The effectiveness of voice therapy for teachers with dysphonia.

OBJECTIVE: An incorrect voice emission is a risk factor for developing occupational voice disorders. The study aimed at assessing the effectiveness of voice therapy in female teachers with dysphonia. METHODS: The study comprised 133 subjects with voice disorders, taking part in a vocal training programme. A reference group for the present study included 53 teachers with dysphonia. Questionnaire surveys, phoniatric examination and videostroboscopic evaluation were conducted at initial and control examination. RESULTS: In the study group, an improvement after the vocal training was noted in most of the reported symptoms and also in some quantitative parameters of phoniatric examinations compared to the findings for the reference group. The number of patients who assessed their voice as normal increased significantly after the vocal training (2.3 vs. 46.6%). A significant increase in the mean maximum phonation time, from 13.3 to 16.6 s, was observed. The same applied to voice frequency range (increase from 171 to 226.8 Hz). CONCLUSIONS: The outcomes of vocal training, such as a subjective improvement of voice quality and an increase in the quantitative parameters (prolonged maximum phonation time, extended voice range) seem to be important parameters for monitoring the effectiveness of training in correct voice emission.

Second language acquisition after traumatic brain injury: a case study.

BACKGROUND: Post-traumatic language and memory impairment, as well as a subsequent recovery in monolinguals have been widely documented in the literature, yet little is known about learning the second language after a severe head trauma followed by coma, as well as the relationship of this process with cognitive recovery, psychological status and quality of life. PURPOSE: The present study investigates the relationship of learning the second language (English) in the process of rehabilitation, with quality of life in a Polish female university student who, as a result of a car accident, suffered a major closed-head injury and was comatose for a month. METHOD: The subject was enrolled in an English learning program nine months after the trauma. The experiment lasted six months and comprised monthly meetings. RESULTS: The patient improved the major components of the second language, including vocabulary. Within the 6 months, the subject was gradually capable of learning additional and more complex lexical items. DISCUSSION: Learning the second language after traumatic brain injury may positively influence emotional well-being, self-esteem, and, perhaps, recovery of quality of life. A long-term beneficial effect of learning L2 was a consequential improvement of the patient's memory.

The prevalence and risk factors for occupational voice disorders in teachers.

OBJECTIVE: Occupational voice disorders in Poland account for over 25% of all occupational diseases. The aim of the study was to assess the prevalence of voice problems in the general population of Polish teachers, and identify risk factors for developing voice pathology. PATIENTS AND METHODS: The study group comprised 425 female full-time teachers (most of them primary and secondary school, age ranging from 23 to 61 years) and 83 non-teacher women (control) whose jobs did not involve vocal effort, matched for age to the study group. All participants were subjected to a survey using an extensive questionnaire, and to laryngological, phoniatric and videostroboscopic examinations. RESULTS: The overall lifetime vocal symptoms were more frequent in the teachers than in the non-teachers (69 vs. 36%), and in particular it related to permanent and recurrent hoarseness, and dryness in the throat. Mean number of the voice symptoms was 3.21 in teachers and 1.98 in controls (p < 0.001). Abnormal (non-euphonic) voice, neck muscle hypertension during phonation and incorrect resonator function were also significantly more frequent in the teachers. Mean maximum phonation time was shorter in teachers than in the controls (14.3 vs. 15.9 s, p < 0.01). Occupational voice disorders and hyperfunctional dysphonia (that is thought to predispose to such pathology) were found in 32.7% of teachers and 9.6% of control subjects. The probability of developing incomplete glottal closure (odds ratio 13.2x; 95% CI: 1.8-96.8) and hyperfunctional dysphonia (odds ratio 2.7; 95% CI: 1.14-6.44) were significantly higher in the teacher group versus non-teachers. A significant positive relationship was found in teachers between the prevalence of hyperfunctional dysphonia and strained phonation, neck muscle hypertension, instability of voice, self-assessed hyper-arousal, and lifetime vocal effort index (years of employment as a teacher x hours of professional activity/week). The prevalence of vocal nodules and incomplete glottal closure were correlated with incorrect phonation technique parameters, but not with psychological factors. No correlation was found with environmental variables, such as classroom temperature, humidity, airborne dust. CONCLUSION: The prevalence of self-reported symptoms and clinical signs of voice disorders is around 2-3 times more frequent in Polish female teachers than in non-teachers. Lifetime vocal effort, incorrect technique of phonation and psychological predisposition seem to constitute major risk factors for developing occupational voice disorders.

Hearing loss among workers exposed to moderate concentrations of solvents.

OBJECTIVES: It is known that some industrial organic solvents are ototoxic. This study was aimed at evaluating the hearing effects of a mixture of organic solvents alone or in combination with noise on employees in paint and lacquer enterprises. The concentration of solvents was below the occupational exposure limits (OEL) for most of the subjects. METHODS: Altogether 517 subjects were divided into the following three groups: persons with no risk due to noise or organic solvent exposure at the workplace, workers exposed to organic solvents only, and workers exposed to both organic solvents and noise. RESULTS: The relative risk (RR) of hearing loss in the solvent-only exposure group was significantly increased (RR 4.4 and RR 2.8 for noise exposure of < 80 dB-A and < 85 dB-A, respectively) in a wide range of frequencies (2-8 kHz). No additional risk in the solvent + noise exposure group was found (RR 2.8). Hearing thresholds were significantly poorer in a wide range of frequencies (1-8 kHz) for both groups exposed to solvents, when compared with the reference group. The mean hearing thresholds at frequencies of 2-4 kHz were poorer for workers exposed to solvents + noise than for the solvent-only group; this finding suggests an additional effect for noise. However, there was no correlation between hearing loss and the extent of solvent exposure. CONCLUSIONS: The results indicate that occupational organic solvent exposure at moderate concentrations increases the risk of hearing loss, and the ototoxic effects should be considered when the health effects of exposed workers are monitored.

