Deficiencia, discapacidad y minusvalía asociadas a los problemas de voz y audición en profesores colombianos
Objetivos: 1. definir la ocurrencia de problemas de audición y de voz relacionados con el trabajo de docentes que contactaron la Junta Nacional de Evaluación de la Discapacidad de Colombia (NBDA) para su seguimiento; 2. identificar los factores individuales asociados a los problemas de audición y voz entre los profesores; 3. evaluar las limitaciones y restricciones debidas a problemas de audición y voz asociados al trabajo entre los participantes. Métodos: estudio retrospectivo. Se revisó la Base de Datos Nacional de la NBDA colombiana. Se analizó información sobre distribuciones de ocupación, características individuales y código de diagnóstico (CIE-10). Resultados: Los trastornos de comunicación entre los docentes que han contactado a la... Ver más
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Revista de Investigación e Innovación en Ciencias de la Salud - 2021
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Deficiencia, discapacidad y minusvalía asociadas a los problemas de voz y audición en profesores colombianos discapacidad de la comunicación Artículo de revista profesor enseñanza educación minusvalía discapacidad deficiencia vocología discapacidad auditiva problemas de la voz Deficiencia, discapacidad y minusvalía asociadas a los problemas de voz y audición en profesores colombianos Objetivos: 1. definir la ocurrencia de problemas de audición y de voz relacionados con el trabajo de docentes que contactaron la Junta Nacional de Evaluación de la Discapacidad de Colombia (NBDA) para su seguimiento; 2. identificar los factores individuales asociados a los problemas de audición y voz entre los profesores; 3. evaluar las limitaciones y restricciones debidas a problemas de audición y voz asociados al trabajo entre los participantes. Métodos: estudio retrospectivo. Se revisó la Base de Datos Nacional de la NBDA colombiana. Se analizó información sobre distribuciones de ocupación, características individuales y código de diagnóstico (CIE-10). Resultados: Los trastornos de comunicación entre los docentes que han contactado a la NBDA colombiana para seguimiento incluyeron problemas de la voz, con una prevalencia del 51%, y problemas de audición, con una prevalencia del 7%. Las profesoras que se han puesto en contacto con la NBDA colombiana para el seguimiento tenían 4 veces más probabilidades de ser identificadas con trastornos de la voz en comparación con sus colegas masculinos. Conclusiones: Si bien los maestros que contactaron a la NBDA colombiana para el seguimiento tienen una alta incidencia de trastornos de la voz, es más probable que los problemas de audición se consideren una condición debilitante. Una posible explicación es que los maestros que se comunicaron con la NBDA colombiana para el seguimiento continuaron trabajando incluso cuando muchos síntomas vocales eran evidentes, mientras que los problemas de audición evitarían que un maestro interactuara con los estudiantes, afectando así el proceso de enseñanza-aprendizaje. Sin embargo, tanto los problemas de voz como de audición, el desempeño laboral y la interacción social se ven afectados y, por lo tanto, la calidad de vida se reduce. Servilha EAM, Delatti MdA. Noise perception in the workplace and auditory and extra-auditory symptoms referred by university professors. Jornal da Sociedade Brasileira de Fonoaudiologia. 2012;24(3):233-8. Doi: https://doi.org/10.1590/S2179-64912012000300008 Ilomaki I, Leppanen K, Kleemola L, Tyrmi J, Laukkanen A, Vilkman E. Relationships between self-evaluations of voice and working conditions, background factors, and phoniatric findings in female teachers. Logopedics Phoniatrics Vocology. 