title: The economic impact of vocal attrition in public school teachers in Miami-Dade County.
abstract: OBJECTIVE
  Teachers are a known at-risk population for voice disorders. The prevalence and risk factors for voice disorders have been well studied in this population, but little is known about the associated economic cost. The purpose of this study is to assess the economic impact of voice dysfunction in teachers and understand the difference between the cost of absenteeism and presenteeism as a direct result of voice dysfunction.
  
  
  METHODS
  Cross-sectional analysis via self-administered online questionnaire.
  
  
  METHODS
  A total of 14,256 public school teachers from Miami-Dade County, Florida, were asked to participate. Questions were formatted based on the previously validated Work Productivity and Activity Impairment: Specific Health Problem questionnaire adapted for hoarseness and voice disorders. Additional demographic questions were included in the questionnaire.
  
  
  RESULTS
  A total of 961 questionnaire responses were received. The demographic characteristics of respondents closely matched known statistics for public school teachers in Miami-Dade County. Economic calculations were performed for each questionnaire respondent and summed for all respondents to avoid bias. Per week, absenteeism-related costs were $25,000, whereas presenteeism-related costs were approximately $300,000. These figures were used to extrapolate annual cost. Per year, absenteeism-related costs were $1 million, whereas presenteeism-related costs were approximately $12 million.
  
  
  CONCLUSIONS
  The economic impact of voice dysfunction on the teaching profession is enormous. With the above calculations only including lost wages and decreased productivity, the actual figures may in fact be larger (cost of substitute teachers, impact on nonwork activities, etc.). Research investigating preventative measures for voice dysfunction in teachers is necessary to reduce this costly issue.
  
  
  METHODS
  2C. Laryngoscope, 126:665-671, 2016.
authors.affiliation: Department of Otolaryngology, University of Miami Miller School of Medicine, Miami, Florida.|Department of Vocal Performance, University of Miami Frost School of Music, Coral Gables, Florida.
authors.forename: David E
authors.identifier: http://orcid.org/0000-0002-4289-0158
authors.initials: DE
authors.lastname: Rosow
authors.affiliation: Department of Otolaryngology, University of Miami Miller School of Medicine, Miami, Florida.
authors.forename: Mikhaylo
authors.initials: M
authors.lastname: Szczupak
authors.affiliation: Department of Otolaryngology, University of Miami Miller School of Medicine, Miami, Florida.
authors.forename: Sandra
authors.initials: S
authors.lastname: Saint-Victor
authors.affiliation: Department of Otolaryngology, University of Miami Miller School of Medicine, Miami, Florida.|Department of Vocal Performance, University of Miami Frost School of Music, Coral Gables, Florida.|Department of Music, University of North Carolina at Charlotte, Charlotte, North Carolina, U.S.A.
authors.forename: Julia D
authors.initials: JD
authors.lastname: Gerhard
authors.affiliation: Department of Vocal Performance, University of Miami Frost School of Music, Coral Gables, Florida.|Department of Music, University of North Carolina at Charlotte, Charlotte, North Carolina, U.S.A.
authors.forename: Carl
authors.initials: C
authors.lastname: DuPont
authors.affiliation: Division of Biostatistics, Department of Public Health Sciences, Biostatistics Collaboration and Consulting Core, University of Miami Miller School of Medicine, Miami, Florida.
authors.forename: Kaming
authors.initials: K
authors.lastname: Lo
mesh_terms: D000041:Absenteeism; D000328:Adult; D016009:Chi-Square Distribution; D003362:Cost-Benefit Analysis; D003430:Cross-Sectional Studies; D004526:Efficiency; D005178:Faculty; D005260:Female; D005431:Florida; D006801:Humans; D008297:Male; D008875:Middle Aged; D009784:Occupational Diseases / Q000191:economics* / Q000209:etiology / Q000503:physiopathology; D018570:Risk Assessment; D012574:Schools / Q000191:economics*; D018709:Statistics, Nonparametric; D011795:Surveys and Questionnaires; D013663:Teaching; D014832:Voice Disorders / Q000191:economics* / Q000209:etiology / Q000503:physiopathology*; D055815:Young Adult
keywords: Teachers; absenteeism; cost; economic; hoarseness; presenteeism; voice disorders