[Hearing impairment in the plastics industry workers exposed to styrene and noise]. / Ocena uszkodzen sluchu u pracowników narazonych na styren i halas w przemysle tworzyw sztucznych.

Styrene exerts ototoxic effect in animals, and the combined exposure to this solvent and noise produces a synergistic effect relative to the isolated exposure to noise. However, there is a lack of reliable evidence that chronic occupational exposure to styrene is ototoxic to humans. Neither has been documented its additive effect with noise. The present study was aimed to assess hearing impairment and the risk of hearing loss in workers exposed to both styrene and noise. The study group included 72 male workers occupationally exposed to styrene in the plastics industry. The results were compared with two control groups, matched by age, gender and personal traits: one group composed of 82 male workers employed in a printing house and exposed only to noise at the levels almost twice as high as those observed in the group exposed to styrene and noise, and the other consisted of 65 male workers exposed neither to solvents nor to noise at workplace. In the group exposed to styrene and noise, significantly increased average hearing loss, as compared to both control groups, was found at all frequencies (1-8 kHz). The risk of hearing loss in the group exposed to styrene and noise was seven times higher (RR: 6.6; 3.0-15.9) than in the non-exposed group, and four times higher (RR: 4.0; 1.8-9.1) than in when workers exposed only to noise. However, no relationship could be observed between the amount of styrene exposure and hearing impairment, taking account of the confounding effect of noise and age. The results of the study suggest that the exposure to solvent mixtures with styrene as a basic component may exert additional, to noise, adverse effect on the auditory organ.

[Assessment of hearing impairment in workers exposed to mixtures of organic solvents in the paint and lacquer industry]. / Ocena uszkodzen sluchu u pracowników narazonych na mieszaniny rozpuszczalników organicznych w przemysle farb i lakierów.

Clinical and experimental studies indicate a possible harmful effect of chemicals, especially organic solvents, on the hearing system. In combined exposure to noise and solvents, very common in industry, it is most likely that a synergetic action of these factors enhances the traumatising effect of exposure to noise. The aim of this study was to assess the incidence and the risk of hearing impairment in 117 paint and lacquer factory workers exposed to a mixture of organic solvents. An analysis of organic solvent mixtures reveals that xylene and ethyl acetate are their major components whose concentrations depend on individual workposts. The control group consisted of 76 workers exposed to noise exceeding, Threshold Limit Value and 125 healthy subjects exposed neither to noise nor to solvents in their occupational setting. Pure tone audiometry revealed the highest hearing thresholds in workers exposed to solvents, lower thresholds in those exposed to noise, and the lowest ones in the non-exposed individuals. Hearing loss was found in 30% of workers exposed to organic solvents, in 20% of noise-exposed subjects, and in only 6% of non-exposed subjects. The comparison of relative risk values also indicated significantly enhanced probability of hearing impairment in workers of the paint and lacquer factory (9.6; 3.2-25.6), which is even more strongly pronounced than in the group of subjects exposed to noise (4.2; 1.2-13.2). An analysis of hearing impairment risk in particular frequencies suggests that organic solvents may damage the inner ear in much greater extent than noise. The results of the study show that exposure to organic solvents may create a significant risk of hearing impairment. Therefore, further steps should be taken to include the exposed population into effective preventive programmes.

[Evaluation of voice quality in students from teaching colleges]. / Ocena stanu narzadu glosu u studentów szkoly pedagogicznej.

Vocal disorders are very common occupation-related disease in teachers. Their remarkable incidence might be associated with inappropriate techniques of speech and poor vocal hygiene. The aim of this study was to assess the function of vocal organ including voice emission technique in persons starting their teaching occupation. The study group included 66 female students at Teaching College. Their were thoroughly interviewed and subjected to laryngological, phoniatric and videostroboscopic examinations. All subjects reported subjective symptoms after vocal effort. Hoarseness and throat dryness were the most common. In the majority of students functional vocal disorders were observed. In 30% of them insufficiency of glottis and in four (6.1%) students soft vocal nodules were found. Signs and symptoms of vocal diseases were more frequent in a subgroup of students exposed to increased vocal effort during their professional education. The results indicate that young teachers are not sufficiently prepared for increased vocal strain, apparently associated with their profession. It is indeed necessary to introduce preventive programs including special training of appropriate speech technique, into the curricula of schools for teachers.

[Cerebrospinal fluid prealbumins in children with subacute sclerosing panencephalitis]. / Prealbuminy plynu mózgowo-rdzeniowego u dzieci chorych na podostre stwardniajace zapalenie mozgu.

In the cerebrospinal fluid of 26 children with SSPE the levels of prealbumins and total proteins were determined and electrophoretic separation of proteins was done. The usefulness is discussed of the percent proportion of prealbumins in the cerebrospinal fluid as a criterion indicating damage to the blood-cerebrospinal fluid barrier with increased penetration of proteins in SSPE. It is concluded that in diseases in which biosynthesis occurs of proteins in the central nervous system the percent proportion of prealbumins fails to reflect the integrity of the brain-cerebrospinal fluid barrier.