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J Commun Disord. 2013 Mar-Apr;46(2):143-55. doi: 10.1016/j.jcomdis.2013.01.001. Epub 2013 Jan 25.

Voice disorders in teachers and their associations with work-related factors: a systematic review.

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Department of Public Health, Erasmus MC, University Medical Center, Rotterdam, The Netherlands.



To provide a quantitative assessment of the occurrence of voice disorders among teachers and to identify associated work-related and individual factors in the teaching profession.


A systematic review was conducted using three computerized databases on the occurrence of voice disorders among teachers and their associations with work-related and individual factors. Some of the keywords used were: "teacher", "voice disorder", "voice problem", and "dysphonia". Information regarding the occurrence of voice disorders and associations between work-related and individual factors and voice disorders were extracted from each paper. Occurrence and associations were expressed in prevalence and odds ratios, respectively.


In total, 23 publications met the criteria for inclusion. All publications were cross-sectional studies. Prevalence estimates varied widely, reflecting disparity in definitions of "voice problem". Teachers had a significantly increased occurrence of voice disorders compared to other occupations. Several work-related and individual factors were consistently associated with voice disorders, most notably high levels of noise in classrooms, being a physical education instructor, and habitual use of a loud speaking voice.


This review shows that teachers report voice disorders more often than non-teachers. Various work-related and individual factors are associated with reported voice disorders. Longitudinal studies are urgently required to get more insight into the development of voice disorders, their work-related determinants, and the consequences of these voice disorders for functioning and work performance among teachers.


Describe the occurrence of voice disorders among teachers. Identify some work-related factors of voice disorders among teachers. Interpret the quality of the publications to describe or analyze the relationship between working conditions and voice disorders among teachers.

[Indexed for MEDLINE]

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