Voice Disorders in the General Population: Prevalence, Risk Factors, and Occupational Impact (original) (raw)

Prevalence of Voice Disorders in the General Population, Based on the Stockholm Public Health Cohort

Journal of Voice, 2018

To investigate the prevalence of voice disorders in the general population. Study design. Analysis of data from the Stockholm Public Health Cohort. Methods. A public health survey was distributed to an open cohort of 114,538 adults >18 years of age in the area of Stockholm County, Sweden. The survey included one question about voice problems, estimating the extent of occurrence of voice problems, excluding voice problems during colds/upper airway infections. The question was tested for validity and reliability in n = 166 voice healthy individuals and n = 183 patients with benign voice lesions. The construct validity was tested against two established self-assessment questionnaires. The question was established to correspond to tiring, strain, and hoarseness. Prevalence of voice problems and correlations with age, gender, occupation, hearing, smoking, and socioeconomic status were calculated. Results. The overall prevalence of voice disorders in the entire group was estimated to 16.9%, where 15.5% voice problems were rated to occur to a small extent and 1.4% to a great extent. Women were significantly more prone to report voice problems than men. The highest ratings of a great extent of voice problems were found in both women and men >85 years of age. As for occupation, the highest prevalence of voice problems was found in teaching and service occupations. Conclusions. The prevalence of voice problems was estimated to 16.9% in the entire group. Women reported significantly more voice problems than men and voice problems were significantly more common in ages >65. This study of self-reported voice problems in a general population is one of the largest of its kind.

Epidemiology of Voice Disorders in the Elderly: Preliminary Findings

The Laryngoscope, 2007

Objectives: Epidemiologic studies of the prevalence and risk factors of voice disorders in the elderly, nontreatment seeking population are nonexistent. The purpose of this preliminary investigation was to 1) estimate the prevalence of voice disorders, 2) identify variables associated with increased risk of voice disorders, and 3) measure the socioemotional impact of voice disorders on the elderly who live independently. Study Design: Prospective, cross-sectional survey. Methods: One hundred seventeen seniors (39 males and 78 females; mean age, 76.1 yr; SD, 8.5 yr; range, 65-94 yr), residing in Utah and Kentucky, were interviewed using a questionnaire that addressed three areas related to voice disorders: prevalence, potential risk factors, and socioemotional consequences/effects. Results: The lifetime prevalence of a voice disorder was 47%, with 29.1% of participants reporting a current voice disorder. The majority of respondents (60%) reported chronic voice problems persisting for at least 4 weeks. Seniors who had experienced esophageal reflux, severe neck/back injury, and chronic pain were at increased risk. Voice-related effort and discomfort, combined with increased anxiety and frustration and the need to repeat oneself, were specific areas that adversely affected quality of life. Conclusions: This preliminary epidemiologic study confirmed that voice disorders are common among the elderly, and further research is needed to identify additional risk factors contributing to voice disorder vulnerability.

Risk Factors And Quality Of Life Of Adult Patients With Chronic Voice Disorders

The Egyptian Journal of Hospital Medicine

The aim of the present research is to determine the common causes of chronic voice disorders, to determine the sociodemographic and behavioral risk factors for patients with chronic voice disorders and to study the QOL of them. The ORL Outpatient Clinics, Al-Azhar University hospitals were chosen to carry out this study. A total of 495 patients with chronic voice disorders and a control group of the same number were enrolled in the study. A casecontrol, hospital based study design was used. The most common causes of chronic voice disorders among these patients were chronic laryngitis (35.6%), vocal fold nodules (22.6%), functional dysphonia (18.6%) and vocal fold polyps (13.5%). The 25-44 years age group, low social class, sale man occupation, urban residence and female gender were the most important significant sociodemographic risk factors for patients with chronic voice disorders (ORs= 4.17, 2.01, 1.71, 1.60 and 1.32, respectively). The +ve reflux symptoms index, voice abuse and smoking were an important significant clinical risk factors (ORs=16.94, 8.33 and 6.01, respectively). Also, patients with chronic voice disorders had a significantly poorer self-reported health related domain scores than the controls on all eight SF-36 domains (P=0.00). Moreover, patients with chronic voice disorders due to different laryngeal diseases had a significantly poorer self-reported health related domain scores than the controls on all eight SF-36 domains except in the miscellaneous diseases group.

