• Tanja Soklič Klinika za otorinolaringologijo in cervikofacialno kirurgijo Klinični center Zaloška 2 1525 Ljubljana
  • Irena Hočevar Boltežar Klinika za otorinolaringologijo in cervikofacialno kirurgijo Klinični center Zaloška 2 1525 Ljubljana
Keywords: voice disorders, teachers, prevalence, risk factors, vocal habits, vocal loading


Background. Teachers as voice professionals with heavy vocal load represent a population at high risk of vocal problems. Until now there has not been any study evaluating prevalence and risk factors for voice disorders among teachers in Slovenia.

Methods. Questionnaires about voice disorders and vocal habits were sent to randomly chosen 10% of elementary, middle schools and kindergarten in Slovenia. Answers from 1509 completed questionnaires were analyzed by statistical program SPSS 11.0.

Results. In the school year 2002/03 51% of teachers occasionally experienced voice disorders and 15% did frequently. The prevalence of transient voice problems was therefore about 66%. By univariate χ 2 test we found statistically significant relationship to frequent voice disorders for female sex (p < 0.02), middle school teachers (p < 0.02), age over 40 years (p < 0.0005) and atopic constitution (p < 0.006); voice disorders during study showed borderline significance (p < 0.07). There was no significant relationship to voice problems for yelling, talking loudly or rapidly, using chalk while talking, cigarette smoking, water intake and gastroesophageal reflux. Statistically significant variates were included in the multivariate logistic regression model. There was 1.9-times higher risk of experiencing frequent voice disorders in females than for males (p < 0.003). Risk of vocal problems in middle school teachers was 1.5-times higher than in kindergarten teachers (p < 0.01) and 1.8-times higher than in elementary school teachers (p < 0.0005). Age over 40 years carried 2,3-times higher risk for hoarseness than age under 40 years (p < 0.0005). Voice disorders during study showed 1.7-times higher risk for later occupational vocal problems (p < 0.02). Atopic constitution had 1.6-times higher risk for frequent vocal problems (p < 0.008). The questionaire also showed how unfamiliar to vocal hygiene Slovene teachers are.

Conclusions. The prevalence of voice disorders among teachers in Slovenia is high – about 66%. In our opinion the teaching of right vocal technique, vocal hygiene, prevention and therapy of voice disorders should be included in the study for the future vocal professionals. Before entering study vocal constitution of candidates should be evaluated.


Download data is not yet available.


Koufman JA, Isaacson G. The spectrum of vocal dysfunction. Otolaryngologic Clinics of North America 1991; 24: 985–8.

Kambič V, Fischinger J, Gale N. Hripavost. Ljubljana: Lek, 1986.

Friedrich G. Leitsymptom Heiserkeit. Der Praktische Arzt 1994; 48: 330–8.

Child DR, Johnson TS. Preventable and nonpreventable causes of voice disorders. Seminars in Speech and Language 1991; 12(1): 1–13.

Titze R, Lemke J, Montequin D. Populations in the US workforce who rely on voice as a primary tool of trade: a preliminary report. J Voice 1997; 11: 254–9.

Russell A, Oates J, Greenwood KM. Prevalence of voice problems in teachers. J Voice 1998; 12(4): 467–79.

Roy N, Gray S, Simon M, Dove H, Corbin-Lewis K, Stemple JC. An evaluation of the effects of two treatment approaches for teachers with voice disorders: a prospective randomized clinical trial. Journal of Speech, Language, and Hearing Research 2001; 44: 286–96.

Simberg S, Laine A, Sala E, Roennemaa AM. Prevalence of voice disorders among future teachers. J Voice 2000; 14(2): 231–5.

Radšel Z, Jarc A, Hočevar-Boltežar I. Ocena glasa i govora kod studentkinja pedagoškog smera, razredna nastava. V. Zbornik radova XIII. kongresa otorinolaringologa Jugoslavije, 3. deo: Epidemiologija patologije sluha, glasa i govora. Priština: Udruženje otorinolaringologa Jugoslavije, 1988; 102–7.

Smith E, Lemke J, Taylor M, Kirchner HL, Hoffman H. Frequency of voice problems among teachers and other occupations. J Voice 1998; 12(4): 480–8.

Gotaas C, Starr CD. Vocal fatigue among teachers. Folia Phoniatr 1993; 45: 120–9.

Smith E, Gray SD, Dove H, Kirchner L, Heras H. Frequency and effects of teachers’ voice problems. J Voice 1997; 11: 81–7.

Smith E, Kirchner HL, Taylor M, Hoffman H, Lemke JH. Voice problems among teachers: differences by gender and teaching characteristics. J Voice 1998; 12: 328–34.

Titze IR. Mechanical stress in phonation. J Voice 1994; 2: 99–105.

Kahane JC. A survey of age-related changes in the connective tissues of the human larynx. In: Bless DM, Abbs JH eds. Vocal fold physiology. San Diego: College Hill Press, 1983.

Methieson L. The voice and its disorders. 6th Edition. London, Philadelphia: Whurr Publishers, 2001.

Koufman JA, Blalock PD. Functional voice disorders. Otolaryngol Clin North Am 1991; 24: 1059–73.

Hočevar-Boltežar I, Radšel Z, Žargi M. The role of allergy in the ethiopathogenesis of laryngeal mucosal lesions. Acta Otolaryngol (Stockh) 1997; Suppl 527: 134–7.

Jackson-Menaldi CA, Dzul AL, Holland RW. Allergies and vocal fold edema: a preliminary report. J Voice 1999; 13: 113–22.

Murry T, Rosen CA. Vocal education for the professional voice user and singer. Otolaryngologic Clinics of North America 2000; 33(5): 967–81.

Koufman JA. The otolaryngologic manifestations of gastroesophageal reflux disease (GERD): a clinical investigation of 225 patients using ambulatory 24-hour pH monitoring and an experimental investigation of the role of acid and pepsin in the development of laryngeal injury. Laryngoscope 1991; 101: Suppl 53: 1–78.

Casper JK, Murry T. Voice therapy methods in dysphonia. Otolaryngologic Clinics of North America 2000; 33(5): 983–1002.

Roy N, Weinrich B, Gray SD, Tanner K, Toledo SW, Dove H, Corbin-Lewis K, Stemple JC. Voice amplification versus vocal hygiene instruction for teachers with voice disorders: a treatment outcome study. J Speech Lang Hear Res 2002; 45: 625–38.

Vilkman E. Voice problems at work: A challenge for occupational safety and health arrangement. Folia Phoniatr Logop 2000; 52: 120–5.

How to Cite
Soklič T, Hočevar Boltežar I. VOICE DISORDERS AMONG TEACHERS IN SLOVENIA: PREVALENCE AND SOME RISK FACTORS. ZdravVestn [Internet]. 1 [cited 15Sep.2019];73(6). Available from: https://vestnik.szd.si/index.php/ZdravVest/article/view/2336
Professional Article

Most read articles by the same author(s)