) (n=21) e Não Sempre (NS) (n=63). Houve diferença quanto ao pátio e a outra sala de aula como fontes de ruído, classificado como de forte intensidade; acústica insatisfatória e eco. Não houve associação entre referência à presença de ruído e queixas extra-auditivas do tipo digestivo, hormonal, osteoarticular, dentário, circulatório, emocional e respiratório. Não houve associação entre autopercepção de presença de ruído e de queixas auditivas e o grupo S mostrou maior ocorrência de respostas em incômodo ao ruído, dificuldade de ouvir e tontura/vertigem, zumbido e dor de ouvido. Houve associação entre autopercepção de alterações na voz e ruído e o grupo NS apresentou maior porcentagem de casos com alteração na voz que o grupo S. CONCLUSÃO: O ambiente universitário foi considerado ruidoso, porém não houve associação com doenças extra-auditivas e auditivas. As queixas auditivas foram mais evidentes naqueles professores que referiram ruído na modalidade Sempre. A saúde dos docentes é produto multidimensional, desta forma, o ruído não pode ser considerado fator único de agravo.

Twelve-month clinical follow-up study of voice patients' recovery using the Voice Activity and Participation Profile (VAPP)

OBJECTIVE

To study the effects of voice treatment including brief voice therapy for 12 months in two groups of voice patients: organic and functional.

DESIGN AND METHODS

A clinical prospective follow-up study with repeated measurements in five phases: medical session, first voice therapy session, last voice therapy session, and 6 months and 12 months after voice therapy. The mean number of voice therapy sessions was 3.4. The main outcome measures were the Voice Activity and Participation Profile (VAPP) and the Symptom Questionnaire. Of consenting patients (n=141) with chronic voice disorders, 46 dropped out during follow-up. Ninety-five patients formed the study group. Forty-one of them received only voice therapy, but the rest of them received combined treatment (medication, amplifiers, and voice massage), but also experienced life events affecting voice. Patients with any laryngeal pathology formed the organic group (n=47), others had a functional voice disorder.

RESULTS

Using the improvement criterion that the change of the VAPP score should exceed standard error of measurement, the percentage of individual patients achieving improvement was 47% in the mild, 59% in the moderate, and 75% in the severe disorder groups. Effect size for VAPP total score was 0.89. The positive effect continued to progress after the therapy ended. Patients with functional or organic voice disorder improved almost equally, although minor findings indicate that functional patients benefited more.

CONCLUSIONS

Voice treatment had a progressive effect for 1 year in half of our patients. No statistical difference was found between the functional and organic patient groups.

Speaker's comfort in teaching environments: voice problems in Swedish teaching staff

OBJECTIVES

The primary objective of this study was to examine how a group of Swedish teachers rate aspects of their working environment that can be presumed to have an impact on vocal behavior and voice problems. The secondary objective was to explore the prevalence of voice problems in Swedish teachers.

METHOD

Questionnaires were distributed to the teachers of 23 randomized schools. Teaching staff at all levels were included, except preschool teachers and teachers at specialized, vocational high schools. The response rate was 73%.

RESULTS

The results showed that 13% of the whole group reported voice problems occurring sometimes, often, or always. The teachers reporting voice problems were compared with those without problems. There were significant differences among the groups for several items. The teachers with voice problems rated items on room acoustics and work environment as more noticeable. This group also reported voice symptoms, such as hoarseness, throat clearing, and voice change, to a significantly higher degree, even though teachers in both groups reported some voice symptoms. Absence from work because of voice problems was also significantly more common in the group with voice problems--35% versus 9% in the group without problems.

CONCLUSION

We may conclude that teachers suffering from voice problems react stronger to loading factors in the teaching environment, report more frequent symptoms of voice discomfort, and are more often absent from work because of voice problems than their voice-healthy colleagues.