Voice Disorders in the Metropolitan Area of San Juan, Puerto Rico: Profiles of Occupational Groups

Journal of Voice, 2011

Objectives/Hypothesis. Approximately 28 000 000 workers in the United States experience voice problems everyday. In general, voice problems are very common, but they are more frequent among certain occupational groups. Study Design. Descriptive cross-sectional study. Method. We analyzed 129 available records of voice-disordered cases reported during the period of 2000-2005 from the Corporación del Fondo del Seguro del Estado in the Metropolitan Areas of Puerto Rico of Bayamón, San Juan, and Carolina. The following variables were studied: sex, age, occupation, possible job hazards, diagnosis, and type of treatment. Measures of central tendency, including percentage frequencies, were used. Results. The findings revealed that 81% of all the cases of voice disorders available during the study period were females. The average age at diagnosis for different voice disorders was 42 years (±10 years). Vocal problems were reported with a higher frequency by teachers at the elementary and high school levels (72%). The most common complaints were job-related voice overuse (30%) and excessive dust at the workplace. The most frequent medical diagnoses related to voice disorders were rhynopharyngitis (27%), several types of laryngitis (21%), and laryngopharyngitis (10%). The most frequent treatment modality for laryngeal disease and voice problems was the prescription of medication.

Voice Disorders: Etiology and Diagnosis

Journal of Voice, 2016

Voice disorders affect adults and children and have different causes in different age groups. The aim of the study is to present the etiology and diagnosis dysphonia in a large population of patients with this voice disorder.for dysphonia of a large population of dysphonic patients. Methods. We evaluated 2019 patients with dysphonia who attended the Voice Disease ambulatories of a university hospital. Parameters assessed were age, gender, profession, associated symptoms, smoking, and videolaryngoscopy diagnoses. Results. Of the 2019 patients with dysphonia who were included in this study, 786 were male (38.93%) and 1233 were female (61.07). The age groups were as follows: 1-6 years (n = 100); 7-12 years (n = 187); 13-18 years (n = 92); 19-39 years (n = 494); 41-60 years (n = 811); and >60 years (n = 335). Symptoms associated with dysphonia were vocal overuse (n = 677), gastroesophageal symptoms (n = 535), and nasosinusal symptoms (n = 497). The predominant professions of the patients were domestic workers, students, and teachers. Smoking was reported by 13.6% patients. With regard to the etiology of dysphonia, in children (1-18 years old), nodules (n = 225; 59.3%), cysts (n = 39; 10.3%), and acute laryngitis (n = 26; 6.8%) prevailed. In adults (19-60 years old), functional dysphonia (n = 268; 20.5%), acid laryngitis (n = 164; 12.5%), and vocal polyps (n = 156; 12%) predominated. In patients older than 60 years, presbyphonia (n = 89; 26.5%), functional dysphonia (n = 59; 17.6%), and Reinke's edema (n = 48; 14%) predominated. Conclusions. In this population of 2019 patients with dysphonia, adults and women were predominant. Dysphonia had different etiologies in the age groups studied. Nodules and cysts were predominant in children, functional dysphonia and reflux in adults, and presbyphonia and Reinke's edema in the elderly.

Identifying Concomitant Health Conditions in Individuals With Chronic Voice Problems

Journal of Voice, 2020

Objective: Current clinical practice guidelines recommend a laryngoscopic referral for patients who present with hoarseness for longer than 28 days and earlier for patients with certain high-risk factors. The goal of this study was to identify additional possible concomitant health conditions in individuals with chronic (>28 days) hoarseness to improve early detection of chronic voice problems. Methods: Using data from the 2012 National Health Interview Survey, four health conditions were selected: swallowing problems, respiratory problems, hormonal-cycle problems, and physical activity limitations. Multivariable logistic regressions controlling for age, gender, race, and smoking status, were used to calculate the odds ratios for the association of each of these four health conditions to chronic versus acute voice problems. Results: Of the 2,746 respondents who reported a voice disorder within the last year, 736 reported a voice problem lasting longer than 4 weeks in duration. After controlling for covariates, individuals reporting swallowing problems and physical activity limitations were more likely to report a chronic voice problem versus an acute voice problem, odds ratios with 95% confidence intervals of 1.983 [1.619, 2.430] and 1.716 [1.355, 2.173], respectively. No significant associations were found for respiratory or hormonal-cycle problems. Conclusion: Individuals who present with both a voice problem and a swallowing problem or physical activity limitation may be at increased risk for developing a chronic voice problem. Therefore, these two health conditions should be included as high-risk factors when determining the escalation of care for a patient presenting with acute dysphonia.

Prevalence and Voice Characteristics in an Indian Treatmentseeking Population for Voice Disorders

