Risk Factors for Voice Disorders in Teachers and the Effect of Occupational Intervention on Work Ability

Teachers are at higher risk for voice disorders (VDs) than workers in other sectors. This study aims to identify the demographic, medical, and occupational characteristics that affect voice problems in teachers, and to assess the effectiveness of occupational interventions.

This case-control study included all teachers with VDs who were assessed by the Israeli Medical Department for Civil Service Employees for voice problems between 2006 and 2016. Those cases were compared with a sex- and age-matched sample of teachers who appeared before a medical committee for reasons unrelated to VDs, and the calculated power analysis was 78.6%. Data included pre-employment records, committee findings, and detailed interviews regarding occupational history, demographic and lifestyle data, treatments received, and their perceived effect. Univariate and multivariable analyses assessed risk factors for VDs, the effect of treatments, and the predictive factors for permanent work cessation.

A total of 550 teachers were included in this study, divided by 218 cases and 332 controls. Teachers with voice problems had significantly more children at home (P = 0.03), longer teaching careers (P = 0.03), and were current or previous smokers (P = 0.03). They taught a higher number of students (P = 0.01), and classrooms were situated in a noisy area (P = 0.01). Training in classroom management and a reduction of teaching hours were the most successful treatments. Additional health problems (odds ratios [OR] 2.4, 95% confidence intervals [CI] 1.8-3.6), vocal cord paralysis (OR 1.6, 95%CI 1.4-2.8), and working in special education (OR 1.3, 95%CI 1.2-1.4) were the highest predictors for termination of employment among teachers who had VDs.

Given the high risk of VDs among teachers, classroom management training should be provided and sustained throughout teachers' careers, in addition to the reduction of teaching hours.