2009;34(1):20-31. Doi: https://doi.org/10.1080/14015430802042013 De Medeiros A, Barreto S, Assuncao A. Voice disorders (dysphonia) in public school female teachers working in Belo Horizonte: prevalence and associated factors. Journal of Voice. 2008;22(6):676-87. Doi: https://doi.org/10.1016/j.jvoice.2007.03.008 Cantor Cutiva L, Burdorf A. Effects of noise and acoustics in schools on vocal health in teachers. Noise Health. 2015;17(74):17-22. Doi: https://doi.org/10.4103/1463-1741.149569 Hunter EJ, Tanner K, Smith ME. Gender differences affecting vocal health of women in vocally demanding careers. Logopedics Phoniatrics Vocology. 2011;36(3):128-36. Doi: https://doi.org/10.3109/14015439.2011.587447 Mattiske J, Oates J, Greenwood K. Vocal problems among teachers: a review of prevalence, causes, prevention, and treatment. Journal of Voice. 1998;12(4):489-99. Doi: https://doi.org/10.1016/S0892-1997(98)80058-1 Roy N, Merrill R, Thibeault S, Parsa R, Gray S, Smith E. Prevalence of voice disorders in teachers and the general population. Journal of Speech, Language, and Hearing Research. 2004;47(2):281-93. Doi: https://doi.org/10.1044/1092-4388(2004/023) Penteado RZ, Pereira IMTB. Qualidade de vida e saúde vocal de professores. Revista de Saúde Pública. 2007;41:236-43. Doi: https://doi.org/10.1590/S0034-89102007000200010 Cantor Cutiva LC, Burdorf A. Work-related determinants of voice complaints among school workers: An eleven-month follow-up study. American Journal of Speech-Language Pathology. 2016;25(4):590-7. Doi: https://doi.org/10.1044/2016_AJSLP-14-0191 Grillo MHM, Penteado RZ. Impacto da voz na qualidade de vida de professore(a)s do ensino fundamental. Pró-Fono Revista de Atualização Científica. 2005;17:311-20. Doi: https://doi.org/10.1590/s0104-56872005000300006 Roy N, Merrill R, Thibeault S, Gray S, Smith E. Voice disorders in teachers and the general population: Effects on work performance, attendance, and future career choices. Journal of Speech, Language, and Hearing Research. 2004;47(3):542-51. Doi: https://doi.org/10.1044/1092-4388(2004/042) Pekkarinen E, Himberg L, Pentti J. Prevalence of vocal symptoms among teachers compared to nurses-a questionnaire study. Scandinavian Journal of Logopedics and Phoniatrics. 1992;17:112-7. Doi: https://doi.org/10.3109/14015439209098721 Fritzell B. Voice disorders and occupations. Log Phon Vocol. 1996;21(1):7-12. Doi: https://doi.org/10.3109/14015439609099197 Preciado-Lopez J, Perez-Fernandez C, Calzada-Uriondo M, Preciado-Ruiz P. Epidemiological study of voice disorders among teaching professionals of La Rioja, Spain. Journal of Voice. 2008;22(4):489-508. Doi: https://doi.org/10.1016/j.jvoice.2006.11.008 Lane H, Tranel B. The Lombard Sign and the Role of Hearing in Speech. Journal of Speech and Hearing Research. 1971;14(4):677-709. Doi: https://doi.org/10.1044/jshr.1404.677 Presidencia de la República de Colombia. Decree 917 of 1999 (Decreto 917 de 1999). Bogotá D.C.; 1999. Rondinelli R, Genovese E, Katz R, Mayer T, Mueller K, Ranavaya M. Guides to the evaluation of permanent impairment. Chicago: American Medical Association press; 2009. Doi: https://doi.org/10.1001/978-1-57947-888-9 Maldonado G, Greenland S. Simulation Study of Confounder-Selection Strategies. American Journal of Epidemiology. 1993;138(11):923-36. Doi: https://doi.org/10.1093/oxfordjournals.aje.a116813 Cantor Cutiva L, Fajardo A, Burdorf A. Associations between self-perceived voice disorders in teachers, perceptual assessment by speech-language pathologists, and instrumental analysis. International Journal of Speech-Language Pathology. 2016;18(6):550-9. Doi: https://doi.org/10.3109/17549507.2016.1143969 Jiang T. Can noise levels at school gymnasia cause a hearing loss: A case study of a physical education teacher. Journal of the Acoustical Society of America. 