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Voice problems in chronic cough: prevalence and implications for health and sick leave in a Northern European
Sofia Ögefeldt1,2, Greta Öhlund Wistbacka3,4, Ellika Schalling3,4
1Department of Public Health and Caring Sciences, Speech-Language Pathology, Uppsala University, Uppsala, Sweden. sofia.ogefeldt@uu.se.
Background:
Voice problems have been reported in individuals with chronic cough, but population-based prevalence data are not yet available. While both conditions independently affect health and sick leave, their combined effects have not been studied. This study investigated the prevalence of voice problems in individuals with chronic cough and whether a cough duration of over 10 years is associated with a higher prevalence. Additionally, the relationship between chronic cough, voice problems, general health, and sick leave was explored.
Method:
Cross-sectional and longitudinal data from the Respiratory Health In Northern Europe, RHINE III (n = 7,372) and RHINE IV (n = 10,101) surveys were analyzed. Logistic regression was used to analyze associations between chronic cough, voice problems, general health, and sick leave.
Results:
Voice problems were reported by 30% of individuals with dry cough and 51% with productive cough, compared to 17% without cough. Among those with dry cough, prevalence increased from 24% (< 10 years) to 37% (> 10 years), with no significant difference for productive cough. Poor health was reported by 7.5% with dry cough and voice problems, 10% with productive cough and voice problems, and 1.7% without either condition. Chronic cough and voice problems were independently associated with poorer health, with an additive effect when co-occurring (adjusted Odds Ratio (95% CI): Dry cough 1.78 (1.34-2.37), Productive cough 2.03 (1.56-2.63), Voice problems 1.73 (1.54-1.94)). Chronic cough, but not voice problems, was linked to increased sick leave.
Conclusion:
Voice problems are common among individuals with chronic cough, especially in productive cough. Both chronic cough and voice problems are independently associated with poorer general health, with additive effects when co-occurring. Chronic cough, but not voice problems, was associated with more sick leave. These findings highlight the need to address the combined burden of chronic cough and voice problems to improve patient outcomes and well-being.
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