Jiang Guilian, Xu Xiangjing, Yu Konghong, Tang Guangming, Yang Rong, Li Xin
Department of Otorhinolaryngology-Head and Neck Surgery, Second Clinical Medical College of China Three Gorges University, Yichang, China.
Hospital-Acquired Infection Control Department, Second People's Hospital of China Three Gorges University, Yichang, China.
J Voice. 2024 Dec 5. doi: 10.1016/j.jvoice.2024.10.023.
Teachers are often considered to be at high risk for voice disorders. Many studies have been conducted globally. However, the risk factors included in these studies varied, and even for the same influencing factors, the results were inconsistent across studies. No uniform conclusions have yet been drawn. The aim of this study is to identify the risk factors of voice disorders in non-university teachers and to provide insights for their prevention, treatment, and mitigation of recurrence.
In this systematic review (PROSPERO/CRD42024554265), PubMed, Scopus, Web of Science, Embase, and Wiley were searched up to January 14, 2024. A manual search was performed in gray literature through OpenGrey and ProQuest Dissertations and Theses. There was no limitations to the date of publication and language. Studies with a cross-sectional or case-control design and investigating the risk factors of voice disorders in non-university teachers were included. Two researchers performed separately to select articles, extract data, and evaluate the quality of the included studies. The 95% confidence interval and odds ratio were applied to examine the effect size. A meta-analysis was performed with a random effects model using the Stata 16.0 software.
A total of 23 studies were considered, with a total of 73.609 teachers. The results of this meta-analysis: sex[OR = 1.63, confidence interval (CI) (1.17, 2.28)], smoking[OR = 1.31, CI(1.00，1.72)], upper respiratory tract infections [OR = 2.88, CI(1.59，5.23)], respiratory allergies [OR = 3.02, CI(2.21, 4.10)], endocrine diseases [OR = 2.25, CI(1.52, 3.34)]; acid reflux symptoms [OR = 2.41, CI(1.32, 4.40)], stress [OR = 2.47, CI(1.45, 4.19)], lack of discipline in the classroom [OR = 1.63, CI(1.20，2.20)], physical education [OR = 1.58, CI(1.10, 2.28)], noise in the classroom [OR = 1.89, CI(1.42, 2.53)], excessive speaking [OR = 2.52, CI(1.77, 3.60)], throat clearing [OR = 2.10, CI(1.18, 3.75)], shouting [OR = 1.42, CI(1.02, 1.96)], and speaking loudly [OR = 3.06, CI(1.91, 4.91)] may contribute to the development of voice disorders. Subgroup analyses revealed that the diagnostic tool may contribute to high heterogeneity.
The etiopathology of voice disorders in non-university teachers is frequently complex. Multidimensional diagnosis of voice disorders plays an important role in the study of voice disorders It is imperative to undertake early vocal training and implement preventive measures to prevent the currency of voice disorders.
教师常被认为是嗓音疾病的高危人群。全球已开展了许多研究。然而，这些研究纳入的危险因素各不相同，甚至对于相同的影响因素，各研究结果也不一致。尚未得出统一结论。本研究旨在确定非大学教师嗓音疾病的危险因素，并为其预防、治疗及降低复发率提供见解。
在本系统评价（PROSPERO/CRD42024554265）中，检索了截至2024年1月14日的PubMed、Scopus、Web of Science、Embase和Wiley数据库。通过OpenGrey和ProQuest Dissertations and Theses对灰色文献进行了手工检索。对发表日期和语言无限制。纳入采用横断面或病例对照设计且调查非大学教师嗓音疾病危险因素的研究。两名研究人员分别进行文献筛选、数据提取及纳入研究的质量评估。应用95%置信区间和比值比来检验效应大小。使用Stata 16.0软件采用随机效应模型进行荟萃分析。
共纳入23项研究，涉及教师总数73609名。本荟萃分析结果显示：性别[比值比（OR）=1.63，置信区间（CI）（1.17，2.28）]、吸烟[OR = 1.31，CI（1.00，1.72）]、上呼吸道感染[OR = 2.88，CI（1.59，5.23）]、呼吸道过敏[OR = 3.02，CI（2.21，4.10）]、内分泌疾病[OR = 2.25，CI（1.52，3.34）]；反酸症状[OR = 2.41，CI（1.32，4.40）]、压力[OR = 2.47，CI（1.45，4.19）]、课堂纪律差[OR = 1.63，CI（1.20，2.20）]、体育教学[OR = 1.58，CI（1.10，2.28）]、课堂噪音[OR = 1.89，CI（1.42，2.53）]、过度讲话[OR = 2.52，CI（1.77，3.60）]、清嗓[OR = 2.10，CI（1.18，3.75）]、呼喊[OR = 1.42，CI（1.02，1.96）]及大声说话[OR = 3.06，CI（1.91，4.91）]可能导致嗓音疾病的发生。亚组分析显示，诊断工具可能导致高度异质性。
非大学教师嗓音疾病的病因病理通常较为复杂。嗓音疾病的多维诊断在嗓音疾病研究中起着重要作用。必须尽早进行嗓音训练并采取预防措施，以防止嗓音疾病的发生。
