Incidence of Voice Disorders among Private School Teachers in Taiwan: A Nationwide Longitudinal Study

Bo-Lei Chen, Ya-Yun Cheng, Cheng-Yu Lin and How-Ran Guo
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Bo-Lei Chen: Department of Occupational and Environmental Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 704, Taiwan
Ya-Yun Cheng: Department of Environmental Health, Harvard University T.H. Chan School of Public Health, Boston, MA 02115, USA
Cheng-Yu Lin: Department of Otolaryngology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 704, Taiwan
How-Ran Guo: Department of Occupational and Environmental Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 704, Taiwan

IJERPH, 2022, vol. 19, issue 3, 1-10

Abstract: Background: Teachers are more likely to use a loud voice at work than the general working population, but few longitudinal studies have been conducted on their risk of voice disorders. The occurrence of voice disorders in private school teachers was assessed by using the Longitudinal Health Insurance Database 2000 of Taiwan, which contains information on a random sample of 1 million beneficiaries of National Health Insurance. Methods: This study included private school teachers who were under 35 years old and newly employed between 2000 and 2010, and used workers with other occupations as the comparison cohort. Patients with voice disorders were identified using diagnostic codes on insurance claims. Cox proportional hazards regressions were applied to obtain relative risk estimates. Results: After adjusting for age, sex, income, and comorbidities of sinusitis and laryngitis, private school teachers had a higher risk of developing voice disorders (hazard ratio [HR] = 1.58; 95% confidence intervals: 1.43–1.75). In addition, the finding that elementary and high-school teachers had a higher risk than college teachers (HR: 2.56 vs. 1.44) and the pattern of increases in cumulative incidence over time supported a dose–response relationship between teaching and voice disorders. Conclusions: Private school teachers had higher risks of voice disorders. The results support the causality between occupation and voice disorders in teachers.

Keywords: voice disorders; teachers; incidence (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2022
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