Self-reported voice disorders of teachers and indoor air quality in schools: a cross-sectional study in Finland.

OBJECTIVE: We aimed to study the association between self-reported voice disorders among teachers and indoor air quality in school buildings. METHODS: We performed a questionnaire study of 538 Finnish teachers working in 67 school buildings utilizing both perceived and technical evaluations; the agreement between these two assessments was also studied. The technical assessment was provided by technical experts. RESULTS: Teachers with voice disorders reported significantly more complaints from indoor air than those without voice disorders. The results also indicated a possible connection between the technical assessment and voice disorders. After adjustment for sex, stress and asthma, the prevalence of voice disorders was 47% higher in teachers working in renovated buildings compared to those working in the non-problem buildings (aRR1.47; CI 95% 1.11-1.95). The prevalence of voice disorders was 28% higher among teachers working in buildings with problems compared to those working in non-problem buildings (aRR 1.28; 95% CI 0.99-1.64). DISCUSSION: In our study, poor perceived indoor air was significantly associated with self-reported voice disorders in teachers and there was an agreement between the perceived and technical assessments. Our results also indicated a possible connection between the technical assessment and voice disorders. Our results imply the need for longitudinal research with technical assessment to study the effect of renovation on voice disorders.

The interaction between voice disorders and stress for work ability of teachers.

OBJECTIVE: Less attention has been paid to the interaction between voice disorders, stress, and indoor environmental quality for work ability in teachers. Therefore, our aim was to study whether lower work ability associated more strongly when the variables of voice disorders and stress at work were combined as opposed to evaluating these two factors separately. METHODS: We conducted a questionnaire study including validated self-assessment of work ability and a technical assessment of school buildings utilizing a sample of 1198 and a subsample (n = 538) of Finnish teachers. RESULTS: When combined, voice disorders and stress at work had a stronger association to decreased work ability than when they were evaluated separately. The occurrence of stress was more prevalent in poor and moderate work ability than the occurrence of voice disorders. Nine out of 10 of the teachers who had neither voice disorders nor stress reported good work ability, while four out of 10 of the teachers who suffered from both voice disorders and stress had poor work ability. As regards the background variables, nearly half of the subjects working in the non-problem buildings have neither stress nor voice disorders. DISCUSSION: We recommend offering support for reducing stress at work to improve teachers' work performance. The findings also support the maintenance of school buildings and keeping them in good condition. Follow-up studies are needed to investigate the possible effects of voice disorders and the associated variables on work ability.

Work ability of teachers associated with voice disorders, stress, and the indoor environment: A questionnaire study in Finland.

OBJECTIVES: The purpose of this study was to determine whether self-reported work ability is associated with voice disorders, stress at work, and the quality of the perceived indoor environment. STUDY DESIGN: A cross-sectional study. METHODS: We conducted a questionnaire study of 1 198 Finnish teachers utilizing the Work Ability Score. RESULTS: The Work Ability Score median was 8 (Q1: 7, Q3: 9), and 71% (CI 95% 69%-74%) of the subjects reported that they had good work ability. Female teachers had a significantly lower Work Ability Score than male teachers. The median number of days absent due to sickness during the previous year was 4 (Q1: 2, Q3: 10). Voice disorders (adjusted odds ratio (aOR) 2.44; CI95% 1.73-3.44), stress at work (rather or very much vs. not at all or little; aOR 6.53; CI95% 4.31-9.90), and poor perceived indoor environment quality (aOR 2.63; CI95% 1.86-3.71) were all clear risk factors for the Work Ability Score. CONCLUSION: We determined that decreased work ability in teachers is connected to voice disorders, stress at work, and poor perceived indoor environment quality. Thus, in order to better maintain teachers' work ability, we recommend that special attention should be paid to occupational health care when there are problems in the indoor environment of teachers, and they suffer from voice disorders and stress.

Voice Disorders are Associated With Stress Among Teachers: A Cross-Sectional Study in Finland.

OBJECTIVES: Voice disorders are considered to be more common among teachers than other occupations. However, epidemiological data are scarce and only a few researchers have studied stress as a risk factor in voice disorders in teachers. This paper presents data from a study on Finnish school teachers which investigated the prevalence of voice disorders and evaluated the risk factors for voice disorders, especially stress. STUDY DESIGN: A cross-sectional study was conducted among primary and secondary education teachers across Finland. METHODS: Voice disorders were assessed with a seven-item voice questionnaire and stress at work was measured with a validated single-item question. RESULTS: The prevalence of voice disorders over the 12-month period was 54% in the sample of 1198 primary and secondary education teachers in Finland. Of the teachers, 81% were female, and they suffered more voice disorders than the males. Stress was the most significant explanatory variable with a 3.6-fold risk as regards voice disorders. The association between voice disorders and stress was even stronger than that of asthma, asthma medication, and allergic rhinitis, which are known to cause serious risks for voice disorders in general. CONCLUSIONS: Our results hypothesize that stress may be a multi-dimensional problem associated with various risk factors and result in an even more urgent risk of voice disorders in teachers than estimated. Longitudinal research is needed to investigate the causality between voice disorders and stress among teachers. In addition, it is recommended that in the occupational health care of teachers' consideration should be given to the fact that voice disorders and stress may have a multi-dimensional association.