Eeva Sala

University of Turku | UTU · Department of Otorhinolaryngology

Objective: To evaluate associations between voice and working postures used during teaching. Methods: A researcher assessed 30 teachers' typical working postures of the torso, head, shoulders, upper back, and arms by observing and/or asking questions about them. Teachers' options to rest and to adjust furniture according to their needs were also...

School classrooms are learning spaces for children and workplaces where a teacher’s most important tool, his or her voice, is subjected to considerable loading. Because noise has several detrimental effects on human functioning including speech production and perception, a noiseless environment and good acoustics in classrooms are important. The ma...

The aim of the study was to research associations between classroom acoustic parameters and teachers' voice use and vocal health (N = 40). From voice samples, sound pressure level (SPL), fundamental frequency ( F 0 ), and the tilt of spectrum slope were analysed. Information on voice symptoms was collected by means of questionnaires. Room acoustic...

In this study, associations between classroom conditions and teachers’ voce use were researched (N=40). Acoustic variables were reverberation time (T60), early decay time (EDT), sound strength (G), the ratio of early and late sound energy arriving to a listener (C50), the ratio of early arriving sound energy to overall sound energy (D50), speech tr...

High activity noise levels that result in detrimental effects on speech communication have been measured in preschools. To find out if different pedagogical ideologies affect the perceived loudness and levels of noise, a questionnaire study inquiring about the experience of loudness and voice symptoms was carried out in Iceland in eight private pre...

The aim of this study was to research the associations between noise (ambient and activity noise) and objective metrics of teachers' voices in real working environments, i.e. classrooms. Thirty-two female and eight male teachers from 14 elementary schools were randomly selected for the study. Ambient noise was measured during breaks in unoccupied c...

Objective Early laryngeal cancer is usually treated with either transoral laser surgery or radiation therapy. The quality of voice achieved with these treatments has not been compared in a randomized trial. Methods and Materials Male patients with carcinoma limited to 1 mobile vocal cord (T1aN0M0) were randomly assigned to receive either laser sur...

The associations between voice ergonomic risk factors in 40 classrooms and the acoustic parameters of 40 schoolteachers' voices were investigated. The risk factors assessed were connected to participants' working practices, working postures, and the indoor air quality in their workplaces. The teachers recorded spontaneous speech and sustained /a/ b...

Stress reaction provokes changes in the body involving cardiovascular alterations, autonomic reactions, neuroendocrine and immunologic as well as psychoneuroimmunologic changes. Both the primary and secondary effect of stress reaction may be of consequence for vocal function. The purpose of this questionnaire study was to determine the effect of st...

Voice disturbances cause significant disability for speech professionals and persons using plenty of speech in their work. It is important for a basic healthcare physician to know when to refer the patient to specialized care, speech therapist or occupational health care. A general practitioner should be able to carry out endoscopy of the vocal cor...

Objective: The aim of the study was to investigate if voice ergonomic risk factors in classrooms correlated with acoustic parameters of teachers' voice production. Methods: The voice ergonomic risk factors in the fields of working culture, working postures and indoor air quality were assessed in 40 classrooms using the Voice Ergonomic Assessment...

Objectives: The aim of the study was to investigate the connections between voice ergonomic risk factors found in classrooms and voice-related problems in teachers. Methods: Voice ergonomic assessment was performed in 39 classrooms in 14 elementary schools by means of a Voice Ergonomic Assessment in Work Environment--Handbook and Checklist. The...

Recently, Simberg et al. (2009) found genetic effects on a composite variable consisting of 6 vocal symptom items measuring dysphonia. The purpose of the present study was to determine genetic and environmental effects on the individual vocal symptoms in a population-based sample of Finnish twins. The sample comprised 1,728 twins (125 monozygotic a...

The present study investigated, for the first time, the long-term prognosis of hypersensitivity type of occupational laryngitis (OL). Thirteen patients with OL diagnosed in 1990–1993 at the Finnish Institute of Occupational Health participated in a questionnaire follow-up study. The records of the primary diagnostic investigations were also reviewe...

To explore the existence of genetic effects as well as the interaction between potential genetic effects and a voice-demanding occupation on dysphonia. One thousand seven hundred and twenty-eight Finnish twins (555 male; 1,173 female) born between 1961 and 1989 completed a questionnaire concerning vocal symptoms and occupation. The zygosity determi...

