Population characteristics and self-assessment of speaking and singing voice in Polish contemporary commercial music singers-an exploratory, cross-sectional study.

Background: The domination of the Contemporary Commercial Music (CCM) industry in music markets has led to a significant increase in the number of CCM performers. Performing in a wide variety of singing styles involves exposing CCM singers to specific risk factors potentially leading to voice problems. This, in turn, necessitates the consideration of this particular group of voice users in the Occupational Health framework. The aim of the present research was threefold. First, it sought to profile the group of Polish CCM singers. Second, it was designed to explore the prevalence of self-reported voice problems and voice quality in this population, in both speech and singing. Third, it aimed to explore the relationships between voice problems and lifetime singing involvement, occupational voice use, smoking, alcohol consumption, vocal training, and microphone use, as potential voice risk factors. Materials and methods: The study was conducted in Poland from January 2020 to April 2023. An online survey included socio-demographic information, singing involvement characteristics, and singers' voice self-assessment. The prevalence of voice problems was assessed by the Polish versions of the Vocal Tract Discomfort Scale (VTDS) and the Singing Voice Handicap Index (SVHI). Also, a self-reported dysphonia symptoms protocol was applied. The perceived overall voice quality was assessed by a Visual Analogue Scale (VAS) of 100 mm. Results: 412 singers, 310 women and 102 men, completed the survey. Nearly half of the studied population declared lifetime singing experience over 10 years with an average daily singing time of 1 or 2 h. 283 participants received vocal training. For 11.4% of respondents, singing was the primary income source, and 42% defined their career goals as voice-related. The median scores of the VTDS were 11.00 (0-44) and 12.00 (0-40) for the Frequency and Severity subscales, respectively. The median SVHI score of 33 (0-139) was significantly higher than the normative values determined in a systematic review and meta-analysis (2018). Strong positive correlations were observed between SVHI and both VTD subscales: Frequency (r = 0.632, p < 0.001) and Severity (r = 0.611, p < 0.001). The relationships between most of the other variables studied were weak or negligible. Conclusion: The examined CCM singers exhibited substantial diversity with regard to musical genre preferences, aspirations pertaining to singing endeavors, career affiliations, and source of income. Singing voice assessment revealed a greater degree of voice problems in the examined cohort than so far reported in the literature, based on the SVH and VTDS.

Índice de discapacidad vocal en niños: autoevaluación. Traducción, transculturalización y validación al español de Latinoamérica / Children´s Voice Handicap Index: self-assessment. Translation, transculturalization and validation to Latinoamerican Spanish

Objetivo: Los trastornos de la voz son muy frecuentes en la población pediátrica, entre el 6% y el 23% de todos los niños presentan alguna forma de disfonía. La evaluación de la voz abarca los aspectos perceptuales, análisis acústico, métodos de diagnóstico visual, y cuestionarios que orientan al impacto sobre la calidad de vida. El objetivo de nuestro estudio es realizar la traducción, transculturalización y validación del cuestionario Children Voice Handicap Index (CVHI) a hispanohablantes latinoamericanos. Material y Método: El estudio se realizó en el Hospital Italiano de Buenos Aires, Argentina y en el Hospital de Niños Dr. Luis Calvo Mackenna de Santiago de Chile. Se incluyeron pacientes entre 8 y 15 años de edad. Se tradujo, transculturalizó y validó el CVHI para dicha población. Se realizó el cuestionario en dos grupos de pacientes: un grupo de niños con antecedentes de disfonías, n = 48 y el otro grupo pacientes de control, sin patología de la voz, n = 86. El cuestionario se aplicó a los niños, en presencia de sus cuidadores o padres, con la correspondiente conformidad. Resultados: Se encontró una diferencia significativa entre ambos grupos (p < 0,05) con una confianza interna óptima de 0,98 obtenida mediante alfa de Cronbach y una alta fiabilidad test-retest (correlación de Pearson = 0,96). Conclusión: La validación y transculturalización del CVHI para la población hispanohablante de latinoamérica presentó una adecuada validez y fiabilidad. Complementar la evaluación de la patología vocal con un sencillo cuestionario de auto-rrealización en población pediátrica, constituye una valiosa herramienta que completa el diagnóstico del impacto de la alteración de la voz en la calidad de vida.

