Impact of a Workplace Vocal Health Promotion Program on Vocal Doses in College Professors: a Colombian Exploratory Study
Impacto de un programa de promoción de la salud vocal en los lugares de trabajo en las dosis vocales de los profesores universitarios: un estudio exploratorio en Colombia

This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Show authors biography
Objective. To determine the effect of a workplace vocal health promotion (WVHP) program on Colombian college professors’ vocal doses. This is an exploratory pre-post-intervention study.
Methods. College professors were randomly allocated to one of two groups: no-intervention or intervention. Participants filled out a general questionnaire and were monitored using a vocal dosimeter during the complete duration of an in-person class before and after their participation in the program. The WVHP program consisted of four sessions (2 in-person and 2 online sessions; one per week) focused on vocal hygiene and training and teaching-learning strategies to be implemented inside the classrooms.
Results. The intervention group (n = 6) had a 3% decrease in time dose percentage after participating in the WVHP program, whereas professors from the no-intervention group had an increase of 1% after the follow-up (p >0.05). Participants from the no-intervention group had a statistically significant increased distance dose normalized (β = 0.078; p = 0.01) in comparison with the intervention group.
Conclusions. The WVHP program seems to be a good preventive strategy for reducing voice disorders among occupational voice users. Although statistical significance was not achieved for most vocal dose parameters, the observed trends suggest that work-based structured vocal health interventions may contribute to safer and more sustainable voice use in occupational settings.
Article visits 41 | PDF visits 14
- Bottalico P, Astolfi A, Hunter EJ. Teachers’ voicing and silence periods during continuous speech in classrooms with different reverberation times. J Acoust Soc Am [Internet]. 2017;141(1):EL26-EL31. doi: https://doi.org/10.1121/1.4973312
- Calosso G, Puglisi GE, Astolfi A, Castellana A, Carullo A, Pellerey F. A one-school year longitudinal study of secondary school teachers’ voice parameters and the influence of classroom acoustics. J Acoust Soc Am [Internet]. 2017;142(2):1055-66. doi: https://doi.org/10.1121/1.4998707
- Cantor-Cutiva LC, Puglisi GE, Astolfi A, Carullo A. Four-day Follow-up Study on the Self-reported Voice Condition and Noise Condition of Teachers: Relationship Between Vocal Parameters and Classroom Acoustics. J Voice [Internet]. 2017;31(1):120.E1-120.E8. doi: https://doi.org/10.1016/j.jvoice.2016.02.017
- Gama ACC, Santos JN, Pedra EFP, Rabelo ATV, Magalhaes MC, Casas EBL. Vocal dose in teachers: correlation with dysphonia. CoDAS [Internet]. 2016;28(2):190-2. doi: https://doi.org/10.1590/2317-1782/20162015156
- Mehta DD, Van Stan JH, Hillman RE. Relationships between vocal function measures derived from an acoustic microphone and a subglottal neck-surface accelerometer. IEEEACM Trans Audio Speech Lang Process [Internet]. 2016;24(4):659-68. doi: https://doi.org/10.1109/TASLP.2016.2516647
- Mozzanica F, Selvaggio A, Ginocchio D, Pizzorni N, Scarponi L, Schindler A. Speech and Language Pathologists’ Voice Use in Working Environments: A Field Study Using Ambulatory Phonation Monitoring. Folia Phoniatr Logop [Internet]. 2017;68(6):268-73. doi: https://doi.org/10.1159/000481884
- Nusseck M, Richter B, Spahn C, Echternach M. Analysing the vocal behaviour of teachers during classroom teaching using a portable voice accumulator. Logoped Phoniatr Vocol [Internet]. 2018;43(1):1-10. doi: https://doi.org/10.1080/14015439.2017.1295104
- Pirila S, Pirila P, Ansamaa T, Yliherva A, Sonning S, Rantala L. Relationship between Activity Noise, Voice Parameters, and Voice Symptoms among Female Teachers. Folia Phoniatr Logop [Internet]. 2018;69(3):94-102. doi: https://doi.org/10.1159/000484204
- Puglisi GE, Astolfi A, Cantor Cutiva LC, Carullo A. Four-day-follow-up study on the voice monitoring of primary school teachers: Relationships with conversational task and classroom acoustics. J Acoust Soc Am [Internet]. 2017;141(1):441-52. doi: https://doi.org/10.1121/1.4973805
