Department of Otolaryngology, Head and Neck Surgery, Khoo Teck Puat Hospital, Yishun Central, Singapore, Singapore.
J Voice. 2012 Jul;26(4):e141-7. doi: 10.1016/j.jvoice.2011.05.004. Epub 2011 Sep 17.
HYPOTHESIS/OBJECTIVES: Teachers are often cited to be at high risk of vocal disturbances. Many studies were performed in the West, but none locoregionally. The aim of this study is to determine the prevalence of voice problems amongst primary school teachers in six schools in Singapore and explore the associated risk factors.
A cross-sectional study was conducted across six primary schools and 214 full-time teachers were surveyed. Teachers were asked to report if they have voice problems at the day of the interview, during the past 1 year and throughout their careers. Teachers who reported having current voice problems were invited for videolaryngostroboscopy. Multivariate analyses were performed to analyze risk factors associated with voice problems.
The point prevalence was 13.1% (95% confidence intervals [CI]: 9.3-18.3%). The past year prevalence and career prevalence were 25.4% (95% CI: 20-31.6%) and 32.1% (95% CI: 26.2-38.6%), respectively. Results showed that reflux symptoms (adjusted odds ratio [adj OR]=6.1, CI: 2.5-14.6) and microphone usage (adj OR=5.6, CI: 1.8-17.6) are risk factors for current voice disorders. Allergic rhinitis symptoms (adj OR=2.1, CI: 1.1-4.3), hypothyroid-like symptoms (adj OR=2.6, CI: 1.3-5.1), and microphone use (adj OR=3.4, CI: 1.1-10.0); allergic rhinitis symptoms (adj OR=2.6, CI: 1.4-5.1), reflux symptoms (adj OR=3.1, CI: 1.5-6.5), and the teaching of arts and theater studies (adj OR=2.8, CI: 1.4-5.9) are risk factors for voice problems in past 1 year and throughout the career, respectively.
The findings confirm that teaching is a high-risk profession for acquiring voice problems. The risk factors uncovered are statistically and clinically significant and biologically plausible. There is a need for educational authorities and healthcare providers to develop effective and comprehensive prevention programs to arrest vocal attrition and its detrimental effects on the quality of teaching.
假设/目的：教师常被认为存在发生嗓音障碍的高风险。许多研究都在西方进行，但没有局部地区的研究。本研究的目的是确定新加坡六所小学教师的嗓音问题发生率，并探讨相关的危险因素。
在六所小学进行了横断面研究，共调查了 214 名全职教师。教师在接受采访当天、过去 1 年和整个职业生涯中被问到是否有嗓音问题。报告有当前嗓音问题的教师被邀请进行视频喉镜频闪检查。采用多变量分析来分析与嗓音问题相关的危险因素。
时点患病率为 13.1%（95%置信区间[CI]：9.3-18.3%）。过去 1 年患病率和职业生涯患病率分别为 25.4%（95%CI：20-31.6%）和 32.1%（95%CI：26.2-38.6%）。结果表明，反流症状（调整后的优势比[adj OR]=6.1，CI：2.5-14.6）和使用麦克风（adj OR=5.6，CI：1.8-17.6）是当前嗓音障碍的危险因素。过敏性鼻炎症状（adj OR=2.1，CI：1.1-4.3）、甲状腺功能减退样症状（adj OR=2.6，CI：1.3-5.1）和使用麦克风（adj OR=3.4，CI：1.1-10.0）；过敏性鼻炎症状（adj OR=2.6，CI：1.4-5.1）、反流症状（adj OR=3.1，CI：1.5-6.5）和教授艺术和戏剧研究（adj OR=2.8，CI：1.4-5.9）分别是过去 1 年和整个职业生涯中出现嗓音问题的危险因素。
研究结果证实，教学是导致嗓音问题的高风险职业。发现的危险因素在统计学和临床上都有意义，且具有生物学合理性。教育当局和医疗保健提供者有必要制定有效的综合预防计划，以遏制嗓音损耗及其对教学质量的不利影响。
