Teachers' Voice Disorders and Loss of Work Ability: A Case-Control Study

Abstract

Teachers constitute a profession with a high occurrence of voice disorders due to the occupation's intense vocal demands and unfavorable work environment. To identify the association between voice disorders and work ability among teachers from public schools in São Paulo, Brazil. This is a case-control study. The case group comprised teachers with voice disorder complaints, vocal quality deviations in speech pathology evaluations, and vocal fold lesions according to an evaluation by an otorhinolaryngologist. The control group was randomly selected from the same schools as those in the case group. Both groups answered the following questionnaires: sociodemographic, lifestyles, working conditions, work organization, conditions of vocal production-teacher (CVP-T), and Work Ability Index (WAI). The analysis used the chi-square association test and univariate and multivariate regression models. The analyses of both groups showed comparable populations with no significant differences in the demographic and control variables. The groups differed, as expected, in vocal symptoms. Analyzing associations with the WAI, there was an association between decreased work ability and voice disorder (P<0.001). This association remained in multivariate analyses where decreased (OR=9.5, P=0.001) and moderate (OR=6.7, P<0.001) work ability were also associated with voice disorders. Analyzing the ability to work, age, and acoustics; decreased (OR=12.2, P<0.001) and moderate (OR=7.7, P<0.001) work ability, age 50-65years (OR=3.7, P=0.006) and poor acoustics (OR=2.7, P=0.007) were factors associated with voice disorders. The occurrence of voice disorders is significantly associated with work ability, which may eventually compromise teachers' ability to continue working.