title: Voice disorders in teachers: occupational risk factors and psycho-emotional factors.
abstract: BACKGROUND
  Teaching is a high-risk occupation for developing voice disorders. The purpose of this study was to investigate previously described vocal risk factors as well as to identify new risk factors related to both the personal life of the teacher (fluid intake, voice-demanding activities, family history of voice disorders, and children at home) and to environmental factors (temperature changes, chalk use, presence of curtains, carpet, or air-conditioning, acoustics in the classroom, and noise in and outside the classroom).
  
  
  METHODS
  The study group comprised 994 teachers (response rate 46.6%). All participants completed a questionnaire. Chi-square tests and logistic regression analyses were performed.
  
  
  RESULTS
  A total of 51.2% (509/994) of the teachers presented with voice disorders. Women reported more voice disorders compared to men (56.4% versus 40.4%, P < 0.001). Vocal risk factors were a family history of voice disorders (P = 0.005), temperature changes in the classroom (P = 0.017), the number of pupils per classroom (P = 0.001), and noise level inside the classroom (P = 0.001). Teachers with voice disorders presented a higher level of psychological distress (P < 0.001) compared to teachers without voice problems.
  
  
  CONCLUSIONS
  Voice disorders are frequent among teachers, especially in female teachers. The results of this study emphasize that multiple factors are involved in the development of voice disorders.
authors.affiliation: Department of Otorhinolaryngology and Head and Neck Surgery, University Hospital Ghent, Belgium. Evelyne.vanhoutte@ugent.be
authors.forename: Evelyne
authors.initials: E
authors.lastname: van Houtte
authors.forename: Sofie
authors.initials: S
authors.lastname: Claeys
authors.forename: Floris
authors.initials: F
authors.lastname: Wuyts
authors.forename: Kristiane
authors.initials: K
authors.lastname: van Lierde
mesh_terms: D000328:Adult; D000368:Aged; D016009:Chi-Square Distribution; D003430:Cross-Sectional Studies; D004644:Emotions; D004777:Environment; D005178:Faculty; D005260:Female; D006801:Humans; D008019:Life Style; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009784:Occupational Diseases / Q000209:etiology* / Q000503:physiopathology / Q000523:psychology; D016017:Odds Ratio; D018570:Risk Assessment; D012307:Risk Factors; D013315:Stress, Psychological / Q000150:complications* / Q000503:physiopathology / Q000523:psychology; D011795:Surveys and Questionnaires; D013663:Teaching; D014832:Voice Disorders / Q000209:etiology* / Q000503:physiopathology / Q000523:psychology; D014833:Voice Quality; D055815:Young Adult