- Rabelo ATV, Santos JN, Souza BO, Gama ACC, Castro Magalhães M. The Influence of Noise on the Vocal Dose in Women. J Voice [Internet]. 2019;33(2):214-9. doi: https://doi.org/10.1016/j.jvoice.2017.10.025
- Schloneger MJ, Hunter EJ. Assessments of Voice Use and Voice Quality Among College/University Singing Students Ages 18–24 Through Ambulatory Monitoring with a Full Accelerometer Signal. J Voice [Internet]. 2017;31(1):124.E21-124.E30. doi: https://doi.org/10.1016/j.jvoice.2015.12.018
- Szabo Portela A, Granqvist S, Ternström S, Södersten M. Vocal Behavior in Environmental Noise: Comparisons Between Work and Leisure Conditions in Women with Work-related Voice Disorders and Matched Controls. J Voice [Internet]. 2018;32(1):126.E23-126.E38. doi: https://doi.org/10.1016/j.jvoice.2017.04.010
- Vilkman E. Voice problems at work: A challenge for occupational safety and health arrangement. Folia Phoniatr Logop [Internet]. 2000;52(1-3):120-5. doi: https://doi.org/10.1159/000021519
- Whitling S, Lyberg-Åhlander V, Rydell R. Long-Time Voice Accumulation During Work, Leisure, and a Vocal Loading Task in Groups with Different Levels of Functional Voice Problems. J Voice [Internet]. 2017;31(2):246.E1-246.E10. doi: https://doi.org/10.1016/j.jvoice.2016.08.008
- Morrow SL, Connor NP. Comparison of Voice-Use Profiles Between Elementary Classroom and Music Teachers. J Voice [Internet]. 2011;25(3):367-72. doi: https://doi.org/10.1016/j.jvoice.2009.11.006
- Remacle A, Morsomme D, Finck C. Comparison of Vocal Loading Parameters in Kindergarten and Elementary School Teachers. J Speech Lang Hear Res [Internet]. 2014;57(2):406-15. doi: https://doi.org/10.1044/2013_JSLHR-S-12-0351
- Atará-Piraquive AP, Cantor-Cutiva LC. Gender differences in vocal doses among occupational voice users: a systematic review of literature and meta-analysis. Logoped Phoniatr Vocol [Internet]. 2022(1);63-72. doi: https://doi.org/10.1080/14015439.2021.1873415
- Kristiansen J, Lund SP, Persson R, Shibuya H, Nielsen PM, Scholz M. A study of classroom acoustics and school teachers’ noise exposure, voice load and speaking time during teaching, and the effects on vocal and mental fatigue development. Int Arch Occup Environ Health [Internet]. 2014;87(8):851-60. doi: https://doi.org/10.1007/s00420-014-0927-8
- Munier C, Brockmann-Bauser M, Laukkanen AM, Ilomäki I, Kankare E, Geneid A. Relationship Between Laryngeal Signs and Symptoms, Acoustic Measures, and Quality of Life in Finnish Primary and Kindergarten School Teachers. J Voice [Internet]. 2020;34(2):259-71. doi: https://doi.org/10.1016/j.jvoice.2018.12.006
- Darius S, Voigt-Zimmermann S, Böckelmann I. Effects of occupation-specific vocal stress on the mental health of day care teachers. Folia Phoniatr Logop [Internet]. 2023;75(5):306-15. doi: https://doi.org/10.1159/000530283
- Cantor-Cutiva LC, Robles-Vega HY, Sánchez EA, Morales DA. Differences on Voice Acoustic Parameters between Colombian College Professors with and without Vocal Fatigue. J Voice [Internet]. 2022;36(2):219-25. doi: https://doi.org/10.1016/j.jvoice.2020.05.008
- Higgins KP, Smith AB. Prevalence and Characteristics of Voice Disorders in a Sample of University Teaching Faculty. CICSD [Internet]. 2012;39(Fall):69-75. doi: https://doi.org/10.1044/cicsd_39_F_69
- Kyriakou K, Petinou K, Phinikettos I. Risk Factors for Voice Disorders in University Professors in Cyprus. J Voice [Internet]. 2018;32(5):643.E1-643.E9. doi: https://doi.org/10.1016/j.jvoice.2017.07.005
- Hunter EJ, Cantor-Cutiva LC, van Leer E, van Mersbergen M, Nanjundeswaran CD, Bottalico P, et al. Toward a Consensus Description of Vocal Effort, Vocal Load, Vocal Loading, and Vocal Fatigue. J Speech Lang Hear Res [Internet]. 2020;63(2):509-32. doi: https://doi.org/10.1044/2019_JSLHR-19-00057
- Švec JG, Popolo PS, Titze IR. Measurement of vocal doses in speech: Experimental procedure and signal processing. Logoped Phoniatr Vocol [Internet]. 2003;28(4):181-92. doi: https://doi.org/10.1080/14015430310018892
- Titze IR, Švec JG, Popolo PS. Vocal Dose Measures: Quantifying Accumulated Vibration Exposure in Vocal Fold Tissues. J Speech Lang Hear Res [Internet]. 2003;46(4):919-32. doi: https://doi.org/10.1044/1092-4388(2003/072)
- Titze IR, Hunter EJ. Comparison of Vocal Vibration-Dose Measures for Potential-Damage Risk Criteria. J Speech Lang Hear Res [Internet]. 2015;58(5):1425-39. doi: https://doi.org/10.1044/2015_JSLHR-S-13-0128