1997;101(5):3069. Doi: https://doi.org/10.1121/1.418754 Chesky K. Schools of music and conservatories and hearing loss prevention. International Journal of Audiology. 2011;50(sup1):S32-S7. Doi: https://doi.org/10.3109/14992027.2010.540583 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. Journal of Speech, Language, and Hearing Research. 2020;2:509-532. Doi: https://doi.org/10.1044/2019_JSLHR-19-00057 Text http://purl.org/coar/access_right/c_abf2 info:eu-repo/semantics/openAccess http://purl.org/coar/version/c_970fb48d4fbd8a85 info:eu-repo/semantics/publishedVersion http://purl.org/redcol/resource_type/ART http://purl.org/coar/resource_type/c_2df8fbb1 http://purl.org/coar/resource_type/c_6501 info:eu-repo/semantics/article Cantor Cutiva L, Burdorf A. Medical Costs and Productivity Costs Related to Voice Symptoms in Colombian Teachers. Journal of Voice. 2015;29(6):776.e15-.e22. Doi: https://doi.org/10.1016/j.jvoice.2015.01.005 Vilkman E. Voice problems at work: A challenge for occupational safety and health arrangement. Folia Phoniatr Logop. 2000 Jan-Jun;52(1-3):120-5. Doi: https://doi.org/10.1159/000021519 Sala E, Rantala L. Acoustics and activity noise in school classrooms in Finland. Applied Acoustics. 2016;114:252-9. Doi: https://doi.org/10.1016/j.apacoust.2016.08.009 Lindblad A-C, Rosenhall U, Olofsson Å, Hagerman B. Tinnitus and Other Auditory Problems-Occupational Noise Exposure below Risk Limits May Cause Inner Ear Dysfunction. PloS one. 2014;9(5):e97377. Doi: https://doi.org/10.1371/journal.pone.0097377 Occupational Safety and Health Administration (OSHA). 1910.95, Occupational noise exposure. In: United States Department of Labor, editor. Washington DC: United States Department of Labor; 2011. McAllister AM, Granqvist S, Sjölander P, Sundberg J. Child voice and noise: a pilot study of noise in day cares and the effects on 10 children's voice quality according to perceptual evaluation. Journal of Voice. 2009;23(5):587-93. Doi: https://doi.org/10.1016/j.jvoice.2007.10.017 Ramig LO, Verdolini K. Treatment Efficacy: Voice Disorders. Journal of Speech, Language, and Hearing Research. 1998;41(1):S101-S16. Doi: https://doi.org/10.1044/jslhr.4101.s101 Presidencia de la República de Colombia. Decree 1295 of 1994 (Decreto 1295 de 1994). In: Ministerio de Trabajo y Seguridad Social, editor. Bogotá D.C.; 1994. Behar A, MacDonald E, Lee J, Cui J, Kunov H, Wong W. Noise exposure of music teachers. Journal of Occupational and Environmental Hygiene. 2004 Apr;1(4):243-7. Doi: https://doi.org/10.1080/15459620490432178 Cutietta R, Klich R, Royse D, Rainbolt H. The Incidence of Noise-Induced Hearing Loss among Music Teachers. Journal of Research in Music Education. 1994;42(4):318-30. Doi: https://doi.org/10.2307/3345739 Zollinger SA, Brumm H. The evolution of the Lombard effect: 100 years of psychoacoustic research. Behaviour. 2011;148(11-13):1173-98. Doi: https://doi.org/10.1163/000579511X605759 Presidencia de la República de Colombia. Decree 1477 of 2014 (Decreto 1477 de 2014). Bogotá D.C.; 2014. Carrillo-Gonzalez, A, Camargo-Mendoza, M, & Cantor-Cutiva, LC.. Relationship between sleep quality and stress with voice functioning among college professors: a systematic review and meta-analysis. Journal of Voice. 