Aim: Voice disorders are very common in the pediatric population, since between 6% and 23% of all children present some type of dysphonia. Voice evaluation includes perceptual aspects, acoustic analysis, visual diagnostic methods, and questionnaires that guide the impact on quality of life. The objective of this study is to carry out the translation, transculturalization and validation of the Children Voice Handicap Index (CVHI) questionnaire for Latin American Spanish speakers. Material and Method: The study was conducted at the Italian Hospital in Buenos Aires, Argentina and at the Dr. Luis Calvo Mackenna Children's Hospital in Santiago de Chile, Chile. Patients between 8 and 15 years of age were included. The CVHI was translated, transculturalized, and validated for said population. The questionnaire was carried out in two groups of patients: a group of children with a history of dysphonia, n = 48, and the other group, control patients, without voice pathology, n = 86. The questionnaire was applied to the children, in the presence of their caregivers or parents, with the corresponding consent. Results: A significant difference was found between both groups (p < 0.05) with an optimal internal confidence of 0.98 obtained using Cronbach's alpha and high test-retest reliability (Pearson's correlation = 0.96). Conclusion: The validation and transculturalization of the CVHI for the Spanish-speaking population of Latin America presented adequate validity and reliability. Complementing the evaluation of vocal pathology with a simple self-administration questionnaire in the pediatric population constitutes a valuable tool that completes the diagnosis of the impact of voice alteration on quality of life.

Percepção de queixa vocal e autoavaliação do impacto de um problema de voz em atores profissionais de teatro / Perceived vocal complaint and self- assessment of the vocal problem impact in professional theater actors

RESUMO Objetivo investigar a ocorrência de queixa vocal autorreferida no uso profissional da voz em atores profissionais de teatro; correlacionar presença de queixa vocal com três protocolos de autoavaliação do impacto de uma alteração vocal: Escala de Sintomas Vocais (ESV), Escala de Desconforto do Trato Vocal (EDTV) e Índice de Desvantagem Vocal -10 (IDV-10); verificar quais protocolos são mais robustos à detecção do impacto de possível disfonia nessa população. Métodos Participaram 75 atores profissionais de teatro, ambos os gêneros, 18 a 64 anos. Os atores informaram a presença ou ausência de queixa vocal e responderam a três protocolos de autoavaliação: Escala de Sintomas Vocais (ESV), Escala de Desconforto do Trato Vocal (EDTV) e Índice de Desvantagem Vocal-10 (IDV-10). Resultados constatou-se que 25% dos atores apresentaram queixa vocal. O grupo com queixa (GCQ) apresentou maior número de sintomas vocais e maior frequência e intensidade de desconforto de trato vocal, quando comparado ao grupo sem queixa (GSQ). IDV-10 não identificou desvantagem vocal nos grupos. No GCQ, houve correlação forte entre ESV e IDV-10 e correlação muito forte entre os escores de frequência e intensidade da EDTV. No GSQ, houve correlação moderada entre ESV e EDTV, ESV e IDV-10 e correlação muito forte entre os escores de frequência e intensidade da EDTV. Conclusão neste estudo, 25% dos atores profissionais de teatro apresentaram queixa vocal. A correlação entre a queixa vocal e os protocolos foi positiva e variou de moderada à forte. No GCQ, a ESV e a EDTV foram instrumentos mais robustos na detecção do impacto de uma possível disfonia.

ABSTRACT Purpose To investigate the occurrence of self-reported vocal complaints in the professional use of the voice in professional theater actors; analyze the correlation between the presence of vocal complaint and three self-assessment protocols of the vocal problem impact; The Voice Symptom Scale (VoiSS), the Vocal Tract Discomfort (VTD) scale and the Voice Handicap Index -10 (VHI -10); verify the most robust protocols to identify dysphonia in this population. Methods The participants were 75 professional theater actors, men and women, between 18 and 64 years old. They answered to a questioner informing presence or absence of vocal complaint and to three self-assessment protocols: VoiSS, VTD and VHI-10. Results 25% of the actors presented vocal complaints. The group with vocal complaint (GwVC) had more voice symptoms and higher frequency and intensity of vocal tract discomfort than the group with no vocal complaint (GnVC). No group presented voice handicap considering the VHI-10 and a very high correlation between the VTD frequency and intensity scores. The GnVC presented moderate correlation between the VoiSS and the VTD, moderate correlation between the VoiSS and the VHI-10 and, a very high correlation between the VTD frequency and intensity scores. Conclusion In this study, 25% of professional theater actors presented vocal complaints. The correlation between vocal complaints and protocols was positive and ranged from moderate to strong. The VoiSS and the VTD were more robust identify dysphonia in the GwVC.

The Effect of Pulmonary Function on the Incidence of Vocal Fatigue Among Teachers.

