Dysphonia prevalence and its relationship with risk factors among teachers

Öz

Purpose: The aim of this study was to determine the relationship between the prevalence of and risk factors for dysphonia among teachers. Materials and methods: According to the questionnaire results of 167 teachers, 87 teachers who described dysphonia were included in the patient group and 80 teachers who did not describe dysphonia were included in the control group. For both groups, statistical evaluations were performed using non-parametric statistical methods. Results: 87 (52.1%) of 167 teachers included in the study had the complaint of dysphonia. The presence of laryngopharyngeal reflux and allergic diseases caused increase in the risk of dysphonia. The risk of dysphonia was also increased with increasing stage of education that the teachers were responsible for. Laryngeal endoscopy revealed no organic lesion in 65.5% of the patients, whereas showed laryngopharyngeal reflux findings in 26.4%, vocal cord nodule in 6.8% and vocal cord polyp in 1.1%. Conclusion: This study showed that dysphonia is a common disorder among teachers and while evaluating these subjects the presence of laryngopharyngeal reflux and allergic diseases should primarily be considered.

Anahtar Kelimeler

• Dysphonia
• risk factors
• laryngopharyngeal reflux
• allergic diseases

Öğretmenlerde disfoni prevelansı ve risk faktörleri ile ilişkisi

Öz

Amaç: Öğretmenlerde disfoni prevelansını ve disfoni yapan risk faktörleri arasındaki ilişkiyi tesbit etmek. Gereç ve yöntem: Araştırmaya alınan 167 öğretmenin anket sonuçlarına göre disfoni tarifleyen 87 öğretmen hasta grubu, disfoni tariflemeyen 80 öğretmen anketi ise kontrol grubu olarak alındı. Her iki grup için non parametrik istatistiksel yöntemler kullanılarak değerlendirmeler yapıldı. Bulgular: Çalışmaya alınan 167 öğretmenin 87’sinde (%52,1) disfoni şikayeti saptandı. Larengofarengeal reflü varlığının ve alerjik hastalık varlığının disfoni riskini arttırdığı belirlendi. Öğretmenlerin sorumlu olduğu eğitim-öğretim kademesinin arttıkça disfoni riskinin de arttığı görüldü. Larenks endoskopisinin %65,5’inde organik bir lezyon saptanmazken, %26,4’ünde larengofarengeal reflü bulguları, %6,8’de vokal kord nodülü ve %1,1’de vokal kord polibi olduğu görüldü. Sonuç: Çalışmamız, öğretmenlerdeki ses kalite bozukluğunun yaygın görülen fiziksel bir rahatsızlık olduğunu ve bu kişilerin değerlendirilirken larengofarengeal reflü ve alerjik hastalık varlığının öncelikle sorgulanması gerektiğini düşündürmektedir.

Anahtar Kelimeler

• Disfoni
• risk faktörleri
• larengofarengeal reflü
• alerjik hastalıklar

Kaynakça

1. 1. Williams NR. Occupational groups at risk of voice disorders: a review of the literature [published correction appears in Occup Med (Lond). 2012 Oct;62(7):588]. Occup Med (Lond). 2003;53(7):456-460. doi:10.1093/occmed/kqg113
2. 2. Smith E, Gray SD, Dove H, Kirchner L, Heras H. Frequency and effects of teachers' voice problems. J Voice. 1997;11(1):81-87. doi:10.1016/s0892-1997(97)80027-6
3. 3. Russell A, Oates J, Greenwood KM. Prevalence of voice problems in teachers. J Voice. 1998;12(4):467-479. doi:10.1016/s0892-1997(98)80056-8
4. 4. Urrutikoetxea A, Ispizua A, Matellanes F. Pathologie vocale chez les professeurs: une étude vidéo-laryngo-stroboscopique de 1.046 professeurs [Vocal pathology in teachers: a videolaryngostroboscopic study in 1046 teachers]. Rev Laryngol Otol Rhinol (Bord). 1995;116(4):255-262.
5. 5. Roy N, Merrill RM, Thibeault S, Gray SD, Smith EM. Voice disorders in teachers and the general population: effects on work performance, attendance, and future career choices. J Speech Lang Hear Res. 2004;47(3):542-551. doi:10.1044/1092-4388(2004/042)
6. 6. Sapir S, Keidar A, Mathers-Schmidt B. Vocal attrition in teachers: survey findings. Eur J Disord Commun. 1993;28(2):177-185. doi:10.3109/13682829309041465
7. 7. Sala E, Laine A, Simberg S, Pentti J, Suonpää J. The prevalence of voice disorders among day care center teachers compared with nurses: a questionnaire and clinical study. J Voice. 2001;15(3):413-423. doi:10.1016/S0892-1997(01)00042-X
8. 8. Smith E, Kirchner HL, Taylor M, Hoffman H, Lemke JH. Voice problems among teachers: differences by gender and teaching characteristics. J Voice. 1998;12(3):328-334. doi:10.1016/s0892-1997(98)80022-2

