Dysphonia in School Teachers: An Occupational Risk Concern?

Abstract

BackgroundSchool teachers are known to be at risk for dysphonia. However, they do not always get the benefits that are guaranteed to people with occupational diseases. Objective parameters attempting to quantify the condition are a requirement. Based on an earlier smaller study done in a single district of Kerala, a highly literate State in south India, the present study was envisaged as a Statewide survey of the problem. ObjectivesThe aim was to check the possibility of designating voice problem (dysphonia) in school teachers as a distinct occupational health issue. The primary objective was to document the prevalence of subjective dysphonia. Secondarily, the study sought to look for possible associations between known risk factors and dysphonia. MethodsA cross-sectional, questionnaire-based survey was conducted. The tool was developed from an earlier version, with the addition of risk factor questions and subjective handicap scoring. Three categories of dysphonia were obtained. Statistical analyses were done for all variables, with p value < 0.05 considered statistically significant. Odds ratios (OR) with 95% confidence limits were calculated for four of the risk factors. ResultsCompleted responses were obtained from 4014 school teachers. Of these, 1885 (46.96%) had dysphonia at the time of responding, 1922 (47.88%), in the last one year, and 2650 (66.02%), at some point during their career. Most risk factors had statistically significant association with dysphonia. OR calculation showed greater risk for teachers in government managed or aided schools, those teaching in secondary (5th to 12th grade) schools, those in the job for more than 20 years, and teaching social sciences subject. ConclusionsThere is a high prevalence of dysphonia in school teachers in a Statewide survey of Kerala. Several risk factors have been identified; some peculiar to the region. There is enough numerical evidence to designate dysphonia in school teachers as an occupational health issue.