INTRODUCTION: Females face a significantly higher risk of presenting with voice problems than males. This discrepancy has been associated with a number of differences in respiratory behavior and the physiology of the laryngeal and endocrine systems. METHODS: In conjunction with established spirometry measures, the Vocal Fatigue Index (VFI) was used to determine (1) if there is a relationship between base pulmonary function and vocal fatigue among teachers; and (2) if that relationship is different in females from males. One hundred and twenty-two elementary and middle school teachers (96 females and 26 males) from the Jordan School District in Northern Utah participated in the study. RESULTS: VFI factors were predictors of the outcomes of several raw spirometry measures for female participants, but the same predictive relationship was not found for male participants. Additionally, there appeared to be no relationship between VFI and spirometry measures in females when using normalized, rather than raw, spirometry metrics. CONCLUSIONS: The results suggest that the pulmonary physiology that would result in reduced raw pulmonary function, in combination with other differences associated with gender, may lead to a greater incidence of vocal fatigue among female teachers than their male counterparts.

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

PURPOSE OF REVIEW: The current article reviews recent literature examining occupational voice use and occupational voice disorders (January 2018-July 2019). RECENT FINDINGS: Our understanding of the prevalence of voice disorders and work-related vocal use, vocal load and vocal ergonomics (environmental and person influences) across different occupations is continuing to build. There is encouraging evidence for the value of intervention programs for occupational voice users, particularly of late with performers, teachers and telemarketers. Education and prevention programs are emerging for other 'at risk' occupations. SUMMARY: Occupational health and workforce legislation does not adequately acknowledge and guide educational, preventive and intervention approaches to occupational voice disorders. Voice disorders are prevalent in certain occupations and there is an urgent need for research to support occupational voice health and safety risk measurement, prevention and intervention. Large population-based studies are required with a focus on the health and economic burden of occupational voice disorders.

Prevalence of smoking in Brazilian schoolteachers, 2016. / Prevalência de tabagismo entre professores da Educação Básica no Brasil, 2016.

This cross-sectional study investigated the prevalence of smoking and associated factors in a nationally representative sample of 6,510 Brazilian schoolteachers. Data were obtained from telephone interviews using a questionnaire on sociodemographic information, health status, work absenteeism, and the characteristics of teaching work. Smoking was analyzed as a dichotomous variable using univariate and multivariate logistic regression. Overall smoking prevalence was 4.4%. Prevalence in men was 5.9% and was higher in those over 55 years of age (10.7%). Prevalence in women was 3.5% and was higher from 45 to 54 years of age (5.5%). The final multivariate model showed a negative association between smoking and female gender (OR = 0.46), being married or living with partner (OR = 0.53), occasional voice problems at work (OR = 0.64), and longer commuting time to and from school (OR = 0.58). The results showed positive associations between smoking and older age (OR = 2.59), living in the South (OR = 1.98) and Southeast Brazil (OR = 2.07), insufficient physical activity (OR = 1.66), and use of anxiolytics or antidepressants (OR = 2.46). Prevalence of smoking in Brazilian schoolteachers was relatively low. Unexpectedly, although cited as inadequate by the teachers, work conditions and demands in the schools did not reach statistical significance with smoking in the current study.

Estudo transversal que investigou a prevalência e os fatores associados ao tabagismo em uma amostra aleatória e representativa de 6.510 professores da Educação Básica brasileira. Os dados foram obtidos por meio de questionários aplicados por telefone, contendo informações sociodemográficas, estado de saúde, afastamentos do trabalho e características do trabalho docente. O tabagismo foi analisado como variável dicotômica por meio de regressão logística univariada e multivariada. A prevalência de fumantes atuais foi de 4,4%. Entre os homens, a prevalência foi de 5,9%, sendo maior na faixa etária acima de 55 anos (10,7%). Para as mulheres, a taxa foi de 3,5% e maior na faixa etária entre 45 e 54 anos (5,5%). O modelo final da análise multivariada evidenciou associação negativa entre tabagismo e sexo feminino (OR = 0,46), viver acompanhado (OR = 0,53), problemas ocasionais no trabalho por causa da voz (OR = 0,64) e maior tempo de deslocamento entre a casa do professor e a escola (OR = 0,58). Foi encontrada associação positiva entre o desfecho e maior idade (OR = 2,59), viver nas regiões Sul (OR = 1,98) e Sudeste (OR = 2,07), insuficiência de atividades físicas (OR = 1,66) e o uso de ansiolíticos ou antidepressivos (OR = 2,46). A prevalência de tabagismo entre os professores da Educação Básica no Brasil foi relativamente baixa. Contrariamente ao esperado, apesar de indicadas como inadequadas pelos entrevistados, condições e demandas de trabalho nas escolas não alcançaram significância estatística em relação ao tabagismo no presente estudo.

