Reflux symptoms in professional opera choristers.
OBJECTIVE
A specific, occupation-related susceptibility of professional singers to experience gastroesophageal reflux was hypothesized. We investigated the prevalence of gastroesophageal reflux symptoms in a series of professional opera choristers in comparison with a general population sample.


METHODS
A total of 351 professional opera choristers from well-known chorus in different Italian regions were identified and a sample of 578 subjects residing in the same areas with a similar distribution in age and sex was selected. Reflux symptoms in the year preceding the survey together with selected individual characteristics and lifestyle habits were investigated in both study groups through a structured questionnaire. Prevalence rate ratios, adjusted for sex, age, body mass index, smoking status, alcohol consumption, and other confounding factors, were computed.


RESULTS
Opera choristers reported a statistically significant higher prevalence of heartburn, regurgitation, cough, and hoarse voice than the population sample, with adjusted prevalent rate ratios of 1.60 (95% confidence interval [CI], 1.32-1.94), 1.81 (95% CI, 1.42-2.30), 1.40 (95% CI, 1.18-1.67), and 2.45 (95% CI, 1.97-3.04), respectively. Regurgitation appeared to be associated consistently with the cumulative lifetime duration of singing activity (P = .04) and with the weekly duration of singing activity (P = .005) when different multivariate models were applied.


CONCLUSIONS
Opera choristers reported a higher prevalence of reflux symptoms than the population sample. Future studies will be needed to clarify whether gastroesophageal reflux in professional opera choristers is stress-induced and therefore may be considered as a work-related disease.
Cammarota
Giovanni
G
Institute of Internal Medicine, Catholic University of Medicine and Surgery, Rome, Italy. gcammarota@rm.unicatt.it
Masala
Giovanna
G
Cianci
Rossella
R
Palli
Domenico
D
Capaccio
Pasquale
P
Schindler
Antonio
A
Cuoco
Lucio
L
Galli
Jacopo
J
Ierardi
Enzo
E
Cannizzaro
Oreste
O
Caselli
Michele
M
Dore
Maria P
MP
Bendinelli
Benedetta
B
Gasbarrini
Giovanni
G
D000328:Adult; D003371:Cough / Q000453:epidemiology; D003964:Diaphragm / Q000503:physiopathology; D005260:Female; D005764:Gastroesophageal Reflux / Q000453:epidemiology* / Q000209:etiology / Q000503:physiopathology; D006356:Heartburn / Q000453:epidemiology; D006685:Hoarseness / Q000453:epidemiology; D006801:Humans; D007558:Italy / Q000453:epidemiology; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009146:Music; D009784:Occupational Diseases / Q000453:epidemiology* / Q000209:etiology / Q000503:physiopathology; D016017:Odds Ratio; D015995:Prevalence; D018570:Risk Assessment; D012307:Risk Factors; D011795:Surveys and Questionnaires; D013997:Time Factors