Analysis of possible factors of vocal interference during the teaching activity

Silva, Bárbara Gabriela; Chammas, Tiago Visacre; Zenari, Marcia Simões; Moreira, Renata Rodrigues; Samelli, Alessandra Giannella; Nemr, Kátia

doi:10.11606/S1518-8787.2017051000092

Brasil

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Original Articles • Rev. Saúde Pública 51 • 2017 • https://doi.org/10.11606/S1518-8787.2017051000092 linkcopy

Analysis of possible factors of vocal interference during the teaching activity

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

OBJECTIVE To measure the risk of dysphonia in teachers, as well as investigate whether the perceptual-auditory and acoustic aspects of the voice of teachers in situations of silence and noise, the signal-to-noise ratio, and the noise levels in the classroom are associated with the presence of dysphonia.

METHODS This is an observational cross-sectional research with 23 primary and secondary school teachers from a private school in the municipality of São Paulo, Brazil, divided into the groups without dysphonia and with dysphonia. We performed the following procedures: general Dysphonia Risk Screening Protocol (General-DRSP) and complementary to speaking voice - teacher (Specific-DRSP), voice recording during class and in an individual situation in a silent room, and measurement of the signal-to-noise ratio and noise levels of classrooms.

RESULTS We have found differences between groups regarding physical activity (General-DRSP) and particularities of the profession (Specific-DRSP), as well as in all aspects of the perceptual-auditory vocal analysis. We have found signs of voice wear in the group without dysphonia. Regarding the vocal resources in the situations of noise and silence, we have identified a difference for the production of abrupt vocal attack and the tendency of a more precise speech in the situation of noise. Both the signal-to-noise ratio and the room noise levels during class were high in both groups.

CONCLUSIONS Teachers in both groups are at high risk for developing dysphonia and have negative vocal signals to a greater or lesser extent. Signal-to-noise ratio was inadequate in most classrooms, considering the standards for both children with normal hearing and with hearing loss, as well as equivalent noise levels.

DESCRIPTORS School Teachers; Voice Disorders; epidemiology; Noise; adverse effects; Hearing Loss; Risk Factors; Working Conditions

Characteristic	Group	Average	SD	Minimum	Maximum	p^a a ANOVA test.
General-DRSP
Visual analogue scale	GWOD	3.38	2.37	0	6.3	0.066
Visual analogue scale	GWD	5.24	2.24	1	8.3	0.066
Previous vocal disorders	GWOD	1.64	0.92	0	2	0.505
Previous vocal disorders	GWD	1.83	0.39	1	2	0.505
Current symptoms	GWOD	20	13.17	2	39	1
Current symptoms	GWD	20.16	7.75	9	33	1
Vocal use outside work	GWOD	2.27	1.27	0	4	0.534
Vocal use outside work	GWD	2.42	0.79	1	4	0.534
Diet	GWOD	2.36	1.36	0	4	0.578
Diet	GWD	2.08	0.99	1	4	0.578
Hydration	GWOD	1.73	1.27	0	3	0.584
Hydration	GWD	1.42	1.38	0	3	0.584
Medication	GWOD	0.09	0.3	0	1	0.336
Medication	GWD	0.25	0.45	0	1	0.336
Smoking	GWOD	0.18	0.4	0	1	0.609
Smoking	GWD	0.33	0.89	0	3	0.609
Sleep	GWOD	1.36	1.36	0	3	0.755
Sleep	GWD	1.5	0.52	1	2	0.755
Diseases	GWOD	0.91	0.94	0	2	0.348
Diseases	GWD	1.33	1.15	0	3	0.348
History of vocal disorder in the family	GWOD	0.18	0.4	0	1	0.134
History of vocal disorder in the family	GWD	0	0	0	0	0.134
Family dynamics	GWOD	0	0	0	0	0.351
Family dynamics	GWD	0.08	0.29	0	0	0.351
Physical activity	GWOD	0.36	0.5	0	1	0.004^b b p < 0.05
Physical activity	GWD	0.92	0.29	0	1	0.004^b b p < 0.05
Leisure	GWOD	0	0	0	0	0.171
Leisure	GWD	0.17	0.39	0	1	0.171
Final score	GWOD	36.47	16.26	11	62	0.572
Final score	GWD	39.74	10.75	25	58	0.572
Specific-D
Usage time	GWOD	2.73	1.01	1	4	0.596
Usage time	GWD	2.92	0.67	2	4	0.596
Profession	GWOD	11.72	0.47	11	12	0.043^b b p < 0.05
Profession	GWD	10.91	1.16	9	12	0.043^b b p < 0.05
Environmental conditions	GWOD	8.64	1.03	8	11	0.534
Environmental conditions	GWD	9.25	3.08	2	14	0.534
Medical leave	GWOD	0.27	0.47	0	1	0.249
Medical leave	GWD	0.08	0.29	0	1	0.249
Smoking	GWOD	0	0	0	0	0.171
Smoking	GWD	0.5	1.17	0	3	0.171
Alcohol consumption	GWOD	0.27	0.47	0	1	0.921
Alcohol consumption	GWD	0.25	0.45	0	1	0.921
Consumption of drugs	GWOD	0	0	0	0	1
Consumption of drugs	GWD	0	0	0	0	1
Dental prosthesis	GWOD	0.09	0.3	0	1	0.306
Dental prosthesis	GWD	0	0	0	0	0.306
Hormonal factors	GWOD	0.64	0.5	0	1	0.304
Hormonal factors	GWD	0.83	0.39	0	1	0.304
Final score	GWOD	24.36	2.01	22	27	0.743
Final score	GWD	34.75	3.44	19	30	0.743