- Assad JP, Gama ACC, Santos JN, Castro Magalhães M. The Effects of Amplification on Vocal Dose in Teachers with Dysphonia. J Voice [Internet]. 2019;33(1):73-9. doi: https://doi.org/10.1016/j.jvoice.2017.09.011
- Morrow SL, Connor NP. Voice Amplification as a Means of Reducing Vocal Load for Elementary Music Teachers. J Voice [Internet]. 2011;25(4):441-6. doi: https://doi.org/10.1016/j.jvoice.2010.04.003
- Zabret M, Hočevar Boltežar I, Šereg Bahar M. The Importance of The Occupational Vocal Load for The Occurence and Treatment of Organic Voice Disorders. Slovenian Journal of Public Health. Sciendo [Internet]. 2018;57(1):17-24. doi: https://doi.org/10.2478/sjph-2018-0003
- Alvarez Cáceres R. Ensayos clínicos: diseño, análisis e interpretación. 1st ed. Madrid: Ediciones Diaz de Santos; 2005. 197 p.
- Atará-Piraquive AP, Herrera-Guzmán CL, Hernández-Contreras JR, Rincón-Pinilla MP, Peña-Campagnoli AT, Florez-Lancheros GP, et al. Effect of a Workplace Vocal Health Promotion Program and Working Conditions on Voice Functioning of College Professors. J Voice [Internet]. 2021;37(6):886-96. doi: https://doi.org/10.1016/j.jvoice.2021.05.016
- Hunter EJ. Vocal Dose Measures: General Rationale, Traditional Methods and Recent Advances. In I International Conference on Occupational Voice [Internet]. 2016 Sep 16-18; Bogotá, Colombia: Asociación Colombiana de Fonoaudiología (Asofono); 2016. 5 p. Available from: https://www.researchgate.net/publication/311192575_Vocal_Dose_Measures_General_Rationale_Traditional_Methods_and_Recent_Advances
- Bottalico P, Ipsaro Passione I, Astolfi A, Carullo A, Hunter EJ. Accuracy of the quantities measured by four vocal dosimeters and its uncertainty. J Acoust Soc Am [Internet]. 2018;143(3):1591-602. doi: https://doi.org/10.1121/1.5027816
- Carullo A, Vallan A, Astolfi A, Pavese L, Puglisi GE. Validation of calibration procedures and uncertainty estimation of contact-microphone based vocal analyzers. Measurement [Internet]. 2015;74:130-42. doi: https://doi.org/10.1016/j.measurement.2015.07.011
- Costello E. Opening up to open source: looking at how Moodle was adopted in higher education. Open Learning: The Journal of Open, Distance and e-Learning [Internet]. 2013;28(3):187-200. doi: https://doi.org/10.1080/02680513.2013.856289
- Roy N, Weinrich B, Gray SD, Tanner K, Toledo SW, Dove H, et al. Voice Amplification Versus Vocal Hygiene Instruction for Teachers with Voice Disorders: A Treatment Outcomes Study. J Speech Lang Hear Res [Internet]. 2002;45(4):625-38. doi: https://doi.org/10.1044/1092-4388(2002/050)
- Timmermans B, Coveliers Y, Wuyts FL, Van Looy L. Voice Training in Teacher Education: The Effect of Adding an Individualized Microteaching Session of 30 Minutes to the Regular 6-Hour Voice Training Program. J Voice [Internet]. 2012;26(5):669.E1-669.E9. doi: https://doi.org/10.1016/j.jvoice.2011.03.001
- Roy N, Gray SD, 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. J Speech Lang Hear Res [Internet]. 2001;44(2):286-96. doi: https://doi.org/10.1044/1092-4388(2001/023)
- Pizolato RA, Rehder MIBC, Meneghim MC, Ambrosano GMB, Mialhe FL, Pereira AC. Impact on quality of life in teachers after educational actions for prevention of voice disorders: a longitudinal study. Health Qual Life Outcomes [Internet]. 2013;11:28. doi: https://doi.org/10.1186/1477-7525-11-28
- Timmermans B, Coveliers Y, Meeus W, Vandenabeele F, Van Looy L, Wuyts F. The Effect of a Short Voice Training Program in Future Teachers. J Voice [Internet]. 2011;25(4):e191-8. doi: https://doi.org/10.1016/j.jvoice.2010.04.005
- Roy N, Weinrich B, Gray SD, Tanner K, Stemple JC, Sapienza CM. Three Treatments for Teachers with Voice Disorders: A Randomized Clinical Trial. J Speech Lang Hear Res [Internet]. 2003;46(3):670-88. doi: https://doi.org/10.1044/1092-4388(2003/053)
- Oliveira Bastos PRH, Hermes EC. Effectiveness of the Teacher’s Vocal Health Program (TVHP) in the Municipal Education Network of Campo Grande, MS. J Voice [Internet]. 2018;32(6):681-8. doi: https://doi.org/10.1016/j.jvoice.2017.08.029
- Rantala L, Sala E, Kankare E. Teachers’ Working Postures and Their Effects on the Voice. Folia Phoniatr Logop [Internet]. 2018;70(1):24-36. doi: https://doi.org/10.1159/000487593
- Plevin R. Take control of the noisy class. From chaos to calm in 15 seconds. 1st ed. Carmarthen: Crown House Publishing; 2016. 255 p.
