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A survey was distributed to teachers in the East Tennessee Tri-Cities area to determine impact of occupational risk factors including voice use, work related factors and common practices of teachers’ everyday lives on the presence or absence of voice problems. Preliminary results regarding voice problems and potential factors are discussed.

Summary Objectives/Hypotheses To assess the utility of a targeted voice hygiene (VH) program compared to VH plus voice training intervention (VH+VT) for the prevention and treatment of voice problems in student teachers. Study Design Prospective, randomized. Methods Thirty-one student teachers with low (good) and high (poor) voice handicap index (VHI) scores in Pittsburgh and Hong Kong were randomly assigned to (1) a targeted, individually tailored VH program, (2) the VH program plus resonant VT (VH+VT), or (c) a control group. Participants assigned to intervention groups were monitored for their adherence to their programs for their first 4 weeks of student teaching. VHI data were collected again 4 weeks postintervention (both sites) and 8 weeks postintervention, following a no-contact washout period (Pittsburgh). Results Descriptive data analysis indicated that across both sites, for initially healthy participants, the VH program was sufficient to prevent worsening of VHI scores that occurred in all control participants over the first 4–8 weeks of student teaching. The addition of VT did not consistently enhance protective benefits over VH alone. In contrast, for participants with initially poor VHI scores, the VH program failed to produce VHI benefits over the control condition. The addition of VT was required to optimize results for that cohort. Conclusions Preliminary data suggest that a minimalist, individually tailored VH program may be sufficient to prevent voice problems from teaching in healthy student teachers. However, for student teachers with existing voice problems, VT may be required to optimize results of intervention.

Teachers frequently present with voice problems as result of functional voice hyperfunction and it seems that occupational duties often impede successful implementation of a conventional voice conservation strategies. The goal of this single-subject study was to investigate the practical value of personal voice amplification as an assistive option for teachers experiencing occupation-related voice problems The physical state of a teacher’s vocal chords and specific perceptual and acoustic attributes of her voice were evaluated before and after a period of conventional voice conservation, and also before and after a period during which personal voice amplification was used as an augmentative strategy. In the course of the study it was in the interest of the subject that a persistent vocal fold nodule be removed surgically. The research design was adapted accordingly and the study consequently included a pre- and post surgical phase. Physical examinations of the vocal cords reflected the positive effect of the surgical removal of a vocal fold nodule. An improvement in the general status of the vocal cords was also noted following periods during which personal voice amplification was used in combination with a conventional voice conservation strategy. Perceptual and acoustic analysis of voice quality confirmed the positive effect of the surgical intervention. Although a panel of judges did not detect an improvement in the subject’s voice quality following the assistive use of the personal amplifier, several acoustic voice parameters showed improvement or normalised after the use of personal voice amplification in combination with conventional voice conservation strategies. The subject’s repeated evaluation of her own voice experiences, as well as her view of the practicability of the two voice conservation strategies, revealed a remarkably positive attitude towards the augmentative use of personal voice amplification. The conclusion is that teachers who experience occupational voice problems could benefit from the use of personal voice amplification in combination with a conventional voice conservation strategy. / Dissertation (M (Communication Pathology))--University of Pretoria, 2006. / Speech-Language Pathology and Audiology / Unrestricted

Made available in DSpace on 2011-05-04T12:36:31Z (GMT). No. of bitstreams: 0 Previous issue date: 2009 / Introdução: A freqüência, a gravidade e as repercussões sociais dos problemas de voz o transformaram em uma questão relevante para a Saúde Pública e para a Saúde do Trabalhador. A análise dos fatores de risco relacionados à voz profissional deve incluir tanto questões individuais como aspectos ambientais e organizacionais. Seu uso incorreto, originando ajustes inapropriados no modo de produção vocal, e a grande demanda vocal são fatores importantes para o desencadeamento de alterações no aparelho fonador dos professores. Uma parcela significativa deles desenvolve sintomas laríngeos, faríngeos e/ou cervicais de diferentes tipos e graus de severidade, afetando seu desempenho vocal. O absenteísmo e freqüentes pedidos de licença médica, além das incapacidades permanentes neste grupo, sobrecarregam os serviços de saúde e de perícia médica. A Lista Brasileira de Doenças Relacionadas ao Trabalho, produzida pelo Ministério da Saúde e adotada pelo Ministério da Previdência, não incluiu os transtornos da voz relacionados ao trabalho e a legislação vigente sobre aptidão e inaptidão vocal para o trabalho é ainda insuficiente e imprecisa. Objetivos: Avaliar diagnósticos, causas e critérios de readaptação funcional por problemas de voz de professores da rede pública municipal de ensino da cidade do Rio de Janeiro durante o ano de 2007. / Material e método: revisão da literatura técnica e normativa, estudo descritivo observacional com uso de prontuários médicos e entrevistas com profissionais da Gerência de Perícias Médicas (GPM) da Prefeitura da Cidade do Rio de Janeiro. Resultado: 41,73 por cento dos professores foram readaptados em 2007 por disfoniacorrespondendo a 1 por cento de todos os professores da rede pública municipal do RJ; 97,67 por cento do sexo feminino; média de idade: 46,6 + 8,4 anos; média de tempo de magistério: 18,5 + 8,2 anos; tempo médio de readaptação: 3,5 + 4,16 anos; 67,37 por cento de lesões orgânicas(espessamento de bordo livre: 26,02 por cento; nódulos: 24,39 por cento) e 32,63 por cento de funcionais(fendas: 79,46 por cento). Conclusão: O adoecimento vocal apresentado pelos professores deve ser valorizado e incluído no roll das patologias relacionadas ao trabalho. Programas desaúde vocal devem ser introduzidos para a prevenção destes agravos. / Introduction: The frequency, severity and impact of social problems due to voice problems turned into an issue for Public and Occupational Health. The analysis of risk factors related to professional voice use should include not only individual issues but also organizational and environmental aspects. Inappropriate settings for the mode of voice production due to incorrect use of the voice, and high vocal demand are important factors for the triggering of changes in teachers' vocal apparatus. Laryngeal, pharyngeal and/or cervical symptoms of different types and degrees and changes in vocal performance are developed by a significant amount of them. The absences and frequent requests for medical leave, in addition to permanent disability in this group, overwhelm the health services and medical expertise. The List of Brazilian Diseases Related to Work, produced by the Ministry of Health and adopted by the Ministry of Welfare, does not include work related voice disorders and legislation about vocal ability and inability to work are still insufficient and imprecise. Objectives: To assess diagnosis, causes and criteria for functional readaptation of teachers with voice problems in the public schools of Rio de Janeiro City during the year of 2007. Material and method: review of technical and normative literature, descriptive observational study using medical records and interviews with professionals from the Medical Expertise Management (GPM) of the City Hall of Rio de Janeiro. Results: 41.73% of teachers in 2007 were readapted by dysphonia corresponding to 1% of all teachers in the public educational municipal system of RJ; 97.67% female, mean age: 46,6 + 8,4 years, average years of teaching: 18,5 + 8,2 years, mean duration of readaptation: 3,5 + 4,16 years, 67.37% of organic lesions (thickening of free vocal cord edge: 26.02%; nodules: 24.39%) and 32.63% of functional (chink: 79.46%). Conclusion: Teachers’ voice disorders should be worth and included in the roll of occupational diseases. Vocal health programs should be introduced to prevent these problems.