Estudio transversal que investigó la prevalencia y factores asociados al tabaquismo en una muestra aleatoria y representativa de 6.510 profesores de Educación Básica brasileña. Los datos se obtuvieron mediante cuestionarios aplicados por teléfono, conteniendo información sociodemográfica, estado de salud, bajas laborales y características del trabajo docente. El tabaquismo fue analizado como variable dicotómica mediante regresión logística univariada y multivariada. La prevalencia de fumadores actuales fue de un 4,4%. Entre los hombres, la prevalencia fue de un 5,9%, siendo mayor en la franja etaria por encima de 55 años (10,7%). Para las mujeres, la tasa fue de 3,5 % y mayor en la franja etaria entre 45 y 54 años (5,5%). El modelo final del análisis multivariado evidenció una asociación negativa entre tabaquismo y sexo femenino (OR = 0,46), vivir acompañado (OR = 0,53), problemas ocasionales en el trabajo por causa de la voz (OR = 0,64), y mayor tiempo de desplazamiento entre la casa del profesor y la escuela (OR = 0,58). Se encontró una asociación positiva entre el resultado y mayor de edad (OR = 2,59), vivir en las regiones Sur (OR = 1,98) y Sudeste (OR = 2,07), insuficiencia de actividades físicas (OR = 1,66) y el uso de ansiolíticos o antidepresivos (OR = 2,46). La prevalencia de tabaquismo entre los profesores de Educación Básica en Brasil fue relativamente baja. Contrariamente a lo esperado, a pesar de ser indicadas como inadecuadas por los entrevistados, las condiciones y demandas de trabajo en las escuelas no alcanzaron significancia estadística, en relación con el tabaquismo en el presente estudio.

Assessing Change Over Time in Voice Handicap and Voice-Related Perceived Control Using Ecological Momentary Assessment.

OBJECTIVES: Voice handicap has generally been measured at a single timepoint. Little is known about its variability from hour to hour or day to day. Voice handicap has been shown to be negatively related to voice-related perceived control in cross-sectional studies, but the within-person variability in voice-related perceived control is also unknown. We aimed to use ecological momentary assessment (EMA) to (1) assess the feasibility of EMA to examine daily voice handicap and voice-related perceived control in patients with voice disorders, (2) measure within-person variability in daily voice handicap and perceived control, and (3) characterize temporal associations (eg, correlations over time) between daily voice handicap and perceived control. METHODS: Adults with voice problems were recruited from a large public university medical center in the Midwest. They completed baseline measures, followed by twice-daily assessments, including selected items measuring voice handicap and perceived control, and then repeated the baseline measures at the final timepoint. Feasibility was assessed via completion rates. Within-person variability was measured using standard deviations. Temporal associations were characterized using simulation modeling analysis. RESULTS: EMA of voice handicap and perceived control was feasible in this patient population. Momentary voice handicap varied more than perceived control, though both were variable. Multiple patterns of temporal associations between daily voice handicap and perceived control were found. CONCLUSIONS: These findings identified important variability in (1) measures of voice handicap and perceived control and (2) their associations over time. Future EMA studies in patients with voice disorders are both feasible and warranted.

Seeking the recognition of voice disorder as work-related disease: historical-political movement. / Em busca do reconhecimento do distúrbio de voz como doença relacionada ao trabalho: movimento histórico-político.

The high prevalence of voice disorders among professionals who use their voice as a working tool, signals the existence of a collective illness caused by voice wear through poor working conditions and lack of social protection. This article describes the construction of a political movement seeking recognition of voice disorder as a work-related disease in Brazil. This is a narrative review on the historical processes, including social subjects, production of knowledge and the proposals for a strategic agenda, in view of the urgency of including voice disorder in the Brazilian Ministry of Health's list of work-related diseases. The analysis comprises three strands: a) technical and scientific, on advances in characterization of voice disorder and establishment of its connection with work; b) juridical and institutional, on legal recognition of this linkage; c) political and professional, on mobilization of social actors to advocate recognition of work-related voice disorders (WRVDs). The key role of the Pontifical Catholic University of São Paulo in fomenting discussions about WRVDs over the course of this movement lasting nearly two decades is highlighted, along with the main difficulties in achieving formal recognition of WRVDs .

A elevada prevalência de alteração vocal no exercício do trabalho sinaliza um adoecimento coletivo, determinado pelo desgaste da voz sob precárias condições ocupacionais. Este artigo descreve a construção, no Brasil, do movimento histórico-político em busca do reconhecimento do distúrbio de voz como doença relacionada ao trabalho (DVRT). Trata-se de uma revisão narrativa, com relato dos processos históricos, incluindo os sujeitos sociais, a produção de conhecimento, os fatos que marcaram a trajetória do movimento e as proposições de uma agenda estratégica, tendo em vista a urgência da inclusão do DVRT na lista de doenças relacionadas ao trabalho do Ministério da Saúde. Foram adotados três eixos de análise: a) técnico-científico, sobre os avanços na caracterização do distúrbio de voz e do nexo com o trabalho; b) jurídico-institucional, relativo às formas institucionais de reconhecimento jurídico deste nexo; e c) político-profissional, no qual se discute a articulação dos atores sociais na defesa do reconhecimento do DVRT. Durante quase duas décadas destacam-se o importante papel da Pontifícia Universidade Católica de São Paulo no fomento às discussões e as principais dificuldades para o reconhecimento formal do DVRT.

