Dysphonia in School Teachers: An Occupational Risk Concern?

Unnikrishnan K Menon; Shajid Pullambalavan; Jayakumar R Menon; Padmanabhan Kumar; Prabhakaran Cherayakattu; Santosh Kumar Poikayil Thankappan; Sathianandan Thayyil Valappil

doi:10.1016/j.jvoice.2024.09.001

Dysphonia in School Teachers: An Occupational Risk Concern?

J Voice. 2024 Oct 19:S0892-1997(24)00294-7. doi: 10.1016/j.jvoice.2024.09.001. Online ahead of print.

Authors

Unnikrishnan K Menon¹, Shajid Pullambalavan², Jayakumar R Menon³, Padmanabhan Kumar⁴, Prabhakaran Cherayakattu⁵, Santosh Kumar Poikayil Thankappan⁶, Sathianandan Thayyil Valappil⁷

Affiliations

¹ ENT, Amrita Institute of Medical Sciences and Research Centre, Amrita Vishwa Vidyapeetham University, Kochi, Kerala, India. Electronic address: unnikrishnanmenon@medical.aims.amrita.edu.
² Dr Shajid's Advanced ENT, Head & Neck Centre, Manjeri, Kerala, India.
³ ENT, Dr. Jayakumar's Laryngology Group, Thiruvananthapuram, Kerala, India.
⁴ ENT, Baby Memorial Hospital, Kannur, Kerala, India.
⁵ ENT, Almas Hospital, Kottakkal, Kerala, India.
⁶ ENT, Meitra Hospital, Kozhikode, Kerala, India.
⁷ Biostatistics, Amrita Institute of Medical Sciences and Research Centre, Kochi, Kerala, India.

PMID: 39428299
DOI: 10.1016/j.jvoice.2024.09.001

Abstract

Background: School teachers are known to be at risk for dysphonia. However, they do not always get the benefits that are guaranteed to people with occupational diseases. Objective parameters attempting to quantify the condition are a requirement. Based on an earlier smaller study done in a single district of Kerala, a highly literate State in south India, the present study was envisaged as a Statewide survey of the problem.

Objectives: The aim was to check the possibility of designating voice problem (dysphonia) in school teachers as a distinct occupational health issue. The primary objective was to document the prevalence of subjective dysphonia. Second, the study sought to look for possible associations between known risk factors and dysphonia.

Methods: A cross-sectional, questionnaire-based survey was conducted. The tool was developed from an earlier version, with the addition of risk factor questions and subjective handicap scoring. Three categories of dysphonia were obtained. Statistical analyses were done for all variables, with P value <0.05 considered statistically significant. Odds ratios (OR) with 95% confidence limits were calculated for four of the risk factors.

Results: Completed responses were obtained from 4014 school teachers. Of these, 1885 (46.96%) had dysphonia at the time of responding, 1922 (47.88%) in the last 1year, and 2650 (66.02%) at some point during their career. Most risk factors had statistically significant association with dysphonia. OR calculation showed greater risk for teachers in government-managed or -aided schools, those teaching in secondary (5th- to 12th-grade) schools, those in the job for more than 20years, and teaching social science subject.

Conclusions: There is a high prevalence of dysphonia in school teachers in a Statewide survey of Kerala. Several risk factors have been identified, some peculiar to the region. There is enough numerical evidence to designate dysphonia in school teachers as an occupational health issue.

Keywords: Dysphonia; Occupational disease; Odds ratio; Risk factors; School teachers.