Characteristic	Group	Average	SD	Minimum	Maximum	p^a a ANOVA test.
Analysis of acoustic measurements
Fundamental frequency (Hz)	GWOD	191.19	22.37	164.45	231.92	0.702
Fundamental frequency (Hz)	GWD	195.19	26.85	142.41	244.24	0.702
Jitter (%)	GWOD	0.39	0.21	0.21	0.95	0.166
Jitter (%)	GWD	0.28	0.16	0.13	0.73	0.166
Shimmer (%)	GWOD	4.41	1.99	1.78	7.38	0.794
Shimmer (%)	GWD	4.19	2.09	1.26	9.44	0.794
Harmonics-to-noise ratio (dB)	GWOD	18.97	5.65	10.19	27.42	0.889
Harmonics-to-noise ratio (dB)	GWD	18.65	4.1	10.23	24.84	0.889
Auditory-perceptual analysis - CAPE-V
Roughness	GWOD	13.64	10.89	0	34	0.0005^b b p < 0.05
Roughness	GWD	43.42	21.42	4	71	0.0005^b b p < 0.05
Breathiness	GWOD	19.91	9.53	5	33	0.0025^b b p < 0.05
Breathiness	GWD	45.25	22.74	0	73	0.0025^b b p < 0.05
Strain	GWOD	1.73	3.47	0	11	0.0001^b b p < 0.05
Strain	GWD	28.5	18.83	0	61	0.0001^b b p < 0.05
Pitch	GWOD	8.73	10.08	0	26	0.0093^b b p < 0.05
Pitch	GWD	27.17	19.01	0	73	0.0093^b b p < 0.05
Loudness	GWOD	1.27	4.22	0	14	0.0229^b b p < 0.05
Loudness	GWD	12.67	14.84	0	37	0.0229^b b p < 0.05

Characteristic	Group	Average	SD	Minimum	Maximum	p^* * ANOVA test.
Signal-to-noise ratio (dB)	GWOD	15.1	2.83	11.1	19.9	0.096
Signal-to-noise ratio (dB)	GWD	17.1	2.68	13.1	21.6	0.096

Variable	Classification	Silence (n)	Noise (n)	p^a a Chi-square test.
Type of voice	Neutral	18	19	0.729
Type of voice	Non-neutral, diverted, or altered	5	4	0.729
Vocal attack	Isocronic	23	18	0.024^b b p < 0.05
Vocal attack	Abrupt	0	5	0.024^b b p < 0.05
Loudness	Average	16	11	0.15
Loudness	Soft or very loud	7	12	0.15
Pitch	Average	14	16	0.155
Pitch	Low or high	9	7	0.155
Resonance	Balanced	10	13	0.397
Resonance	Unbalanced	13	10	0.397
Articulation	Precision	17	22	0.052
Articulation	Reduced	6	1	0.052
Speed of the speech	Adequate	23	22	0.5
Speed of the speech	Increased	0	1	0.5
Speech-breathing coordination	Presence	20	23	0.116
Speech-breathing coordination	Absence	3	0	0.116

Variable	Group	Average	SD	p^* * ANOVA test.
Leq	GWOD	68.91	16.63	0.180
Leq	GWD	76.22	7.32	0.180
Maximum	GWOD	80.25	23.52	0.242
Maximum	GWD	88.97	8.52	0.242
Minimum	GWOD	53.16	7.05	0.361
Minimum	GWD	55.18	2.48	0.361

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[TFN1] GWOD: group without dysphonia; GWD: group with dysphonia

[TFN2] ^a
ANOVA test.

[TFN3] ^b
p < 0.05