Em busca do reconhecimento do distúrbio de voz como doença relacionada ao trabalho: movimento histórico-político / Seeking the recognition of voice disorder as work-related disease: historical-political movement

Resumo A elevada prevalência de alteração vocal no exercício do trabalho sinaliza um adoecimento coletivo, determinado pelo desgaste da voz sob precárias condições ocupacionais. Este artigo descreve a construção, no Brasil, do movimento histórico-político em busca do reconhecimento do distúrbio de voz como doença relacionada ao trabalho (DVRT). Trata-se de uma revisão narrativa, com relato dos processos históricos, incluindo os sujeitos sociais, a produção de conhecimento, os fatos que marcaram a trajetória do movimento e as proposições de uma agenda estratégica, tendo em vista a urgência da inclusão do DVRT na lista de doenças relacionadas ao trabalho do Ministério da Saúde. Foram adotados três eixos de análise: a) técnico-científico, sobre os avanços na caracterização do distúrbio de voz e do nexo com o trabalho; b) jurídico-institucional, relativo às formas institucionais de reconhecimento jurídico deste nexo; e c) político-profissional, no qual se discute a articulação dos atores sociais na defesa do reconhecimento do DVRT. Durante quase duas décadas destacam-se o importante papel da Pontifícia Universidade Católica de São Paulo no fomento às discussões e as principais dificuldades para o reconhecimento formal do DVRT.

Abstract The high prevalence of voice disorders among professionals who use their voice as a working tool, signals the existence of a collective illness caused by voice wear through poor working conditions and lack of social protection. This article describes the construction of a political movement seeking recognition of voice disorder as a work-related disease in Brazil. This is a narrative review on the historical processes, including social subjects, production of knowledge and the proposals for a strategic agenda, in view of the urgency of including voice disorder in the Brazilian Ministry of Health's list of work-related diseases. The analysis comprises three strands: a) technical and scientific, on advances in characterization of voice disorder and establishment of its connection with work; b) juridical and institutional, on legal recognition of this linkage; c) political and professional, on mobilization of social actors to advocate recognition of work-related voice disorders (WRVDs). The key role of the Pontifical Catholic University of São Paulo in fomenting discussions about WRVDs over the course of this movement lasting nearly two decades is highlighted, along with the main difficulties in achieving formal recognition of WRVDs .

Prevalência de tabagismo entre professores da Educação Básica no Brasil, 2016 / Prevalencia del tabaquismo entre profesores de Educación Básica en Brasil, 2016 / Prevalence of smoking in Brazilian schoolteachers, 2016

Estudo transversal que investigou a prevalência e os fatores associados ao tabagismo em uma amostra aleatória e representativa de 6.510 professores da Educação Básica brasileira. Os dados foram obtidos por meio de questionários aplicados por telefone, contendo informações sociodemográficas, estado de saúde, afastamentos do trabalho e características do trabalho docente. O tabagismo foi analisado como variável dicotômica por meio de regressão logística univariada e multivariada. A prevalência de fumantes atuais foi de 4,4%. Entre os homens, a prevalência foi de 5,9%, sendo maior na faixa etária acima de 55 anos (10,7%). Para as mulheres, a taxa foi de 3,5% e maior na faixa etária entre 45 e 54 anos (5,5%). O modelo final da análise multivariada evidenciou associação negativa entre tabagismo e sexo feminino (OR = 0,46), viver acompanhado (OR = 0,53), problemas ocasionais no trabalho por causa da voz (OR = 0,64) e maior tempo de deslocamento entre a casa do professor e a escola (OR = 0,58). Foi encontrada associação positiva entre o desfecho e maior idade (OR = 2,59), viver nas regiões Sul (OR = 1,98) e Sudeste (OR = 2,07), insuficiência de atividades físicas (OR = 1,66) e o uso de ansiolíticos ou antidepressivos (OR = 2,46). A prevalência de tabagismo entre os professores da Educação Básica no Brasil foi relativamente baixa. Contrariamente ao esperado, apesar de indicadas como inadequadas pelos entrevistados, condições e demandas de trabalho nas escolas não alcançaram significância estatística em relação ao tabagismo no presente estudo.

