Left Vocal Cord Paralysis, Lung Function and Exercise Capacity in Young Adults Born Extremely Preterm With a History of Neonatal Patent Ductus Arteriosus Surgery—A National Cohort Study

Background: Left vocal cord paralysis (LVCP) is a known complication of patent ductus arteriosus (PDA) surgery in extremely preterm (EP) born neonates; however, consequences of LVCP beyond the first year of life are insufficiently described. Both voice problems and breathing difficulties during physical activity could be expected with an impaired laryngeal inlet. More knowledge may improve the follow-up of EP-born subjects who underwent PDA surgery and prevent confusion between LVCP and other diagnoses.Objectives: Examine the prevalence of LVCP in a nationwide cohort of adults born EP with a history of PDA surgery, and compare symptoms, lung function, and exercise capacity between groups with and without LVCP, and vs. controls born EP and at term.Methods: Adults born EP (<28 weeks' gestation or birth weight <1,000 g) in Norway during 1999–2000 who underwent neonatal PDA surgery and controls born EP and at term were invited to complete questionnaires mapping voice-and respiratory symptoms, and to perform spirometry and maximal treadmill exercise testing. In the PDA-surgery group, exercise tests were performed with a laryngoscope positioned to evaluate laryngeal function.Results: Thirty out of 48 (63%) eligible PDA-surgery subjects were examined at mean (standard deviation) age 19.4 (0.8) years, sixteen (53%) had LVCP. LVCP was associated with self-reported voice symptoms and laryngeal obstruction during exercise, not with lung function or peak oxygen consumption (VO2peak). In the PDA-surgery group, forced expiratory volume in 1 second z-score (z-FEV1) was reduced compared to EP-born controls (n = 30) and term-born controls (n = 36); mean (95% confidence interval) z-FEV1 was −1.8 (−2.3, −1.2), −0.7 (−1.1, −0.3) and −0.3 (−0.5, −0.0), respectively. For VO2peak, corresponding figures were 37.5 (34.9, 40.2), 38.1 (35.1, 41.1), and 43.6 (41.0, 46.5) ml/kg/min, respectively.Conclusions: LVCP was common in EP-born young adults who had undergone neonatal PDA surgery. Within the PDA-surgery group, LVCP was associated with self-reported voice symptoms and laryngeal obstruction during exercise, however we did not find an association with lung function or exercise capacity. Overall, the PDA-surgery group had reduced lung function compared to EP-born and term-born controls, whereas exercise capacity was similarly reduced for both the PDA-surgery and EP-born control groups when compared to term-born controls.

Multiple Chemical Sensitivity in Patients Exposed to Moisture Damage at Work and in General Working-Age Population—The SAMDAW Study

A considerable proportion of patients having respiratory tract or voice symptoms associated with workplace moisture damage (MD) could have multiple chemical sensitivity (MCS). MCS is characterized by symptoms of different organ systems in association with low-level chemical exposure. The objective of this study was to assess the prevalence of MCS among patients referred to secondary health care because of respiratory or voice symptoms associated with workplace MD compared to the general working-age population. Using three subscales of the QEESI© questionnaire, we assessed MCS in the study patients and 1500 controls in the same district randomly selected from the Finnish Population Information System. Study patients had significantly more often high scores in chemical intolerance (39% vs. 23%, p = 0.001), symptom severity (60% vs. 27%, p < 0.001), and life impact subscales (53% vs. 20%, p < 0.001). Asthma, chronic rhinosinusitis, laryngeal problems, and atopy were not associated with the presence of MCS. MCS is common among patients referred to secondary health care with respiratory tract and/or voice symptoms associated with workplace MD, and it considerably affects their everyday life. MCS should be considered as a possible explanatory factor for MD-associated symptoms.

Voice symptoms in teachers during distance teaching: a survey during the COVID-19 pandemic in Finland

Purpose Due to the coronavirus disease of 2019 (COVID-19), teachers during the pandemic have had to adapt to online teaching at short notice. This study aims to investigate the voice symptoms and their environmental risk factors as well as the work ability associated with distance teaching and to compare these with symptoms in previous contact teaching. Methods We conducted a survey of 121 primary and secondary school teachers across Finland. The survey was advertised online through social media and the replies collected from voluntarily participating teachers. Results During distance teaching vocal symptoms appeared less often than in school with 71% teachers experiencing them in regular teaching and 44% in distance teaching, VHI result decreased from 7.88 in school teaching to 4.58 in distance teaching. Acoustic conditions were reported to be more suitable in distance teaching with 73% of teachers finding them adequate during distance teaching in comparison to 46% for those in regular teaching. Background noise was the most disturbing factor for a teacher’s voice in the classroom and in distance teaching and this was even more conspicuous in the classroom. Also, subjectively experienced poor indoor air quality at school influenced the voice negatively. Further, voice problems were associated with increased subjective stress levels and reduced ability to work. Conclusion Distance teaching has affected teachers’ voices in a positive way compared with regular teaching. This difference is likely to be due to better acoustics and indoor air quality in distance teaching conditions.

