title: Study of Risk Factors for Development of Voice Disorders and its Impact on the Quality of Life of School Teachers in Mangalore, India.
abstract: BACKGROUND
  School teachers are most prone to the development and detrimental effects of voice disorders as a consequence of their work. The risk factors for development of dysphonia in teachers are multifactorial.
  
  
  OBJECTIVE
  The primary aim of our study was to investigate the various risk factors that influence the onset and progression of voice disorders in school teachers in the Indian context. We wanted to assess the effect of voice problems on the physical, psychosocial and functional aspect of a teacher's life.
  
  
  METHODS
  It was a cross-sectional study conducted across three English medium institutions. A total of 105 teachers consented to participate in the study and they had to answer a semi-structured, pre-tested questionnaire, which included demographic details, living habits (drug intake, smoking and alcohol intake) health condition [any Deviated Nasal Septum (DNS), Gastroesophageal Reflux Disease (GERD), stress, etc., or any history of surgery], teaching characteristics, voice symptoms and physical discomforts and quality of life assessment. The completed questionnaires were collected and analyzed based on the responses obtained.
  
  
  RESULTS
  It was found that 81% of the study population had voice problems at some point of their career. A total of 26% of them fell into the voice disorder category. The association of upper respiratory infections DNS and GERD with voice disorders was found to be statistically significant. We also found that a significant number of teachers with voice disorders had changed their teaching styles and were planning to opt for an early retirement. Most importantly, it was also seen that teachers with voice disorders were more likely to have a poorer quality of life as compared to those without a voice disorder (p<0.001).
  
  
  CONCLUSIONS
  Voice disorders had a significant bearing on all the spheres of a school teacher's life. The affected teachers were more likely to take sick leaves, change overall job opinions, retire early, reduce overall communiations, repeat statements and avoid talking to people in person as well as over the telephone. It reduced their overall social abilities and made them avoid social activities. They got easily upset and were dissatisfied with their job performance. All these in turn deteriorate the quality of life in these individuals.
authors.affiliation: Assistant Professor, Department of Ear Nose and Throat, Kasturba Medical College, MAHE University , Mangalore, Karnataka, India .
authors.forename: Arati
authors.initials: A
authors.lastname: Alva
authors.affiliation: Intern, Kasturba Medical College, MAHE University , Mangalore, Karnataka, India .
authors.forename: Megna
authors.initials: M
authors.lastname: Machado
authors.affiliation: Professor and Head, Department of Ear Nose and Throat, Kasturba Medical College, MAHE University , Mangalore, Karnataka, India .
authors.forename: Kiran
authors.initials: K
authors.lastname: Bhojwani
authors.affiliation: Professor, Department of Ear Nose and Throat, Kasturba Medical College, MAHE University , Mangalore, Karnataka, India .
authors.forename: Suja
authors.initials: S
authors.lastname: Sreedharan
keywords: Occupational voice disorder; Preventive voice care; Voice problems