title: Voice disorders in Nigerian primary school teachers.
abstract: BACKGROUND
  The prolonged use or abuse of voice may lead to vocal fatigue and vocal fold tissue damage. School teachers routinely use their voices intensively at work and are therefore at a higher risk of dysphonia.
  
  
  OBJECTIVE
  To determine the prevalence of voice disorders among primary school teachers in Lagos, Nigeria, and to explore associated risk factors.
  
  
  METHODS
  Teaching and non-teaching staff from 19 public and private primary schools completed a self-administered questionnaire to obtain information on personal lifestyles, work experience and environment, and voice disorder symptoms. Dysphonia was defined as the presence of at least one of the following: hoarseness, repetitive throat clearing, tired voice or straining to speak.
  
  
  RESULTS
  A total of 341 teaching and 155 non-teaching staff participated. The prevalence of dysphonia in teachers was 42% compared with 18% in non-teaching staff. A significantly higher proportion of the teachers reported that voice symptoms had affected their ability to communicate effectively. School type (public/private) did not predict the presence of dysphonia. Statistically significant associations were found for regular caffeinated drink intake (odds ratio [OR] = 3.07; 95% confidence interval [CI]: 1.51-6.62), frequent upper respiratory tract infection (OR = 3.60; 95% CI: 1.39-9.33) and raised voice while teaching (OR = 10.1; 95% CI: 5.07-20.2).
  
  
  CONCLUSIONS
  Nigerian primary school teachers were at risk for dysphonia. Important environment and personal factors were upper respiratory infection, the need to frequently raise the voice when teaching and regular intake of caffeinated drinks. Dysphonia was not associated with age or years of teaching.
authors.affiliation: Institute of Occupational and Environmental Medicine, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK.
authors.forename: R
authors.initials: R
authors.lastname: Akinbode
authors.affiliation: Institute of Occupational and Environmental Medicine, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK.
authors.forename: K B H
authors.initials: KB
authors.lastname: Lam
authors.affiliation: Institute of Occupational and Environmental Medicine, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK.
authors.forename: J G
authors.initials: JG
authors.lastname: Ayres
authors.affiliation: Institute of Occupational and Environmental Medicine, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK. s.sadhra@bham.ac.uk.
authors.forename: S
authors.initials: S
authors.lastname: Sadhra
mesh_terms: D000293:Adolescent; D000328:Adult; D001628:Beverages; D002110:Caffeine / Q000009:adverse effects; D055154:Dysphonia / Q000453:epidemiology / Q000209:etiology*; D005178:Faculty; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009549:Nigeria / Q000453:epidemiology; D009784:Occupational Diseases / Q000209:etiology*; D016017:Odds Ratio; D015995:Prevalence; D012141:Respiratory Tract Infections / Q000150:complications; D012307:Risk Factors; D011795:Surveys and Questionnaires; D013663:Teaching; D014705:Verbal Behavior; D014831:Voice; D055815:Young Adult
chemical_list: D002110:Caffeine
keywords: Dysphonia; Nigeria; primary school teachers; risk factors; voice disorders.