Otorhinolaryngology Clinics, 2022

Objective: The purpose of this study was to describe the characteristics of a treatment-seeking population visiting the voice clinic of the Speech and Hearing department in a tertiary care hospital. Study design: Retrospective study. Methods: The study included patient's data who visited the voice clinic from January 2015 to January 2020. The retrospective data related to laryngeal pathology, age, gender, occupation, overall grade (G score of GRBAS), maximum phonation duration, S/Z ratio, and acoustic parameters (F0, jitter, shimmer, noise-to-harmonic ratio) were tabulated and analyzed. Results: The study results were analyzed and reported from 524 patient records. The frequency of organic/structural vocal pathology was observed to be higher (n = 468; 89.3%) than functional/nonstructural pathologies (n = 38; 7.3%). Vocal nodules (28.1%), vocal fold paralysis/ paresis (15.5%), vocal fold edema (13.7%), sulcus vocalis (7.3%), and vocal polyps (6.1%) were the most common (those occurred in more than 5% of the patients) diagnosis observed for the overall sample. Male dysphonic patients (n = 283; 54%) outnumbered the females (n = 241; 46%). The majority of patients consulting the voice clinic for dysphonia were between 25 and 64 years. The most common occupations seeking help for voice problems were homemaker, student, teacher, business, farmer, retired, singer, and laborer. The overall perceived hoarseness was significantly higher in males compared to females. Conclusion: The present study results allowed a better understanding of characteristics of treatment-seeking population for voice disorders visiting voice clinic. Identification of characteristics and diagnosis of individuals seeking treatment for voice disorders help the speech language pathologists to increase the awareness among the general population about preventive voice care strategies.

Voice-related symptoms and their effects on quality of life

The Annals of otology, rhinology, and laryngology, 2013

The purpose of this study was to identify the extent to which selected voice symptoms formed underlying constructs called factors, and the degree to which these factors influenced specific quality-of-life domains among a group of relatively healthy older adults. A cross-sectional survey was completed in October 2010 by 461 individuals 50 years of age and older. The questionnaire items included demographics, medical history, health, voice use, and voice symptoms. Quality-of-life indicators were used from the Short Form 36 Health Survey, an 8-scale measure of functional health and well-being. Two clusters of symptoms were identified in the factor analysis. One cluster, consisting of 5 voice-related symptoms and labeled "phonatory effort," shared all significant negative correlations with health outcomes, whereas the other cluster, consisting of 2 voice-related symptoms and labeled "chronic throat condition," had a pattern of sharing significant negative correlation...

Interventions for preventing voice disorders in adults

Protocols, 1996

Poor voice quality due to a voice disorder can lead to a reduced quality of life. In occupations where voice use is substantial it can lead to periods of absence from work. To evaluate the effectiveness of interventions to prevent voice disorders in adults. We searched MEDLINE (PubMed, 1950 to 2006), EMBASE (1974 to 2006), CENTRAL (The Cochrane Library, Issue 2 2006), CINAHL (1983 to 2006), PsychINFO (1967 to 2006), Science Citation Index (1986 to 2006) and the Occupational Health databases OSH-ROM (to 2006). The date of the last search was 05/04/06. Randomised controlled clinical trials (RCTs) of interventions evaluating the effectiveness of treatments to prevent voice disorders in adults. For work-directed interventions interrupted time series and prospective cohort studies were also eligible. Two authors independently extracted data and assessed trial quality. Meta-analysis was performed where appropriate. We identified two randomised controlled trials including a total of 53 participants in intervention groups and 43 controls. One study was conducted with teachers and the other with student teachers. Both trials were poor quality. Interventions were grouped into 1) direct voice training, 2) indirect voice training and 3) direct and indirect voice training combined.1) Direct voice training: One study did not find a significant decrease of the Voice Handicap Index for direct voice training compared to no intervention.2) Indirect voice training: One study did not find a significant decrease of the Voice Handicap Index for indirect voice training when compared to no intervention.3) Direct and indirect voice training combined: One study did not find a decrease of the Voice Handicap Index for direct and indirect voice training combined when compared to no intervention. The same study did however find an improvement in maximum phonation time (Mean Difference -3.18 sec; 95 % CI -4.43 to -1.93) for direct and indirect voice training combined when compared to no intervention. No work-directed studies were found. None of the studies found evaluated the effectiveness of prevention in terms of sick leave or number of diagnosed voice disorders. We found no evidence that either direct or indirect voice training or the two combined are effective in improving self-reported vocal functioning when compared to no intervention. The current practice of giving training to at-risk populations for preventing the development of voice disorders is therefore not supported by definitive evidence of effectiveness. Larger and methodologically better trials are needed with outcome measures that better reflect the aims of interventions.

Basics of voice dysfunction--etiology and prevention of voice damage

Collegium antropologicum, 2011

Voice is one of the most important means of communication and as such should be taken care of. The etiology of voice disorders is diverse. Due to the development of the society we live in, way of life, environmental factors, and exposure to pharmacological agents as well as demands we make towards our voice, there is a substantial growth in the number of people with voice disorders. We tasked ourselves to find out if it is possible to enlighten people on the importance of voice, to motivate them to take care of it, to notice the changes in its quality and eventually ask for help. We assessed in which measure do we understand the importance of a healthy voice, and do we know which is the most important factor that adds to its decline. For a long number of years voice therapists and other experts in the voice disorder field have been discussing the optimal voice impostation as well as vocal exercises and methods behind voice recovery. They have all come to the same conclusion that pho...