- Wilson Arboleda BM, Frederick AL. Considerations for Maintenance of Postural Alignment for Voice Production. J Voice [Internet]. 2008;22(1):90-9. doi: https://doi.org/10.1016/j.jvoice.2006.08.001
- Saatweber M. How to Help Teachers’ Voices. Folia Phoniatr Logop [Internet]. 2009;60(6):288-90. doi: https://doi.org/10.1159/000170077
- Hackworth RS. The effect of vocal hygiene and behavior modification instruction on the self-reported vocal health habits of public school music teachers. International Journal of Music Education [Internet]. 2007;25(1):20-8. doi: https://doi.org/10.1177/0255761407074889
- Roy N. Optimal dose–response relationships in voice therapy. Int J Speech Lang Pathol [Internet]. 2012;14(5):419-23. doi: https://doi.org/10.3109/17549507.2012.686119
- Bottalico P, Astolfi A. Investigations into vocal doses and parameters pertaining to primary school teachers in classrooms. J Acoust Soc Am [Internet]. 2012;131(4):2817-27. doi: https://doi.org/10.1121/1.3689549
- Gaskill CS, O’Brien SG, Tinter SR. The effect of voice amplification on occupational vocal dose in elementary school teachers. J Voice [Internet]. 2012;26(5):667.E19-27. doi: https://doi.org/10.1016/j.jvoice.2011.10.010
- Atará-Piraquive AP, Forero-Suárez LL, Cárdenas-Martinez JF, Cantor-Cutiva LC. Effect of an online Workplace Vocal Health and Low Stress Levels Promotion Program implemented in a Colombian university during COVID-19 pandemic. CoDAS. 2023;35(6):e20220052. doi: https://doi.org/10.1590/2317-1782/20232022052
- Cantor-Cutiva LC, Cantor-Cutiva AM. Impact of a Three-Week Workplace Vocal Health Promotion Program on a Teacher and Students’ Voice Parameters. Rev Investig Innov Cienc Salud [Internet]. 2023;5(2):3-23. doi: https://doi.org/10.46634/riics.180
- Grillo EU. An Online Telepractice Model for the Prevention of Voice Disorders in Vocally Healthy Student Teachers Evaluated by a Smartphone Application. Perspect ASHA Spec Interest Groups [Internet]. 2017;2(3):63-78. doi: https://doi.org/10.1044/persp2.SIG3.63
- Atará-Piraquive AP, Rute Sanabria BO, Cantor-Cutiva LC. Productivity costs associated to voice symptoms, low sleep quality, and stress among college professors during homeworking in times of COVID-19 Pandemic. Rev Investig Innov Cienc Salud [Internet]. 2022;4(1):4-15. doi: https://doi.org/10.46634/riics.131
- Karjalainen S, Sahlén B, Falck A, Brännström J, Lyberg-Åhlander V. Implementation and evaluation of a teacher intervention program on classroom communication. Logoped Phoniatr Vocol [Internet]. 2020;45(3):110-22. doi: https://doi.org/10.1080/14015439.2019.1595131
- Mello MCMBD, Cantor-Cutiva LC, Ferreira LP. Panorama de tres países latinoamericanos en problemas de voz relacionados con condiciones de trabajo. CoDAS [Internet]. 2021;33(5):e20200304. doi: https://doi.org/10.1590/2317-1782/20202020304
- Eastman SE, Ghasemzadeh H, Van Stan J, Hillman RE, Mehta DD. Quantifying the Occupational Voice Use of Teachers. Perspect ASHA Spec Interest Groups [Internet]. 2023;8(6):1363-79. doi: https://doi.org/10.1044/2023_PERSP-23-00084