title: Voice Problems in New Zealand Teachers: A National Survey.
abstract: OBJECTIVE
  This study determined the prevalence and nature of voice problems in New Zealand (NZ) teachers using a national self-report questionnaire.
  
  
  METHODS
  Epidemiological cross-sectional survey.
  
  
  METHODS
  Participants were 1879 primary and secondary teachers (72.5% females). Three prevalence timeframes were estimated. Severity of voice problems, recovery time, days away from work, symptoms, health assistance, and voice education were also investigated.
  
  
  RESULTS
  Prevalence of self-reported vocal problems was 33.2% during their teaching career, 24.7% over the teaching year, and 13.2% on the day of the survey. Primary teachers (P<0.001; odds ratio [OR]=1.74; confidence interval [CI]=1.33-2.40), females (P=0.008; OR=1.63; CI=1.13-2.37), and those aged 51-60 years (P=0.010; OR=1.45; CI=1.11-3.00) were more likely to report problems. Among teachers reporting voice problems during the year, 47% were moderate or severe; for 30%, voice recovery took more than 1 week. Approximately 28% stayed away from work 1-3 days owing to a vocal problem and 9% for more than 3 days. Women reported longer recovery times and more days away. Symptoms associated with voice problems (P<0.001) were voice quality alteration (OR=4.35; CI=3.40-5.57), vocal effort (OR=1.15; CI=0.96-1.37), voice breaks (OR=1.55; CI=1.30-1.84), voice projection difficulty (OR=1.25; CI=1.04-1.50), and throat discomfort (OR=1.22; CI=1.02-1.47). Of the teachers reporting voice problems, only 22.5% consulted a health practitioner. Only 38% of the teachers with chronic voice problems visited an otolaryngologist. Higher hours of voice training/education were associated with fewer self-reported voice problems.
  
  
  CONCLUSIONS
  Voice problems are of concern for NZ teachers, as has been reported for teachers in other countries. There is still limited awareness among teachers about vocal health, potential risks, and specialized health services for voice problems.
authors.affiliation: Speech Science, School of Psychology & Centre for Brain Research, The University of Auckland, Auckland, New Zealand. Electronic address: s.leao@auckland.ac.nz.
authors.forename: Sylvia H de S
authors.initials: SH
authors.lastname: Leão
authors.affiliation: Department of Human Communication Sciences, LaTrobe University, Melbourne, Australia.
authors.forename: Jennifer M
authors.initials: JM
authors.lastname: Oates
authors.affiliation: Speech Science, School of Psychology & Centre for Brain Research, The University of Auckland, Auckland, New Zealand.
authors.forename: Suzanne C
authors.initials: SC
authors.lastname: Purdy
authors.affiliation: Department of Statistics, The University of Auckland, Auckland, New Zealand.
authors.forename: David
authors.initials: D
authors.lastname: Scott
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, The University of Auckland, Auckland, New Zealand.
authors.forename: Randall P
authors.initials: RP
authors.lastname: Morton
mesh_terms: D000041:Absenteeism; D000328:Adult; D000368:Aged; D016009:Chi-Square Distribution; D003430:Cross-Sectional Studies; D005178:Faculty; D005260:Female; D019538:Health Care Surveys; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009520:New Zealand / Q000453:epidemiology; D009784:Occupational Diseases / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology / Q000628:therapy; D016272:Occupational Health; D016017:Odds Ratio; D010353:Patient Education as Topic; D015995:Prevalence; D020127:Recovery of Function; D012307:Risk Factors; D012720:Severity of Illness Index; D018582:Sick Leave; D011795:Surveys and Questionnaires; D013997:Time Factors; D014832:Voice Disorders / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology / Q000628:therapy; D014833:Voice Quality; D014834:Voice Training; D055815:Young Adult
keywords: Epidemiology; Hoarseness; Prevalence; Teachers; Voice disorder; Voice symptoms; Voice-related health seeking