Occupational Voice Disorders: A Growing Epidemic

Introduction

Maintaining a healthy voice is crucial for individuals who use it in their profession, such as teachers, telemarketers, or singers. According to the studies, individuals in these professions are at a higher risk for developing voice disorders. Therefore, it negatively impacts the affected individual's health and social life.

What Are Occupational Voice Disorders?

Occupational voice disorder is a condition that develops as a result of the amount or type of voice used for a job. The disorder can also develop because of vocal irritants in the work environment or a combination of factors.

What Are the Factors Responsible for Occupational Voice Disorders?

Vocal overuse or abuse is the main triggering factor for occupational voice disorder. Professionals overusing their voices have frequent collisions due to repetitive movements of vocal cords. Therefore, triggering inflammatory processes in laryngeal tissue causes voice disorders.

The factors responsible are:

a) Non-occupational Risk Factors:

Age, gender, excessive and inappropriate use of voice, activities with high vocal demand such as leisure and double working shifts, respiratory allergies, upper respiratory tract diseases, hormonal influence, medication, alcohol abuse, poor hydration, smoking, stress, and GERD are a non-occupational risk factor for voice disorders. These factors can aggravate vocal issues in professionals using their voices.

b) Occupational Risk Factors

1. Organizational Risk Factors: These include extended workdays, overload, accumulation of activities, excessive vocal demand, lack of rest during the work day, no autonomy, stressful working environment, and dissatisfaction with work and remuneration.

2. Environmental Risk Factors

• Physical: A high level of sound pressure, sudden temperature changes, inadequate ventilation, and improper luminosity contribute to vocal damage.

• Chemical: Upper airway chemical irritants such as solvents, poisonous gas, or metal fumes can affect the voice. Smoke or dust in the workplace also causes vocal irritation.

• Ergonomic Factors: Improper posture, lack of material and equipment resources, acoustic environment, and lack of safe drinking water and toilet access.

3. Lifestyle Factors: Professionals with smoking habits and unhealthy diets causing exacerbated pharyngolaryngeal reflux demonstrate exacerbation of vocal disorders.

What Are the Symptoms of Occupational Voice Disorders?

Individuals experiencing occupational voice disorder exhibit soreness, hoarseness, sore throat, dry throat, vocal fatigue, weak voice, effort to speak, and aphonia. These symptoms develop insidiously.

Most of the symptoms in these individuals occur at the end of the work day or work week. The symptoms reduce after an overnight rest or during the weekend. Gradually, the frequency of symptoms increases, is present continuously during work hours and does not improve even with rest. At this stage, the affected individual can hardly exercise their vocal function.

Along with dysphonia, the affected individuals also exhibit symptoms of psychological stress and mental suffering in a demanding work environment. Fear of employment loss and lack of information makes them continue their work despite vocal challenges until it worsens and demands complex treatment.

Which Occupations Cause Voice Disorders?

Many occupations are considered at risk for developing voice disorders due to their inherent work conditions. The occupations with the highest risk of voice disorders are:

1. Teachers: These professionals more frequently visit voice clinics. The prevalence of voice disorder is 10 to 70 percent in this group. It could be due to frequent speaking in the classroom and voice projection, which strains their vocal cord. Many teachers develop throat discomfort, vocal fatigue, and hoarseness. However, the symptoms manifest after several years.

2. Professional Singers: Singers who perform regularly are at high risk for developing vocal issues.

3. Instructors: Individuals working as instructors need vocal projections, which can damage their vocal cords.

4. Telemarketers: Vocal disorder symptoms manifest earlier due to emotional stress and environmental and organizational factors.

Why Is It Essential to Address Occupational Voice Disorders?

Voice is a critical occupational tool for individuals involved in singing, stage performance, sports coaching, sales professionals, teachers, lecturers, lawyers, telephone operators, receptionists, call center workers, priests, and health professionals. A lack of voice leads to no work day for these professionals. Consequently, causing extreme financial repercussions which could ultimately impact their social and professional identity.

Some individuals may change their careers due to vocal issues. Professionals relying on their voice for jobs can face economic difficulties. A loss or hindrance to the job might impact the affected individual's self-confidence and lead to anxiety.

How Is Occupational Voice Disorder Diagnosed?

Medical and occupational history with clinical assessment is crucial for diagnosis. Affected individuals are clinically assessed with laryngoscopy and phono-audiological exam of voice.

A diagnosis of occupational vocal disorder is made when the symptoms are related to work. An early diagnosis and timely treatment of occupational vocal disorder produces better outcomes for the patient.

How Is Occupational Vocal Disorder Treated?

A multidisciplinary team of physicians, speech therapists, physiotherapists, psychologists, and occupational therapists are involved in treating occupational vocal disorder. The affected individual may be advised of biological, environmental, and personality changes and reduced occupational workload.

Medical and surgical interventions help overcome occupational vocal disorders. However, most vocal disorders are resolved without needing surgical intervention. Providing vocal speech rehabilitation with treatment enables better vocal adaptation and an earlier return to the work environment.

Vocal hygiene is recommended for individuals with acute occupational voice disorder. It includes a set of preventive and curative measures such as professional guidance about vocal functioning, avoidance of smoking or alcohol abuse, correcting body postures, treatment of infectious and allergic respiratory diseases, adequate nutrition and hydration, and avoidance of dry environments.

How Can Individuals With a Risk of Occupational Voice Disorders Care for Their Voice?

The following measures can help protect the voice and prevent disorders:

• Hydration: Sufficient hydration helps keep an individual's voice healthy.

• Vocal Rest: Individuals who develop vocal strain must rest their voices to prevent further damage.

• Avoid Irritants: Individuals susceptible to vocal irritants must avoid coming in contact with environmental irritants.

• Proper Technique: Singers or other professionals must learn and practice good vocal habits to conserve their voice.

• Medical Help: If the vocal issue persists, it is crucial to consult a speech therapist or otolaryngologist.

• Voice Rehabilitation: Recently, voice rehabilitation programs for teachers and performers have been adopted. It includes education, vocal screens, and habilitation approaches, such as saline nebulizers and amplifiers.

Conclusion

Individuals in professions like teaching, telemarketing, sales, and attorneys depend on their voices to perform their jobs. These individuals form the high-risk group for voice disorders. Even a minor voice disruption can affect their career prospects. However, most voice disorders are treatable when diagnosed early and treated.