9. 9. Sliwińska Kowalska M, Fiszer M, Niebudek-Bogusz E, Kotyło P, Rzadzińska A. Ocena stanu narzadu głosu u studentów szkoły pedagogicznej [Evaluation of voice quality in students from teaching colleges]. Med Pr. 2000;51(6):573-580.
10. 10. Smolander S, Huttunen K. Voice problems experienced by Finnish comprehensive school teachers and realization of occupational health care. Logoped Phoniatr Vocol. 2006;31(4):166-171. doi:10.1080/14015430600576097
11. 11. Simberg S, Laine A, Sala E, Rönnemaa AM. Prevalence of voice disorders among future teachers. J Voice. 2000;14(2):231-235. doi:10.1016/s0892-1997(00)80030-2
12. 12. Thomas G. The Voice of Student Teachers and Teachers. Yayınlanmamış Yüksek Lisans Tezi. Radboud University Nijmegen Medical Centre, Nijmegen, 2005.
13. 13. de Jong FI, Kooijman PG, Thomas G, Huinck WJ, Graamans K, Schutte HK. Epidemiology of voice problems in Dutch teachers. Folia Phoniatr Logop. 2006;58(3):186-198. doi:10.1159/000091732
14. 14. Kooijman PG, de Jong FI, Oudes MJ, Huinck W, van Acht H, Graamans K. Muscular tension and body posture in relation to voice handicap and voice quality in teachers with persistent voice complaints. Folia Phoniatr Logop. 2005;57(3):134-147. doi:10.1159/000084134
15. 15. Kooijman PG, de Jong FI, Thomas G, et al. Risk factors for voice problems in teachers. Folia Phoniatr Logop. 2006;58(3):159-174. doi:10.1159/000091730
16. 16. Ramig LO, Verdolini K. Treatment efficacy: voice disorders. J Speech Lang Hear Res. 1998;41(1):S101-S116. doi:10.1044/jslhr.4101.s101
17. 17. Sliwinska Kowalska M, Niebudek-Bogusz E, Fiszer M, et al. The prevalence and risk factors for occupational voice disorders in teachers. Folia Phoniatr Logop. 2006;58(2):85-101. doi:10.1159/000089610
18. 18. Meulenbroek LF, de Jong FI. Voice quality in relation to voice complaints and vocal fold condition during the screening of female student teachers. J Voice. 2011;25(4):462-466. doi:10.1016/j.jvoice.2010.01.003
19. 19. Pahn J, Pahn E. Vorschlag zur Einschätzung des Schweregrades von Stimmstörungen [Assessment of the degree of severity of voice disorders]. Folia Phoniatr (Basel). 1975;27(06):472-479.
20. 20. Roy N, Merrill RM, Gray SD, Smith EM. Voice disorders in the general population: prevalence, risk factors, and occupational impact. Laryngoscope. 2005;115(11):1988-1995. doi:10.1097/01.mlg.0000179174.32345.41
21. 21. Mattiske JA, Oates JM, Greenwood KM. Vocal problems among teachers: a review of prevalence, causes, prevention, and treatment. J Voice. 1998;12(4):489-499. doi:10.1016/s0892-1997(98)80058-1
22. 22. Hammond TH, Zhou R, Hammond EH, Pawlak A, Gray SD. The intermediate layer: a morphologic study of the elastin and hyaluronic acid constituents of normal human vocal folds. J Voice. 1997;11(1):59-66. doi:10.1016/s0892-1997(97)80024-0
23. 23. Koufman JA. The otolaryngologic manifestations of gastroesophageal reflux disease (GERD): a clinical investigation of 225 patients using ambulatory 24-hour pH monitoring and an experimental investigation of the role of acid and pepsin in the development of laryngeal injury. Laryngoscope. 1991;101(4 Pt 2 Suppl 53):1-78. doi:10.1002/lary.1991.101.s53.1
24. 24. Ulualp SO, Toohill RJ, Shaker R. Pharyngeal acid reflux in patients with single and multiple otolaryngologic disorders. Otolaryngol Head Neck Surg. 1999;121(6):725-730. doi:10.1053/hn.1999.v121.a98010
25. 25. Koufman JA, Amin MR, Panetti M. Prevalence of reflux in 113 consecutive patients with laryngeal and voice disorders [published correction appears in Otolaryngol Head Neck Surg 2001 Jan;124(1):104]. Otolaryngol Head Neck Surg. 2000;123(4):385-388. doi:10.1067/mhn.2000.109935
26. 26. Morrison MD, Rammage LA. Muscle misuse voice disorders: description and classification. Acta Otolaryngol. 1993;113(3):428-434. doi:10.3109/00016489309135839
27. 27. Pérez Fernández CA, Preciado López J. Nódulos de cuerdas vocales. Factores de riesgo en los docentes. Estudio de casos y controles [Vocal fold nodules. Risk factors in teachers. A case control study design]. Acta Otorrinolaringol Esp. 2003;54(4):253-260. doi:10.1016/s0001-6519(03)78412-x
28. 28. Roy N, Merrill RM, Gray SD, Smith EM. Voice disorders in the general population: prevalence, risk factors, and occupational impact. Laryngoscope. 2005;115(11):1988-1995. doi:10.1097/01.mlg.0000179174.32345.41
29. 29. Gotaas C, Starr CD. Vocal fatigue among teachers. Folia Phoniatr (Basel). 1993;45(3):120-129. doi:10.1159/000266237
30. 30. Ma EP, Yiu EM. Voice activity and participation profile: assessing the impact of voice disorders on daily activities. J Speech Lang Hear Res. 2001;44(3):511-524. doi:10.1044/1092-4388(2001/040)
31. 31. Preciado J, Pérez C, Calzada M, Preciado P. Incidencia y prevalencia de los trastornos de la voz en el personal docente de La Rioja. Estudio clínico: cuestionario, examen de la función vocal, análisis acústico y vídeolaringoestroboscopia [Prevalence and incidence studies of voice disorders among teaching staff of La Rioja, Spain. Clinical study: questionnaire, function vocal examination, acoustic analysis and videolaryngostroboscopy]. Acta Otorrinolaringol Esp. 2005;56(5):202-210. doi:10.1016/s0001-6519(05)78601-5
32. 32. Morrison MD, Nichol H, Rammage LA. Diagnostic criteria in functional dysphonia. Laryngoscope. 1986;96(1):1-8. doi:10.1288/00005537-198601000-00001