Estudio transversal que investigó la prevalencia y factores asociados al tabaquismo en una muestra aleatoria y representativa de 6.510 profesores de Educación Básica brasileña. Los datos se obtuvieron mediante cuestionarios aplicados por teléfono, conteniendo información sociodemográfica, estado de salud, bajas laborales y características del trabajo docente. El tabaquismo fue analizado como variable dicotómica mediante regresión logística univariada y multivariada. La prevalencia de fumadores actuales fue de un 4,4%. Entre los hombres, la prevalencia fue de un 5,9%, siendo mayor en la franja etaria por encima de 55 años (10,7%). Para las mujeres, la tasa fue de 3,5 % y mayor en la franja etaria entre 45 y 54 años (5,5%). El modelo final del análisis multivariado evidenció una asociación negativa entre tabaquismo y sexo femenino (OR = 0,46), vivir acompañado (OR = 0,53), problemas ocasionales en el trabajo por causa de la voz (OR = 0,64), y mayor tiempo de desplazamiento entre la casa del profesor y la escuela (OR = 0,58). Se encontró una asociación positiva entre el resultado y mayor de edad (OR = 2,59), vivir en las regiones Sur (OR = 1,98) y Sudeste (OR = 2,07), insuficiencia de actividades físicas (OR = 1,66) y el uso de ansiolíticos o antidepresivos (OR = 2,46). La prevalencia de tabaquismo entre los profesores de Educación Básica en Brasil fue relativamente baja. Contrariamente a lo esperado, a pesar de ser indicadas como inadecuadas por los entrevistados, las condiciones y demandas de trabajo en las escuelas no alcanzaron significancia estadística, en relación con el tabaquismo en el presente estudio.

This cross-sectional study investigated the prevalence of smoking and associated factors in a nationally representative sample of 6,510 Brazilian schoolteachers. Data were obtained from telephone interviews using a questionnaire on sociodemographic information, health status, work absenteeism, and the characteristics of teaching work. Smoking was analyzed as a dichotomous variable using univariate and multivariate logistic regression. Overall smoking prevalence was 4.4%. Prevalence in men was 5.9% and was higher in those over 55 years of age (10.7%). Prevalence in women was 3.5% and was higher from 45 to 54 years of age (5.5%). The final multivariate model showed a negative association between smoking and female gender (OR = 0.46), being married or living with partner (OR = 0.53), occasional voice problems at work (OR = 0.64), and longer commuting time to and from school (OR = 0.58). The results showed positive associations between smoking and older age (OR = 2.59), living in the South (OR = 1.98) and Southeast Brazil (OR = 2.07), insufficient physical activity (OR = 1.66), and use of anxiolytics or antidepressants (OR = 2.46). Prevalence of smoking in Brazilian schoolteachers was relatively low. Unexpectedly, although cited as inadequate by the teachers, work conditions and demands in the schools did not reach statistical significance with smoking in the current study.

Comparison of laryngeal morbidities with modified reinforced silicone tube intubation guided over a bougie vs. a guidewire: novel assessment with voice analysis.

Semi-rigid flexible introducer-guided tracheal intubation is associated with pharyngolaryngeal morbidities. We compared the practice of railroading a newly described modified reinforced silicone tracheal tube with a built-in guide channel in its wall over a non-kinking guidewire with railroading the same tube over a disposable bougie, with respect to pharyngolaryngeal morbidities. One hundred and twenty-four ASA 1 and 2 adults were randomly assigned to undergo bougie-guided (n = 62) or wire-guided (n = 62) intubation under general anaesthesia. All patients were assessed for postoperative pharyngolaryngeal complaints. In addition, voice parameters (fundamental frequency, shimmer, jitter and harmonic noise ratio) with vowels 'a' and 'i' were analysed pre-operatively and 24 h postoperatively. The success of first-attempt intubation and the associated haemodynamic response were also recorded. A higher incidence of pharyngolaryngeal complaints was seen in the bougie group, 48.3%, 95%CI (35.9-60.9%) when compared with wire-guided group 28.3%, 95%CI (18.0-40.6%), p = 0.01. Postoperatively, all the voice parameters were significantly more affected when compared with their pre-operative value in the bougie-guided group (p < 0.05) but not in the wire-guided group. The success of first-attempt intubation was similar in both groups. Wire-guided orotracheal intubation was associated with a lower incidence of pharyngolaryngeal complaints and effect on voice when compared with bougie-guided intubation.

The Reported Incidence and Nature of Voice Disorders in the Private Healthcare Context of Gauteng.

