Abstract
The objective of this study is to assess work and environment related factors associated with voice disorders among primary school teachers in the Colombo district in Sri Lanka. Methods: An institution based cross sectional study was conducted among 790 primary school teachers, in the Colombo District in Sri Lanka. They were selected by a stratified random sampling method. The validated Voice Handicap Index (VHI-30) questionnaire and a self-administered questionnaire were used for data collection. Sound levels within 10 selected classrooms were measured objectively using CR:303 sound level meter (Cirrus). Data analysis was by bivariate method with chi squared and logistic regression. Results: Among the work related characteristics assessed teaching 5 or more subjects (OR=1.40, CI = 1.039, 2.90), staying after school hours (OR=1.69, CI = 1.19, 2.38) were significantly associated with voice disorders. Among the factors associated with work environment, teachers having a speech pattern in yelling and shouting category (OR=2.25, CI=1.68, 2.99), speaking in noisy environments (OR=1.09, CI= 1.15, 3.15), being exposed to smoky dusty environments (OR = 1.61, CI= 1.19, 2.16), having average or high dust levels in classrooms (OR=2.03, OR=1.50, 2.76), having a moderate to high noise level in classrooms (OR= 1.93, CI=1.45, 2.58) and having ‘just adequate, inadequate and average’ space in a classroom (OR=1.74, CI=1.29, 2.34) were significantly associated with voice disorders. The sound levels objectively measured in classrooms revealed that all classrooms had higher than acceptable noise levels during a teaching session. Conclusions and recommendations: The association of voice disorders with work related characteristics were similar to the findings in other studies. However, the high noise levels detected in the classrooms on objective measurement were high. It is recommended that these findings be addressed through a multidisciplinary approach and National standards for acceptable noise levels within classrooms be established.
Keywords
Voice Disorders, Primary School Teachers, Environmental Factors, Pattern of Speech, Noise Levels,Metrics
References
- Akinbode, R., Lam, K.B.H., Ayres, J.G., & Sadhra, S. (2014). Voice disorders in Nigerian primary school teachers. Occupational Medicine, 64(5), 382–386. https://doi.org/10.1093/occmed/kqu052
- Alva, A., Machado, M., Bhojwani, K., & Sreedharan, S. (2017). Study of risk factors for development of voice disorders and its impact on the quality of life of school teachers in Mangalore, India. In Journal of Clinical and Diagnostic Research (Vol. 11, Issue 1, pp. MC01–MC05).
- Boltežar, L., & Bahar, M. Š. (2014). Voice disorders in occupations with vocal load in Slovenia. Zdravstveno Varstvo, 53(4), 304–310
- Cutiva, L.C.C., & Burdorf, A. (2015). Effects of noise and acoustics in schools on vocal health in teachers. Noise and Health, 17(74), 17–22. https://doi.org/10.4103/1463-1741.149569
- de Ceballos, A.G., Carvalho, F.M., de Araújo, T.M., Dos Reis, E.J. (2011). Auditory vocal analysis and factors associated with voice disorders among teachers. Revista Brasileira de Epidemiologia, 14(2), 285-95. https://doi.org/10.1590/s1415-790x2011000200010
- Department of Census and Statistics, Ministry of Finance and Planning, 2010. Annual Bulletin of Education Statistics.
- Devadas, U., Bellur, R., Maruthy, S. (2017) Prevalence and Risk Factors of Voice Problems Among Primary School Teachers in India. Journal of Voice, 31(1): 117.e1-117.e10. https://doi.org/10.1016/j.jvoice.2016.03.006
- Hermes, E. G. C., & de Oliveira Bastos, P. R. H. (2016). The Prevalence of Teachers‘ Vocal Symptoms in Municipal Network of Education in Campo Grande, Mato Grosso do Sul, Brazil. Journal of Voice, 30(6), 756.e1-756.e7.
- Jacobson, B. H., Benninger, M. S., & Newman, C. W. (1997). The Voice Handicap Index (VHI): Development and Validation. August. Jardim, R., Barreto, S. and Assunção, A., 2007. Voice Disorder: case definition and prevalence in teachers. Revista Brasileira de Epidemiologia, 10(4), pp.625-636
- Kooijman, P.G.C., De Jong, F.I.C.R.S., Thomas, G., Huinck, W., Donders, R., Graamans, K., & Schutte, H. K. (2006). Risk factors for voice problems in teachers. Folia Phoniatrica et Logopaedica, 58(3), 159–174. https://doi.org/10.1159/000091730
- Menon, U.K., Raj, M., Antony, L., Soman, S., & Bhaskaran, R. (2019). Prevalence of Voice Disorders in School Teachers in a District in South India. Journal of Voice, 1-8. https://doi.org/10.1016/j.jvoice.2019.07.005
- Munier, C., Farrell, R. (2016) Working Conditions and Workplace Barriers to Vocal Health in Primary School Teachers, Journal of Voice, 30(1), 127.e31- 127.e41. https://doi.org/10.1016/j.jvoice.2015.03.004
- Ohlsson, A.C., Andersson, E.M., Södersten, M., Simberg, S., & Barregård, L. (2012). Prevalence of voice symptoms and risk factors in teacher students. Journal of Voice, 26(5), 629–634. https://doi.org/10.1016/j.jvoice.2011.11.002
- Rossi-Barbosa, L. A., Gama, A. C. C., & Caldeira, A. P. (2015). Association between readiness for behavior change and complaints of vocal problems in teachers. Codas, 27(2), 170–177. https://doi.org/10.1590/2317-1782/20152013088
- Sliwinska-Kowalska, M., Niebudek-Bogusz, E., Fiszer, M., Los-Spychalska, T., Kotylo, P., Sznurowska-Przygocka, B., & Modrzewska, M. (2006). The prevalence and risk factors for occupational voice disorders in teachers. Folia Phoniatrica et Logopaedica, 58(2), 85–101. https://doi.org/10.1159/000089610
- Stolley, P.D., Schlesselman J.J. (1982). Case-Control Studies: Design, Conduct, Analysis. Oxford University Press, Oxford.
- Thibeault, S.L., Merrill, R.M., Roy, N., Gray, S.D., Smith, E.M. (2004). Occupational Risk Factors Associated with Voice Disorders among Teachers. Annals of Epidemiology, 14(10), 786-92. https://doi.org/10.1016/j.annepidem.2004.03.004