Mori Matthew C, Francis David O, Song Phillip C
1 Department of Otolaryngology-Head and Neck Surgery, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
2 Department of Otolaryngology and the Evidence-Based Practice Center and the Center for Surgical Quality and Outcomes Research, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
Otolaryngol Head Neck Surg. 2017 Oct;157(4):670-675. doi: 10.1177/0194599817726528. Epub 2017 Sep 12.
Objective To identify occupational groups' use of specialty voice clinic evaluation. Study Design Retrospective cohort study. Setting Tertiary subspecialty clinic. Subjects and Methods We analyzed data collected on patients presenting to the Massachusetts Eye and Ear Infirmary Voice and Speech Laboratory over a 20-year period (1993-2013). The relative risk (RR) and 99% confidence interval (CI) of presentation were calculated for each occupational category in the greater Boston population using year-matched data from the Bureau of Labor Statistics (BLS). Results The records of 12,120 new patients were reviewed. Using year- and occupation-matched BLS data from 2005 to 2013, 2726 patients were included in the cohort analysis. Several occupations had significantly higher risk of presentation. These included arts and entertainment (RR 4.98, CI 4.18-5.95), law (RR 3.24, CI 2.48-4.23), education (RR 3.08, CI 2.70-3.52), and social services (RR 2.07, CI 1.57-2.73). In contrast, many occupations had significantly reduced risk of presentation for laryngological disorders, for example, maintenance (RR 0.25, CI 0.15-0.42), food preparation (RR 0.35, CI 0.26-0.48), and administrative support (RR 0.49, CI 0.41-0.57). Conclusion Certain occupations are associated with higher use of laryngological services presumably because of their vocational voice needs. In addition to confirming findings from other studies, we identified several new occupation groups with increased or decreased risk for laryngologic disorders. Understanding what factors predispose to requiring specialty voice evaluation may help in targeting preventative efforts.
目的 确定不同职业群体对专科嗓音诊所评估的使用情况。研究设计 回顾性队列研究。研究地点 三级专科诊所。研究对象与方法 我们分析了在20年期间（1993 - 2013年）就诊于马萨诸塞州眼耳医院嗓音与言语实验室的患者所收集的数据。使用美国劳工统计局（BLS）的年份匹配数据，计算大波士顿地区各职业类别的就诊相对风险（RR）和99%置信区间（CI）。结果 共审查了12120例新患者的记录。利用2005年至2013年与年份和职业匹配的BLS数据，2726例患者纳入队列分析。有几个职业的就诊风险显著更高。这些职业包括艺术与娱乐（RR 4.98，CI 4.18 - 5.95）、法律（RR 3.24，CI 2.48 - 4.23）、教育（RR 3.08，CI 2.70 - 3.52）和社会服务（RR 2.07，CI 1.57 - 2.73）。相比之下，许多职业患喉科疾病的就诊风险显著降低，例如，维修（RR 0.25，CI 0.15 - 0.42）、食品制备（RR 0.35，CI 0.26 - 0.48）和行政支持（RR 0.49，CI 0.41 - 0.57）。结论 某些职业与更高的喉科服务使用率相关，可能是由于其职业嗓音需求。除了证实其他研究的结果外，我们还确定了几个新的职业群体，其患喉科疾病的风险增加或降低。了解哪些因素易导致需要专科嗓音评估，可能有助于针对性地开展预防工作。