Vocal and self-perception effects of straw phonation exercises

ABSTRACT Purpose: to assess the acoustic and self-perceived voice changes in women with and without voice symptoms after 1, 3, 5, and 7 minutes of straw phonation exercises. Methods: a total of 30 women aged 18 to 39 years participated in the study - 17 with and 13 without voice symptoms. The participants filled in the visual analog scale on self-perceived voice discomfort. The sustained vowel /ɛ/ was recorded in maximum phonation time before (m0) and after the first, third, fifth, and seventh minute performing straw phonation exercises. The maximum phonation time was measured, and an acoustic analysis was made, encompassing the following parameters: the number of harmonics, fundamental frequency, noise, glottal-to-noise excitation ratio (GNE), jitter, and shimmer. The Friedman and Wilcoxon tests were used to compare each parameter at the different moments, and the Mann-Whitney test, to compare the groups. The 5% significance level was set for the analyses. Results: no changes were found in either the acoustic variables or the self-perception of voice comparing the moments before and after the exercises in either group. The comparison between the groups revealed that the one with voice symptoms had lower GNE and higher noise values at the second moment performing the technique. Conclusion: the straw phonation did not cause acoustic or self-perceived voice changes in women with and without voice symptoms. The comparison between the groups showed that the women with symptoms had lower GNE and higher noise values than those without symptoms, after 1 minute performing straw phonation.

A Pilot Study on the Relationship between Primary-School Teachers’ Well-Being and the Acoustics of their Classrooms

Although teachers’ well-being and vocal health are affected by noise, research on classroom sound environment from the teachers’ perspective is scarce. This study investigated the relationship between teachers’ well-being and classroom acoustics. The possible influence of teachers’ age, experience, teaching grade and class size on the relationship was also investigated. In this study, well-being refers to self-reported vocal health, stress, burnout and self-efficacy. Twenty-three primary-school teachers answered questionnaires on well-being. In each teacher’s classroom, the acoustical properties were measured with the variables reverberation time, clarity of speech (C50) and ventilation system noise (VSN). A series of non-parametric correlations were run to determine the relationship between teachers’ well-being and classroom acoustics. Initially, there was a significant bivariate correlation between burnout and VSN, as well as voice symptoms correlated with VSN and teaching grade. Although the results became not significant after correction for multiple tests, the findings indicate that higher degree of burnout is associated with higher levels of VSN in classrooms, and voice symptoms increase with higher VSN. Teachers working in lower grades had more voice symptoms than those working in higher grades.

Teachers’ and Children’s Experiences after an Acoustic Intervention and a Noise-Controlling Workshop in Two Elementary Classrooms

<b><i>Introduction:</i></b> Treating sources of noise is a novel aspect of voice ergonomics intended to enhance the preconditions for good voice production and easy listening. <b><i>Objective:</i></b> To improve experiences of listening and voice ergonomics in classrooms. <b><i>Methods:</i></b> Participants were two female elementary school teachers with voice symptoms and their pupils (<i>n</i> = 50). Two interventions were performed: the acoustic intervention and then the workshop intervention where the teachers and pupils were active. Teachers’ voice symptoms and pupils’ and teachers’ experiences of the interventions were elicited by questionnaire. <b><i>Results:</i></b> The teacher with many voice symptoms experienced more annoyance from sounds and benefitted more from the interventions. After the interventions both teachers suffered fewer voice breaks and voice symptoms such as lump and mucus in the throat. The pupils reported improvement in the teachers’ voice clarity and audibility (<i>p</i> = 0.001). Pupils aged 12–13 years were more annoyed by sounds than those aged 8–9 years (<i>p</i> = 0.003). The older pupils experienced less sound annoyance after both interventions and the younger ones after the workshop intervention. <b><i>Conclusions:</i></b> The importance of good acoustics and individuals’ ability to improve voice ergonomics and listening conditions was demonstrated.