OBJECTIVES: The study aimed to determine the incidence and nature of voice disorders, as reported by ear, nose, and throat specialists (ENTs), in the Gauteng private healthcare context. STUDY DESIGN: This is a cross-sectional survey design. METHODS: The respondents had to be certified ENTs working in the private healthcare context in Gauteng. The survey was sent out electronically to all 94 ENTs, registered with the ENT Society, working in the private healthcare context; thus, no additional requirements had to be met. The survey inquired about the total number of referrals from January 2015 to January 2016, the total number of referrals who were diagnosed with a voice disorder, as well as information regarding the patients such as the nature of the voice disorders. RESULTS: Of the 94 surveys sent out, 24 of them were completed (25.5%). The incidence of voice disorders reported was 5.2%. The most commonly diagnosed voice disorder is acute laryngitis (32%). The majority of ENTs (75%) received referrals from general practitioners and referred to speech-language pathologists if the patient presented with a voice disorder. CONCLUSIONS: The results from this study may enable healthcare professionals to adequately plan service delivery resource allocations to provide appropriate services. Additional studies are required to examine the incidence of voice disorders in the public healthcare context as well as the prevalence of voice disorders in Gauteng.

Prevalence and Risk Factors of Voice Problems Among Primary School Teachers in India.

OBJECTIVES: Teachers are more prone to develop voice problems (VPs) when compared with other professional voice users. The aim of present study was to investigate the prevalence and risk factors of VPs among primary school teachers in India. STUDY DESIGN: Epidemiological cross-sectional survey. METHODS: Self-reporting questionnaire data were collected from 1082 teachers. RESULTS: Out of 1082 teachers who participated in the present study, 188 teachers reported VPs that account for a prevalence rate of 17.4%. Tired voice after long hours of talking was the most frequently reported symptom, followed by sore/dry throat, strain in voice, neck muscle tension, and difficulty in projecting voice. The adjusted odds ratio values showed number of years of teaching, high background noise levels in the classroom, experiencing psychological stress while teaching classes, improper breath management (holding breath while speaking), poor focus of the tone (clenching jaw/teeth while speaking), upper respiratory tract infection, thyroid problems, and acid reflux as significant risk factors for the development of VPs in the current cohort of teachers. CONCLUSIONS: Current results suggest that teachers develop VPs due to multiple risk factors. These factors may be either biological, psychomotor, or environment-related factors. A holistic approach (which could include educating teachers about voice care during their training, and if they develop VP during their career, then managing the VP by taking into consideration different risk factors) addressing all these factors needs to be adopted to prevent VPs in primary school teachers.

Functional Voice Disorders: The Importance of the Psychologist in Clinical Voice Assessment.

OBJECTIVES: The etiopathogenesis of functional voice disorders (FVDs) is multifactorial. The purpose of this study was to analyze the severity of depression and anxiety, and the incidence of affective and anxiety disorders, in patients who presented different types of FVDs and were followed at the University Clinic of Otolaryngology. DESIGN: This is a cross-sectional study. METHODS: After ENT observation, 83 women were classified into three groups: psychogenic voice disorder (PVD = 39), primary muscle tension voice disorder (MTVD1 = 16), and secondary muscle tension voice disorder (MTVD2 = 28). A psychologist assessed the severity of depression and anxiety using the Hamilton rating scales, and screened for affective and anxiety disorders using the Mini International Neuropsychiatric Interview. RESULTS: Significant differences in the mean values were found between the groups, with the MTVD1 group having higher levels of depression and anxiety. In affective disorders (current major depression and current mood disorder with psychotic symptoms) and in anxiety disorders (lifetime panic disorder, current generalized anxiety, and current panic disorder with agoraphobia), significant differences in association were found between groups. CONCLUSIONS: Groups presented with significant differences in depression and anxiety levels, and in some psychiatric diagnoses. Patients with FVDs should be independently assessed regarding their voice disorder classification. The integration of a psychologist in the clinical voice assessment team is essential, as findings have corroborated an important incidence of psychiatric disorders in FVDs patients.

Prevalence of and Sociodemographic Factors Related to Voice Disorders in South Korea.

OBJECTIVES: Studies on the prevalence of and the sociodemographic factors related to voice disorders are rare. The purpose of the present study was to analyze the prevalence of voice disorders and to identify sociodemographic factors associated with an increased risk of voice disorder. METHODS: A cross-sectional study was conducted using data from the Korea National Health and Nutrition Examination Survey, 2008-2011. Subjects consisted of 19 636 men and women aged ≥19 years. Sociodemographic factors including occupation, level of education, health status, and economic activity were assessed by means of individual interviews, and health behaviors such as smoking and alcohol consumption and subjective voice problems were assessed with the use of self-administered questionnaires. Laryngology interviews and vocal fold examinations were also conducted. RESULTS: The prevalence of voice disorders was 8.12% (n = 1594). Subjective perception of the presence of voice problems was significantly higher in individuals with vocal nodules and vocal polyps (27.7% and 23.0%, respectively; P < 0.001). Among sociodemographic factors and health behaviors, voice disorders were found to be associated with age, gender, education level, and health status (P < 0.05) but were not associated with occupation, household income, smoking, or alcohol consumption. CONCLUSIONS: The results of this large epidemiologic study provide valuable information regarding the prevalence of voice disorders, and the specific data regarding sociodemographic factors and health behaviors suggest potential ways of targeting counseling and prevention efforts to control voice disorders.

