Vocal health for mask-wearing healthcare providers

Abstract

With the onset of the COVID-19 pandemic, healthcare providers are now required to wear face masks throughout the day. However, masks impact communication by creating a barrier to sound. Our previous studies show that masks attenuate mid-to-high-range frequency content and reduce vowel articulatory space. Mask-wearing healthcare workers also report significant increases in vocal effort compared to unmasked speech, as well as increased vocal effort at the end of their workday. Increased vocal effort co-occurred with a reduction in relative fundamental frequency (RFF) offset cycle 10—an acoustic indicator of vocal effort and laryngeal tension. With this in mind, we developed recommendations to help overcome some of the challenges of masked communication, with a specific focus on vocal health maintenance. A small pilot study in mask-wearing healthcare providers found that providers were able to learn and recall vocal health information with >90% accuracy over one week and implement 4 out of 6 vocal recommendations into their workday. RFF offset cycle 10 improved (Cohen’s d = 0.25) following strategy implementation. More research in a larger group of providers is needed to understand the long-term effects of mask-wearing on vocal health, and the behavioral strategies healthcare workers can use to prevent voice problems.