The objective of this clinical prospective study was to find out if laparoscopic Nissen fundoplication is an effective treatment in laryngopharyngeal reflux disease. Twenty-two consecutive patients, 16 female and 6 male, who were referred to laparoscopic fundoplication and operated by a senior gastroenterology surgeon were included in this study. T...

Allergic rhinitis and asthma are common among university students. Inhalant allergies have been considered to be a risk factor contributing to voice disorders. The purpose of this pilot study was to determine if students with confirmed respiratory allergies have frequently occurring vocal symptoms. A questionnaire concerning the prevalence of vocal...

Normal values of extra-esophageal reflux are difficult to determine owing to variation in the location of the proximal electrode, limited information on the ingestion of acidic food, different exclusion periods for meals, and poor reproducibility of measurement of extra-esophageal reflux. We studied whether ambulatory esophageal pH testing is distu...

Laparoscopic fundoplication is a routine surgical approach in the treatment of moderate or severe gastro-esophageal reflux disease. However, there are still contradictions regarding supraesophageal symptoms as an indication for surgery. The aim of this study was to determine the subjective symptomatic outcome and objective laryngeal findings after...

Previous studies of students studying to be teachers have indicated that these students commonly have voice disorders. Ideally, voice disorders should be treated before students start their work as teachers, but the resources for this treatment are often limited. This study examines whether group voice therapy is effective for teacher students. Acc...

Vocal symptoms and voice disorders among teachers were studied in 1988 using a questionnaire designed to obtain information on six vocal symptoms that had appeared during the past 2 years. Twelve percent of the 478 respondents reported vocal symptoms occurring weekly or more often. The study was repeated using the same questionnaire in 2001. The re...

Studies focusing on different groups of students show that the prevalence of vocal symptoms and voice disorder vary depending on the study populations. A previous study of vocal symptoms and voice disorders among teacher students has shown that 20% of the students studying to become teachers in comprehensive schools and upper secondary schools repo...

Vocal loading-related subjective symptoms were studied in a day-long vocal loading test. The voices of 40 female and 40 male voluntary young students were loaded by having them read aloud a novel for five times 45 min. The subjective symptoms that occurred during the vocal loading session were reported by filling in a questionnaire after each sessi...

Day care center teachers suffer from voice disorders more often than nurses do. Several risk factors may increase voice disorder prevalence of day care center teachers. The risk factors can be bound to their job content and manner of working i.e. having to raise their voice to attract the attention of the children and to offer them the possibility...

It is a common experience that vocal quality changes during a break in vocal loading. The purpose of the present study was (1) to analyse the effects of a short post-loading vocal rest in terms of changes in a large variety of voice parameters and (2) to assess the possible effects of gender and exposure factors on these changes. The voices of a ra...

The acceptance of voice disorders by day care center teachers as an occupational disease is not an invariably established practice. This is due to the lack of reliable evidence of a higher risk for voice disorders in this profession. To find out the risk of voice disorders, an epidemiological study was conducted among day care center teachers (n =...

Vocal warm-up was studied in terms of changes in voice parameters during a 45-minute vocal loading session in the morning. The voices of a randomly chosen group of 40 female and 40 male young students were loaded by having them read a novel aloud. The exposure groups (5 females and 5 males per cell) consisted of eight combinations of the following...

A recent study concerning voice disorders among future teachers showed that about 20% of the students had a voice disorder. Most of the disorders were organic. In the current study, we describe a voice-screening method that can be administered by the health care personnel in order to select students for further examination by the speech language th...

Many voice disorders are associated with vocal loading, but easy measurement of the vocal load has not been possible so far. To fulfil this need, an easily accessible method was developed and tested. Speaking time and speaking sound level can be recorded during normal work, and measurement can be made in a noisy environment. The measurement is made...

This paper presents an application of a linear model with correlated errors to the assessment of the precision of acoustic rhinometry in clinical medicine. The design of the reproducibility study involved 20 healthy subjects measured by five investigators with three replicate measurements of four variates taken from the right and left nasal cavitie...

One common way to describe one's voice in an objective way is to measure the sound levels of the softest (pianissimo) and loudest possible (fortissimo) phonations at given pitches (voice range profile measurement). However, the reliability of the measurement has not been thoroughly investigated. The aim of the present study was to describe the repe...

An epidemiological study was conducted in order to find out the prevalence of voice disorders among students studying to be teachers. Vocal symptoms were inquired of 226 students. Their voices were assessed perceptually by a speech therapist and those who had abnormal voice quality or reported several vocal symptoms were referred to a clinical exam...