2021;35(3):499-e13. Doi: https://doi.org/10.1016/j.jvoice.2019.11.001 World Health Organization (WHO). International classification of impairments, disabilities and handicaps: a manual of classification relating to the consequences of disease. Geneve: World Health Organization; 1980. disability Journal article 1 3 vocology teacher teaching education handicap impairment application/pdf communication disability hearing impairment Voice disorders Moreno-Angarita, Marisol Hunter, Eric J Cuervo-Diaz, Diana Elizabeth Cantor-Cutiva, Lady Catherine Objectives: 1. define the occurrence of work-related hearing problems and voice disorders among teachers that have contacted the Colombian National Board of Disability Assessment (NBDA) for follow-up; 2. identify individual associated factors of hearing problems and voice disorders among teachers; 3. assess the limitations and restrictions due to hearing problems and voice disorders among these participants. Methods: Retrospective study. The National Database of the Colombian NBDA was reviewed. Information on distributions of occupation, individual characteristics, and diagnosis code (ICD-10) was analyzed. Results: Communication disorders among teachers that have contacted the Colombian NBDA for follow-up included voice disorders, with a prevalence of 51%, and hearing problems, with a prevalence of 7%. Female teachers who have contacted the Colombian NBDA for follow-up were 4 times more likely to be identified as having voice disorders compared with their male colleagues. Conclusions: While teachers that have contacted the Colombian NBDA for follow-up have a high occurrence of voice disorders, hearing problems are more likely to be stated as a debilitating condition. One possible explanation is that teachers who contacted the Colombian NBDA for follow-up continued working even when many voice symptoms were evident, while hearing problems would prevent a teacher from interacting with students, thereby affecting the teaching-learning process sooner. Nevertheless, with both voice and hearing problems, work performance and social interaction is affected, and, therefore, quality of life is reduced. Cantor Cutiva L, Burdorf A. Factors associated with voice-related quality of life among teachers with voice complaints. Journal of Communication Disorders. 2014;52:134-42. Doi: https://doi.org/10.1016/j.jcomdis.2014.05.003 Publication application/xml American Speech-Language-Hearing Association (ASHA). Definitions of communication disorders and variations. Maryland: American Speech-Language-Hearing Association; 1993. Doi: https://doi.org/10.1044/policy.RP1993-00208 Revista de Investigación e Innovación en Ciencias de la Salud Yang X, Ge C, Hu B, Chi T, Wang L. Relationship between quality of life and occupational stress among teachers. Public Health. 2009;123(11):750-5. Doi: https://doi.org/10.1016/j.puhe.2009.09.018 Sjödin F, Kjellberg A, Knutsson A, Landström U, Lindberg L. Noise exposure and auditory effects on preschool personnel. Noise Health. 2012;14(57):72-82. Doi: https://doi.org/10.4103/1463-1741.95135 Garcia Martins RH, Mendes Tavares EL, Lima Neto AC, Fioravanti MP. Occupational hearing loss in teachers: a probable diagnosis. Revista Brasileira de Otorrinolaringologia. 2007;73(2):239-44. Doi: https://doi.org/10.1016/S1808-8694(15)31072-7 https://riics.info/index.php/RCMC/article/view/48 Carrillo-González A, Atará-Piraquive ÁP. Vocal health and stress. Revista de Investigación e Innovación en Ciencias de la Salud. 2020;2(2):102-110. Doi: https://doi.org/10.46634/riics.38 Nerrière E, Vercambre M-N, Gilbert F, Kovess-Masféty V. Voice disorders and mental health in teachers: a cross-sectional nationwide study. BMC Public Health. 2009;9(1):370. Doi: https://doi.org/10.1186/1471-2458-9-370 Inglés https://creativecommons.org/licenses/by-nc-sa/4.0/ Revista de Investigación e Innovación en Ciencias de la Salud - 2021 Simberg S, Santtila P, Soveri A, Varjonen M, Sala E, Sandnabba NK. Exploring genetic and environmental effects in dysphonia: a twin study. Journal of Speech, Language, and Hearing Research. 2009;52(1):153-63. Doi: https://doi.org/10.1044/1092-4388(2008/07-0095) Fundación Universitaria María Cano OECD. Education at a Glance 2015: OECD Indicators. Paris: OECD Publishing; 2015. Cantor Cutiva L, Vogel I, Burdorf A. Voice disorders in teachers and their associations with work-related factors: A systematic review. Journal of Communication Disorders. 2013;46(2):143-55. Doi: https://doi.org/10.1016/j.jcomdis.2013.01.001 21 https://riics.info/index.php/RCMC/article/download/48/118 https://riics.info/index.php/RCMC/article/download/48/76 4 https://doi.org/10.46634/riics.48 10.46634/riics.48 2665-2056 2021-08-03T17:53:15Z 2021-08-03T17:53:15Z 2021-08-03 |
