UNMC Researchers find Telemarketers More Susceptible to Voice Disorders

Researchers at the University of Nebraska Medical Center have found

telemarketers have a higher prevalence of voice problems than the general

population. They say the problems affect productivity and are associated

with known risk factors.

The results of the study, funded and conducted by the UNMC Department

of Head and Neck Surgery, were presented Sept. 9 at the American Academy

of OtolaryngologyHead and Neck Surgery Foundation annual meeting in Denver,

Colo.

The study is thought to be one of the first on voice disorders in telemarketers.

According to the Omaha Chamber of Commerce, about 20,000 people are employed

in the telemarketing industry in the Omaha area. At least another 30,000

are employed in other jobs that require extended time on the telephone.

Occupational voice disorders may be the result of the repetitive movement

or collision of the vocal folds. Vocal attrition can be described as

the wear and tear of the vocal mechanism and overall reduction in vocal

capabilities.  Recent studies have shown an association between voice

problems and vocally demanding jobs such as teaching, singing and aerobics

instruction. In industrialized societies, voice problems can affect about

one-third of the labor force where people rely on voice as their primary

work tool.

The UNMC study was conducted last year at six companies in Omaha and

Lincoln: one outbound telemarketing firm, three reservations centers, one

messaging company, and one telephone survey research firm. Researchers

used questionnaires to test their hypothesis.

Of 373 telemarketing employees, 81.5 percent, or 304 employees, completed

a survey. Their responses remained anonymous and the employers approved

of the research. Researchers compared the groups responses to a control

group of 187 community college students similar to the telemarketers in

age range, education level, and smoking status.

The questionnaire polled the groups on demographic, vocational, personality

and biological risk factors for voice problems such as medication usage;

smoking; consumption of caffeinated versus non-caffeinated beverage; amount,

speed, and volume of social speech; general activity level; and participation

in vocally demanding activities. Telemarketers also were asked about the

quality of their voice at the beginning and end of a shift; impact of any

symptoms on the employee’s work; and social life.

Researchers found a significant increase in the prevalence of symptoms

of vocal attrition in telemarketers as compared to the control group of

students. The telemarketing group was twice as likely to have one or more

symptoms of vocal attrition. In addition, 30 percent reported their work

was affected by symptoms.

Telemarketers who said their work was affected by their voice problems

averaged five symptoms, tended to be female and were more likely to smoke,

take drying medications, be sedentary and have sinus problems and frequent

colds.

Voice problems not only decrease productivity, they are an occupational

problem and can be compared to repetitive motion injuries like those associated

with carpal tunnel, said Frederic Ogren, M.D., clinical associate professor,

UNMC Department of Head and Neck Surgery, and principal investigator of

the study titled, Prevalence and Risk Factors for Voice Problems Among

Telemarketers. Omaha has a large group of telemarketers and thats one

of the reasons we decided to do this study.

Dr. Ogren, who now works in private practice and teaches parttime at

UNMC, said most of the voice problems he and the other researchers found

are treatable by staying hydrated to prevent drying out of vocal cords

and to avoid stressing the vocal cords by speaking normally.

The impetus for the study began several years ago when Dr. Ogden and

Marsha Sullivan, speech pathologist at the Munroe-Meyer Institute at UNMC,

began to see more patients with voice disorders who were employed as telemarketers.

We have seen a variety of vocal conditions, from benign growths on

their vocal cords resulting from continual use, to swollen vocal cords

that caused chronic hoarseness, said Sullivan. But not all telemarketers

have these problems.

Researchers expected to find that people working eight hours or more

would have more voice problems, but that wasnt necessarily the case, said

Katherine Jones, of the UNMC Department of Preventive and Societal Medicine

and first author of the study.

To know who is most at risk for voice problems, a comprehensive evaluation

needs to be done on a persons lifestyle and medical history, Jones said.

Its not a simple answer of who is more at risk. You cant talk non-stop

for eight hours and not have it affect your voice.

Evaluation of occupational voice disorders must encompass all of the

determinants of health status, and treatment must focus on modifiable risk

factors, not just reduction of occupational vocal load.

Although voice problems vary with individuals, Sullivan said some remedies

may include drinking plenty of water, not smoking, proper posture, speaking

at a normal rate, stress management and getting enough sleep.

The researchers say more studies need to be done in this area of research

and agree employers and employees need to share responsibility in preventing

and treating voice problems.

We have learned there are steps employers and employees can take that

may help in terms of prevention of voice problems and maintaining productivity

in this population of telemarketers, said Dr. Sigmon, a UNMC physician

who specializes in disorders of the ear, nose and throat and who also worked

on the study. UNMC is a resource in the diagnosis, management and education

of these types of problems.

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