Voice Quality and Vocal Fatigue Among University Teachers:  A Clinical and Acoustic Study

Muhannd Kadhem Madhlom Al-Dhaleme

Authors

Muhannd Kadhem Madhlom Al-Dhaleme Al Muthanna health directorate, Al Muthanna, Iraq

Keywords:

vocal fatigue, voice disorders, university teachers, acoustic analysis, Voice Handicap Index, occupational voice, Iraq

Abstract

Background: There are studies regarding vocal health in school teachers, especially in Iraq, but there are insufficient studies on university staff who usually use various means of communication at all times without assistance. Aim: To assess voice quality and vocal fatigue of university instructors using the integrated method of self-report, auditory-perceptual, laryngoscopic and acoustic methods, and investigate related job and health aspects. Methods: A comparative cross-sectional study was conducted at the otolaryngology and voice clinic of Al-Hussein Teaching Hospital, Samawa, Iraq, from January to December 2023. One hundred and twenty university teachers and 60 age- and sex-matched non-teaching university employees were evaluated with a structured questionnaire, the Arabic Voice Handicap Index-10 (VHI-10), the Vocal Fatigue Index (VFI), the Reflux Symptom Index, GRBAS perceptual rating, videolaryngostroboscopy and acoustic analysis (fundamental frequency, jitter, shimmer, harmonics-to-noise ratio, maximum phonation time and s/z ratio). Acoustic recordings were repeated at the end of a teaching day in the teacher group. Results: The teachers showed an increase in both vocal fatigue (61.7% vs. 21.7%) and hoarseness (48.3% vs. 18.3%) in comparison to the control group (p<0.001). Additionally, the teachers had a significantly higher average VHI-10 score (11.8±7.4 vs. 5.1±4.2), as well as the VFI tiredness and discomfort scores. Furthermore, 55.0% of the teachers and 18.3% of the control group had some type of diagnosis regarding the larynx. The main diagnoses were the presence of vocal nodules (15.0%), reflux larynx changes (13.3%), and tension dysphonia (11.7%). The jitter and shimmer averages were significantly greater (p<0.001), while the teachers showed lower harmonic-to-noise ratio and maximum phonation time in comparison with the control group. This can indicate that the parameters got worse every day of teaching and changed the number and type of parameters included in the voice impairment diagnosis, including the gender, the number of hours teaching more than 16 hours per week, the number of students exceeding 50 per class, and reflux symptoms. To sum up, it can be said that voice problems and fatigue are frequently seen in the university educators in Samawa and can be measured in terms of perceptual, laryngeal and acoustic characteristics of the voice. In the occupational health programs of universities for professors, it is necessary to pay attention to working time regulation, acid reflux treatment, voice amplification and proper education regarding voice hygiene.

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