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FUNDACION UNIVERSITARIA MARIA CANO |
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Colombia |
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Revista de Investigación e Innovación en Ciencias de la Salud |
title |
Deficiencia, discapacidad y minusvalía asociadas a los problemas de voz y audición en profesores colombianos |
spellingShingle |
Deficiencia, discapacidad y minusvalía asociadas a los problemas de voz y audición en profesores colombianos Moreno-Angarita, Marisol Hunter, Eric J Cuervo-Diaz, Diana Elizabeth Cantor-Cutiva, Lady Catherine discapacidad de la comunicación profesor enseñanza educación minusvalía discapacidad deficiencia vocología discapacidad auditiva problemas de la voz disability vocology teacher teaching education handicap impairment communication disability hearing impairment Voice disorders |
title_short |
Deficiencia, discapacidad y minusvalía asociadas a los problemas de voz y audición en profesores colombianos |
title_full |
Deficiencia, discapacidad y minusvalía asociadas a los problemas de voz y audición en profesores colombianos |
title_fullStr |
Deficiencia, discapacidad y minusvalía asociadas a los problemas de voz y audición en profesores colombianos |
title_full_unstemmed |
Deficiencia, discapacidad y minusvalía asociadas a los problemas de voz y audición en profesores colombianos |
title_sort |
deficiencia, discapacidad y minusvalía asociadas a los problemas de voz y audición en profesores colombianos |
description |
Objetivos: 1. definir la ocurrencia de problemas de audición y de voz relacionados con el trabajo de docentes que contactaron la Junta Nacional de Evaluación de la Discapacidad de Colombia (NBDA) para su seguimiento; 2. identificar los factores individuales asociados a los problemas de audición y voz entre los profesores; 3. evaluar las limitaciones y restricciones debidas a problemas de audición y voz asociados al trabajo entre los participantes.
Métodos: estudio retrospectivo. Se revisó la Base de Datos Nacional de la NBDA colombiana. Se analizó información sobre distribuciones de ocupación, características individuales y código de diagnóstico (CIE-10).
Resultados: Los trastornos de comunicación entre los docentes que han contactado a la NBDA colombiana para seguimiento incluyeron problemas de la voz, con una prevalencia del 51%, y problemas de audición, con una prevalencia del 7%. Las profesoras que se han puesto en contacto con la NBDA colombiana para el seguimiento tenían 4 veces más probabilidades de ser identificadas con trastornos de la voz en comparación con sus colegas masculinos.
Conclusiones: Si bien los maestros que contactaron a la NBDA colombiana para el seguimiento tienen una alta incidencia de trastornos de la voz, es más probable que los problemas de audición se consideren una condición debilitante. Una posible explicación es que los maestros que se comunicaron con la NBDA colombiana para el seguimiento continuaron trabajando incluso cuando muchos síntomas vocales eran evidentes, mientras que los problemas de audición evitarían que un maestro interactuara con los estudiantes, afectando así el proceso de enseñanza-aprendizaje. Sin embargo, tanto los problemas de voz como de audición, el desempeño laboral y la interacción social se ven afectados y, por lo tanto, la calidad de vida se reduce.
