Voice Characteristics and Functional Laryngeal Findings in Swimming Coaches: A Multidimensional Cross-Sectional Study

Swimming coaches are occupational voice users exposed to elevated background noise, high humidity and temperature, and chlorination by-products such as nitrogen trichloride (NCl₃). This study aimed to describe the voice quality of Estonian swimming coaches and examine occupational factors associated with dysphonia.

This was an observational, analytical cross-sectional study combining subjective self-report measures with objective acoustic and laryngeal assessment.

Fifty-nine certified swimming coaches (8 males, 51 females) completed a background questionnaire and the Voice Handicap Index in Estonian (VHI-30_EST). Coaches reporting voice-related complaints (n = 34; 58%) were invited for clinical assessment; 21 participants participated. Evaluation included transnasal endoscopic videostroboscopy and acoustic analysis using Praat (acoustic voice quality index [AVQI], smoothed cepstral peak prominence [CPPS], harmonics-to-noise ratio [HNR], and maximum phonation time).

According to the background questionnaire, voice problems were common (58%), and 42.4% of participants had elevated VHI-30 scores (≥16). Occupational variables, including work experience and weekly training hours, were not significantly associated with dysphonia (P > 0.05). Coaches with complaints demonstrated significantly higher VHI scores (P < 0.001). Acoustic measures indicated predominantly mild to moderate voice deviations (mean AVQI = 2.94; mean HNR = 17.32 dB), while CPPS values were largely within normal limits. Laryngoscopic findings were mainly characterized by supraglottic hyperfunction with preserved mucosal waves and without predominant structural pathology.

Estonian swimming coaches demonstrate a high prevalence of voice problems primarily associated with laryngeal hyperfunction. Preventive occupational voice care may be warranted in this professional group.