Distúrbio de voz relacionado ao trabalho docente: um estudo caso-controle

Abstract

Giannini SPP. Voice disorders related to teaching: a case-control study. [tese de doutorado]. Sao Paulo: Faculdade de Saude Publica da USP; 2010. Introduction Teachers constitute a professional category with high occurrence of voice disorders due to this occupation’s intense vocal demand and to unfavorable work environments. The presence of voice disorder may jeopardize their careers because these professionals depend essentially on their voices to work. Aim To identify the association between voice disorders and job stress and voice disorders and work ability among teachers from public schools of Sao Paulo. Methods This is a pair matched case-control study. The case group was composed of teachers with vocal disorder complaints, with vocal quality deviations in the speech pathology evaluation and vocal fold lesion or altered according an otorhinolaryngologist evaluation. The control group was randomly selected at the same schools as the case group individuals worked. Both groups answered the following questionnaires: Conditions of Vocal Production – Teacher (CVP-T), Vocal Handicap Index (VHI), Job Stress Scale (JSS) and Work Ability Index (WAI). The analysis was performed using qui-square association test, univariate and multiple regression models. Results The analyses of the case and control groups showed comparable samples, with no significant differences of demographic and control variables. The groups differed, as expected, on vocal symptoms. Comparison in the Voice Handicap Index confirmed this difference, with the highest scores for the case group. Regarding the association of job stress, 78,8% of control group are concentrated in lower levels of demand, while 69,3% of case group are at higher levels (p=0,019). Regarding the work control, the situation is reversed, 63,1% of the subjects in the control group manifested higher levels of control, while 73,1% of case group are in the lower categories (p=0,034). Analyzing the association of work ability index, there is an association between low work ability and voice disorder (p<0,001). This association is remains in multivariate analysis, where low (OR=9,5, p=0,001) and moderate (OR=6,7, p <0,001) work ability