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description_eng |
Objectives: 1. define the occurrence of work-related hearing problems and voice disorders among teachers that have contacted the Colombian National Board of Disability Assessment (NBDA) for follow-up; 2. identify individual associated factors of hearing problems and voice disorders among teachers; 3. assess the limitations and restrictions due to hearing problems and voice disorders among these participants.
Methods: Retrospective study. The National Database of the Colombian NBDA was reviewed. Information on distributions of occupation, individual characteristics, and diagnosis code (ICD-10) was analyzed.
Results: Communication disorders among teachers that have contacted the Colombian NBDA for follow-up included voice disorders, with a prevalence of 51%, and hearing problems, with a prevalence of 7%. Female teachers who have contacted the Colombian NBDA for follow-up were 4 times more likely to be identified as having voice disorders compared with their male colleagues.
Conclusions: While teachers that have contacted the Colombian NBDA for follow-up have a high occurrence of voice disorders, hearing problems are more likely to be stated as a debilitating condition. One possible explanation is that teachers who contacted the Colombian NBDA for follow-up continued working even when many voice symptoms were evident, while hearing problems would prevent a teacher from interacting with students, thereby affecting the teaching-learning process sooner. Nevertheless, with both voice and hearing problems, work performance and social interaction is affected, and, therefore, quality of life is reduced.
|
author |
Moreno-Angarita, Marisol Hunter, Eric J Cuervo-Diaz, Diana Elizabeth Cantor-Cutiva, Lady Catherine |
author_facet |
Moreno-Angarita, Marisol Hunter, Eric J Cuervo-Diaz, Diana Elizabeth Cantor-Cutiva, Lady Catherine |
topicspa_str_mv |
discapacidad de la comunicación profesor enseñanza educación minusvalía discapacidad deficiencia vocología discapacidad auditiva problemas de la voz |
topic |
discapacidad de la comunicación profesor enseñanza educación minusvalía discapacidad deficiencia vocología discapacidad auditiva problemas de la voz disability vocology teacher teaching education handicap impairment communication disability hearing impairment Voice disorders |
topic_facet |
discapacidad de la comunicación profesor enseñanza educación minusvalía discapacidad deficiencia vocología discapacidad auditiva problemas de la voz disability vocology teacher teaching education handicap impairment communication disability hearing impairment Voice disorders |
citationvolume |
3 |
citationissue |
1 |
publisher |
Fundación Universitaria María Cano |
ispartofjournal |
Revista de Investigación e Innovación en Ciencias de la Salud |
source |
https://riics.info/index.php/RCMC/article/view/48 |
language |
Inglés |
format |
Article |
rights |
http://purl.org/coar/access_right/c_abf2 info:eu-repo/semantics/openAccess https://creativecommons.org/licenses/by-nc-sa/4.0/ Revista de Investigación e Innovación en Ciencias de la Salud - 2021 |
references_eng |
Servilha EAM, Delatti MdA. Noise perception in the workplace and auditory and extra-auditory symptoms referred by university professors. Jornal da Sociedade Brasileira de Fonoaudiologia. 2012;24(3):233-8. Doi: https://doi.org/10.1590/S2179-64912012000300008 Ilomaki I, Leppanen K, Kleemola L, Tyrmi J, Laukkanen A, Vilkman E. Relationships between self-evaluations of voice and working conditions, background factors, and phoniatric findings in female teachers. Logopedics Phoniatrics Vocology. 2009;34(1):20-31. Doi: https://doi.org/10.1080/14015430802042013 De Medeiros A, Barreto S, Assuncao A. Voice disorders (dysphonia) in public school female teachers working in Belo Horizonte: prevalence and associated factors. Journal of Voice. 