This paper presents an application of a linear model with correlated errors to the assessment of the precision of acoustic rhinometry in clinical medicine. The design of the reproducibility study involved 20 healthy subjects measured by five investigators with three replicate measurements of four variates taken from the right and left nasal cavitie...

The effects of prolonged (5 × 45 minute) reading (vocal loading) on fundamental frequency (F0), sound pressure level (SPL), subglottal (intraroral) pressure (p), and two glottal flow waveform parameters (AC amplitude of glottal flow, f, and negative peak amplitude of differentiated flow (d) of normal female and male subjects (N = 80) were studied....

Professional speakers' voice disorders are often connected with environmental and ergonomic factors. The interaction of three such variables was investigated in a 1-day vocal loading test with 40 female and 40 male university students. The vocal loading (5 × 45 min) consisted of reading aloud under various combinations of humid or dry air condition...

The occurrence and causes of hairdressers' occupational skin and respiratory diseases were studied. Of a random sample of 500 female hairdressers aged 15-54 years, 355 were available for study. Of the 189 reporting work-related skin and respiratory symptoms in a computer-aided telephone interview on exposure and health, 130 underwent a physical exa...

Objectives The occurrence and causes of hairdressers' occupational skin and respiratory diseases were studied. Methods of a random sample of 500 female hairdressers aged 15-54 years, 355 were available for study. Of the 189 reporting work-related skin and respiratory symptoms in a computer-aided telephone interview on exposure and health, 130 under...

The effects of prolonged (5 x 45 min) reading in different ergonomic conditions on fundamental frequency (F0), sound pressure level (SPL), subglottal (intraoral) pressure (p) and two amplitude parameters of glottal flow waveforms obtained by inverse filtering (the negative peak amplitude of differentiated glottal flow, d, and the AC amplitude of th...

The effects of prolonged (5 x 45 min) reading in different environmental and ergonomic conditions on time-based glottal waveform parameters of normal female and male subjects (n = 80) were studied. The exposure groups (n = 5 females and males per cell) consisted of eight combinations of the following factors: (1) normal (< 65 dB) or high (> 65 dB)...

The effects of prolonged (5 x 45 min) reading (loading) on time-based glottal waveform parameters of normal female and male subjects (n = 80) were studied. Two rest (morning and noon) and three loading (two in the morning and one in the afternoon) samples were recorded and analyzed. The glottal waveforms were obtained by inverse filtering of the ac...

Hairdressers are exposed daily at their work to many different hair chemicals and dandruff. The work-related nasal symptoms are common, especially with hair bleaching and striping. There are some reports on hairdressers asthma, but publications concerning occupational rhinitis among hairdressers are very few. The purpose of this study is to investi...

Acoustic rhinometry (ARM) has been used to study the nasal cavity geometry and the response in nasal provocations. However, the use of ARM in the diagnosis of occupational rhinitis (OR) has not been reported. The purpose of this study was to find an ARM parameter and a limit value that could be used in provocation tests to express an objective chan...

Ten vocally untrained female university students vocalized /a:/ at five given pitches within the average female speaking range (196, 220, 262, 330, and 396 Hz) as softly as possible (pianissimo) and as loudly as musically acceptable (fortissimo). To study the repeatability of voice range profile (sound level) measurement, the procedure was repeated...

The diagnosis of occupational rhinitis (OR) must be better confirmed than in allergic rhinitis of other aetiology. A provocation test is required to confirm the causality between the disease and the work exposure. The purpose of this study has been to examine the feasibility of active anterior rhinomanometry and visual analogue scale in the diagnos...

Formaldehyde is commonly accepted to be an allergen and irritant. However, specifically diagnosed occupational respiratory diseases caused by formaldehyde are relatively rare. Occupational laryngitis was diagnosed in a 47-year-old dairy foreman. He had been exposed for 9 years to formaldehyde emitted from a milk-packing machine situated underneath...

Reports of allergic laryngitis are sparse. In some reports allergy has been mentioned as an aetiological factor, but the diagnosis has not been confirmed with provocation tests. This paper reports on 20 patients in order to show that laryngitis can be caused by organic substances and chemicals with mechanisms of immediate allergy or immediate type...

A classroom's acoustic design should be constructed so that the highest possible degree of speech intelligibility is achieved for teachers and pupils. Yet classrooms are a noisy and a reverberant environment for speech communication. The aim of this study was to find out the acceptable acoustic conditions for speech intelligibility measured with th...