title: Prevalence and Risk Factors of Voice Problems Among Primary School Teachers in India.
abstract: OBJECTIVE
  Teachers are more prone to develop voice problems (VPs) when compared with other professional voice users. The aim of present study was to investigate the prevalence and risk factors of VPs among primary school teachers in India.
  
  
  METHODS
  Epidemiological cross-sectional survey.
  
  
  METHODS
  Self-reporting questionnaire data were collected from 1082 teachers.
  
  
  RESULTS
  Out of 1082 teachers who participated in the present study, 188 teachers reported VPs that account for a prevalence rate of 17.4%. Tired voice after long hours of talking was the most frequently reported symptom, followed by sore/dry throat, strain in voice, neck muscle tension, and difficulty in projecting voice. The adjusted odds ratio values showed number of years of teaching, high background noise levels in the classroom, experiencing psychological stress while teaching classes, improper breath management (holding breath while speaking), poor focus of the tone (clenching jaw/teeth while speaking), upper respiratory tract infection, thyroid problems, and acid reflux as significant risk factors for the development of VPs in the current cohort of teachers.
  
  
  CONCLUSIONS
  Current results suggest that teachers develop VPs due to multiple risk factors. These factors may be either biological, psychomotor, or environment-related factors. A holistic approach (which could include educating teachers about voice care during their training, and if they develop VP during their career, then managing the VP by taking into consideration different risk factors) addressing all these factors needs to be adopted to prevent VPs in primary school teachers.
authors.affiliation: Department of Speech and Hearing, School of Allied Health Sciences, Manipal University, Manipal, India.
authors.forename: Usha
authors.initials: U
authors.lastname: Devadas
authors.affiliation: Department of Speech-Language Sciences, All India Institute of Speech and Hearing, Manasagangothri, Mysore, India.
authors.forename: Rajashekhar
authors.initials: R
authors.lastname: Bellur
authors.affiliation: Department of Speech-Language Sciences, All India Institute of Speech and Hearing, Manasagangothri, Mysore, India.. Electronic address: santoshm79@gmail.com.
authors.forename: Santosh
authors.initials: S
authors.lastname: Maruthy
mesh_terms: D000328:Adult; D000368:Aged; D016009:Chi-Square Distribution; D017281:Cost of Illness; D003430:Cross-Sectional Studies; D005260:Female; D006306:Health Surveys; D006801:Humans; D007194:India / Q000453:epidemiology; D007587:Job Description; D008019:Life Style; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009784:Occupational Diseases / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology; D016272:Occupational Health; D016017:Odds Ratio; D015995:Prevalence; D012307:Risk Factors; D000070777:School Teachers; D012574:Schools; D057566:Self Report; D013997:Time Factors; D014832:Voice Disorders / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology; D014833:Voice Quality; D017132:Workplace; D055815:Young Adult
keywords: phonotrauma; prevalence; primary school teachers; risk factors; voice problems