2008;22(6):676-87. Doi: https://doi.org/10.1016/j.jvoice.2007.03.008 Cantor Cutiva L, Burdorf A. Effects of noise and acoustics in schools on vocal health in teachers. Noise Health. 2015;17(74):17-22. Doi: https://doi.org/10.4103/1463-1741.149569 Hunter EJ, Tanner K, Smith ME. Gender differences affecting vocal health of women in vocally demanding careers. Logopedics Phoniatrics Vocology. 2011;36(3):128-36. Doi: https://doi.org/10.3109/14015439.2011.587447 Mattiske J, Oates J, Greenwood K. Vocal problems among teachers: a review of prevalence, causes, prevention, and treatment. Journal of Voice. 1998;12(4):489-99. Doi: https://doi.org/10.1016/S0892-1997(98)80058-1 Roy N, Merrill R, Thibeault S, Parsa R, Gray S, Smith E. Prevalence of voice disorders in teachers and the general population. Journal of Speech, Language, and Hearing Research. 2004;47(2):281-93. Doi: https://doi.org/10.1044/1092-4388(2004/023) Penteado RZ, Pereira IMTB. Qualidade de vida e saúde vocal de professores. Revista de Saúde Pública. 2007;41:236-43. Doi: https://doi.org/10.1590/S0034-89102007000200010 Cantor Cutiva LC, Burdorf A. Work-related determinants of voice complaints among school workers: An eleven-month follow-up study. American Journal of Speech-Language Pathology. 2016;25(4):590-7. Doi: https://doi.org/10.1044/2016_AJSLP-14-0191 Grillo MHM, Penteado RZ. Impacto da voz na qualidade de vida de professore(a)s do ensino fundamental. Pró-Fono Revista de Atualização Científica. 2005;17:311-20. Doi: https://doi.org/10.1590/s0104-56872005000300006 Roy N, Merrill R, Thibeault S, Gray S, Smith E. Voice disorders in teachers and the general population: Effects on work performance, attendance, and future career choices. Journal of Speech, Language, and Hearing Research. 2004;47(3):542-51. Doi: https://doi.org/10.1044/1092-4388(2004/042) Pekkarinen E, Himberg L, Pentti J. Prevalence of vocal symptoms among teachers compared to nurses-a questionnaire study. Scandinavian Journal of Logopedics and Phoniatrics. 1992;17:112-7. Doi: https://doi.org/10.3109/14015439209098721 Fritzell B. Voice disorders and occupations. Log Phon Vocol. 1996;21(1):7-12. Doi: https://doi.org/10.3109/14015439609099197 Preciado-Lopez J, Perez-Fernandez C, Calzada-Uriondo M, Preciado-Ruiz P. Epidemiological study of voice disorders among teaching professionals of La Rioja, Spain. Journal of Voice. 2008;22(4):489-508. Doi: https://doi.org/10.1016/j.jvoice.2006.11.008 Lane H, Tranel B. The Lombard Sign and the Role of Hearing in Speech. Journal of Speech and Hearing Research. 1971;14(4):677-709. Doi: https://doi.org/10.1044/jshr.1404.677 Presidencia de la República de Colombia. Decree 917 of 1999 (Decreto 917 de 1999). Bogotá D.C.; 1999. Rondinelli R, Genovese E, Katz R, Mayer T, Mueller K, Ranavaya M. Guides to the evaluation of permanent impairment. Chicago: American Medical Association press; 2009. Doi: https://doi.org/10.1001/978-1-57947-888-9 Maldonado G, Greenland S. Simulation Study of Confounder-Selection Strategies. American Journal of Epidemiology. 1993;138(11):923-36. Doi: https://doi.org/10.1093/oxfordjournals.aje.a116813 Cantor Cutiva L, Fajardo A, Burdorf A. Associations between self-perceived voice disorders in teachers, perceptual assessment by speech-language pathologists, and instrumental analysis. International Journal of Speech-Language Pathology. 2016;18(6):550-9. Doi: https://doi.org/10.3109/17549507.2016.1143969 Jiang T. Can noise levels at school gymnasia cause a hearing loss: A case study of a physical education teacher. Journal of the Acoustical Society of America. 1997;101(5):3069. Doi: https://doi.org/10.1121/1.418754 Chesky K. Schools of music and conservatories and hearing loss prevention. International Journal of Audiology. 2011;50(sup1):S32-S7. Doi: https://doi.org/10.3109/14992027.2010.540583 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. 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