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      Distúrbio de voz relacionado ao trabalho: revisão integrativa Translated title: Work-related voice disorder: an integrative review

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          Abstract

          Resumo Objetivos: identificar e sumarizar evidências de estudos sobre a associação entre trabalho e distúrbio de voz. Métodos: revisão integrativa da literatura publicada nas bases de dados PubMed e SciELO entre 2003 e 2017. Foram elegíveis estudos observacionais, em português ou inglês, disponíveis na íntegra para consulta, que abordassem a frequência de disfonia (prevalência ou incidência). Resultados: foram analisados 47 artigos, a idade media sumarizada dos participantes era de 40,6 anos, 78,7% dos artigos estudaram ambos os sexos e 80,9% pesquisaram professores. A prevalência média de distúrbios da voz associados ao trabalho foi de 44,2% e a incidência de 17,0%. O ruído foi indicado como fator associado à disfonia em 25,5% dos estudos, seguido da carga horária de trabalho extensa (17,0%) e alergias (14,9%). Conclusão: os resultados indicam forte conexão entre distúrbio de voz e trabalho, confirmando a elevada prevalência de disfonia, especialmente em trabalhadores que utilizam a voz profissionalmente, bem como sua associação com fatores da organização e do ambiente de trabalho, contribuindo para: a) fortalecer o reconhecimento formal do distúrbio de voz relacionado ao trabalho; b) oferecer embasamento técnico à legislação; c) reforçar a premência de uma política pública para proteção vocal dos trabalhadores.

          Translated abstract

          Abstract Objectives: to identify and summarize evidence from studies on the association between work and voice disorder. Methods: integrative review of the literature published in PubMed and SciELO between 2003 and 2017. We included open access observational studies in Portuguese or English concerning frequency of dysphonia (prevalence or incidence). Results: we analyzed 47 articles. The participants’ average age was 40.6 years, 78.7 of the articles studied both sexes and 80.9% investigated teachers. The mean prevalence of work-related voice disorder was 44.2% and the incidence of 17.0%. Noise was pointed out as an associated factor of dysphonia in 25.5% of the studies, followed by long work hours (17.0%) and allergies (14.9%). Conclusion: the results show a strong association between voice disorders and work, confirming a high prevalence of dysphonia especially in workers who use their voice professionally, as well as its association to job organization and work environment, contributing to: a) strengthen the formal acknowledgment of work-related voice disorder; b) provide technical grounds to law; c) to reinforce the urgency of public policies to protect the workers’ voice.

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          Most cited references49

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          Voice disorders in the general population: prevalence, risk factors, and occupational impact.

          Epidemiologic studies of the prevalence and risk factors of voice disorders in the general adult population are rare. The purpose of this investigation was to 1) determine the prevalence of voice disorders, 2) identify variables associated with increased risk of voice disorders, and 3) establish the functional impact of voice disorders on the general population. Cross-sectional telephone survey. A random sample (n = 1,326) of adults in Iowa and Utah was interviewed using a questionnaire that addressed three areas related to voice disorders: prevalence, potential risk factors, and occupational consequences/effects. The lifetime prevalence of a voice disorder was 29.9%, with 6.6% of participants reporting a current voice disorder. Stepwise logistic regression identified specific factors that uniquely contributed to increased odds of reporting a chronic voice disorder including sex (women), age (40-59 years), voice use patterns and demands, esophageal reflux, chemical exposures, and frequent cold/sinus infections. However, tobacco or alcohol use did not independently increase the odds of reporting of a chronic voice disorder. Voice disorders adversely impacted job performance and attendance, with 4.3% of participants indicating that their voice had limited or rendered them unable to do certain tasks in their current job. Furthermore, 7.2% of employed respondents reported that they were absent from work 1 or more days in the past year because of their voice, and 2% reported more than 4 days of voice-related absence. The results of this large epidemiologic study provide valuable information regarding the prevalence of voice disorders, factors that contribute to voice disorder vulnerability, and the functional impact of voice problems on the general population.
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            Consensus auditory-perceptual evaluation of voice: development of a standardized clinical protocol.

            This article presents the development of the Consensus Auditory-Perceptual Evaluation of Voice (CAPE-V) following a consensus conference on perceptual voice quality measurement sponsored by the American Speech-Language-Hearing Association's Special Interest Division 3, Voice and Voice Disorders. The CAPE-V protocol and recording form were designed to promote a standardized approach to evaluating and documenting auditory-perceptual judgments of vocal quality. A summary of the consensus conference proceedings and the factors considered by the authors in developing this instrument are included. The CAPE-V form and instructions, included as appendices to this article, enable clinicians to document perceived voice quality deviations following a standard (i.e., consistent and specified) protocol.
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              Laryngeal manual therapy: a preliminary study to examine its treatment effects in the management of muscle tension dysphonia.

              The objectives of this study were to determine appropriate acoustic and outcome measures for the evaluation of a method of laryngeal manual therapy (LMT) used in the treatment of patients with muscle tension dysphonia (MTD). The effects of this technique were also investigated. The study was based on the hypotheses that the vertical position of the larynx in the vocal tract would lower, that the quality of the voice would normalize, and that a reduction in any vocal tract discomfort (VTD) would occur after LMT. This was a small, prospective, repeated measures pilot study in which each member of the research team was "blinded" to all other stages of the study and during which all data were anonymized until the final stage of data analysis. Ten subjects presenting with MTD completed outcome measures and provided audiorecordings immediately before, immediately after, and 1 week after LMT. The Kay CSL 4150 was used for signal acquisition and for some acoustic measurements. Spectrographic evaluation was accomplished with Praat. A new perceptual, self-rating scale, the VTD scale, and a new proforma for use by the clinician for palpatory evaluation, were developed for the study. Relative average perturbation during connected speech was significantly reduced after LMT, indicating a reduction in abnormal vocal function. The severity and frequency of VTD was shown to have reduced after LMT. This pilot study showed positive evidence for LMT as a method of therapy in the treatment of hyperfunctional voice disorders. Its effects were shown to be measurable with both acoustical analysis and the VTD scale.
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                Author and article information

                Journal
                rbso
                Revista Brasileira de Saúde Ocupacional
                Rev. bras. saúde ocup.
                Fundação Jorge Duprat Figueiredo de Segurança e Medicina do Trabalho - FUNDACENTRO (São Paulo, SP, Brazil )
                0303-7657
                2317-6369
                2020
                : 45
                : e26
                Affiliations
                [2] Feira de Santana Bahia orgnameUniversidade Estadual de Feira de Santana orgdiv1Departamento de Saúde Brazil
                [1] Salvador Bahia orgnameUniversidade Federal da Bahia orgdiv1Instituto de Ciências da Saúde orgdiv2Departamento de Fonoaudiologia Brazil
                Article
                S0303-76572020000102601 S0303-7657(20)04500002601
                10.1590/2317-6369000040218
                70564414-d8ce-41ec-be53-4612e5821371

                This work is licensed under a Creative Commons Attribution 4.0 International License.

                History
                : 30 October 2018
                : 29 May 2019
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 60, Pages: 0
                Product

                SciELO Brazil

                Categories
                Tema livre / Revisão

                voice disorders,occupational health,saúde do trabalhador,ambiente de trabalho,labor conditions,riscos ocupacionais,condições de trabalho,occupational risks,work environment,distúrbios da voz

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