Voice dosimetry and monitoring, with emphasis on professional voice diseases: Critical review and framework for future research.

Professional voice has become an important issue in the field of occupational health. Similarly, voice diseases related to occupations gain interest in insurance medicine, particularly within the frame of specific insurance systems for occupational diseases. Technological developments have made possible dosimetry of voice loading in the work-place, as well as long-term monitoring of relevant voice parameters during professional activities. A critical review is given, with focus on the specificity of occupational voice use and on the point of view of insurance medicine. Remaining questions and suggestions for future research are proposed.

Descriptive Epidemiology of Voice Disorders in Rheumatoid Arthritis: Prevalence, Risk Factors, and Quality of Life Burden.

OBJECTIVES: Rheumatoid arthritis (RA) is an autoimmune inflammatory disease which may adversely affect phonatory function. This study aimed to establish the prevalence, risks, and quality of life effects of voice disorders in RA. STUDY DESIGN: This is a cross-sectional, descriptive epidemiology study. METHODS: One hundred individuals with RA underwent a telephone interview to determine the frequency, severity, risks associated with, and quality of life burden of voice disorders. The results were analyzed using summary statistics, frequencies, chi-square tests, regression analysis, and risk ratios (P < 0.05). RESULTS: Thirty-five percent of participants with RA reported a current voice disorder which was chronic and long-standing in most cases. The prevalence of a current voice disorder did not significantly differ across age, sex, medication use, voice use patterns, medical history, or RA severity. These chronic voice disorders produced significant adverse effects on both voice-related quality of life and short form 36 health-related quality of life scales. Specific voice symptoms such as "voice-related discomfort" and "chronic throat dryness" contributed disproportionately to the quality of life burden. Of those participants with a voice disorder, only 37% had ever sought professional help to improve their voice. CONCLUSIONS: These results indicate that voice disorders are common in RA and produce significant adverse effects on quality of life. Further research is necessary to better understand the origin of these disorders and their potential response to treatment.

The Prevalence of Teachers' Vocal Symptoms in Municipal Network of Education in Campo Grande, Mato Grosso do Sul, Brazil.

OBJECTIVE: This study aims to provide an epidemiological overview of the teacher's voice and to examine the prevalence of voice problems at Municipal Board Education in Campo Grande, Mato Grosso do Sul, Brazil. METHODS: This is a cross-sectional, descriptive, and quantitative study. Of the 4957 teachers registered with Municipal Board Education (Semed)/2013, 394 participated in this research. All seven urban areas of Campo Grande (Prosa, Bandeira, Anhanduizinho, Lagoa, Segredo, Centro, and Imbirussu) were sampled. The Ferreira et al. protocol was adapted and used for data collection. The Likert scale was used as the measurement method. RESULTS: There was a high prevalence of vocal symptoms. Teachers had multiple symptoms related to the use of voice at work and acknowledged that the symptoms had adverse effects on their professional performance. CONCLUSION: The severity of voice problems that the teachers experienced in daily speech therapy services and in the Municipal Network of Education was found in a significant number of participants in this research.

Gender Differences in the Prevalence of Vocal Symptoms in Smokers.

OBJECTIVES: The purpose of the present study was to explore possible gender differences in the occurrence of vocal symptoms in smokers. METHODS: A total of 1728 respondents, 68% women and 32% men completed a "Speech, language and voice" questionnaire. The questions concerning six vocal symptoms along with questions concerning smoking habits were used as the main data source for the present study. RESULTS: About 24% of the men and 22% of the women were smokers. Male smokers did not differ from male nonsmokers in reporting vocal symptoms. In contrast, female smokers were more likely than female nonsmokers to report having vocal symptoms. Smoking seemed to have a significant effect on four of the six vocal symptoms in the female smokers. CONCLUSIONS: There appears to be a difference in the effects of smoking between men and women. The female vocal folds may be more vulnerable to cigarette smoke, probably due to anatomical and physiological differences. Nevertheless, it is yet to be demonstrated that the vocal symptoms in female smokers are causally related to smoking. It could be meaningful to use gender specific strategies when informing smokers about the risks for voice problems.