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Every year a number of teachers and early years workers suffer from voice strain exacerbated by prolonged use
of their voice. Some even leave the profession because of it. Martin Hodgson, an education and healthcare
consultant, explores the issue and looks at what schools and early years providers can do to reduce the risks.
Teachers and those working in early years rely upon their voices to carry out their work. But voice strain is a
common complaint. Many accept it as an inevitable part of the job and carry on despite the pain involved. Some
require periods of sickness absence as their voice recovers, but some leave the profession altogether.
In the education and early years sectors, staff use their voices for prolonged periods. Mild voice loss is common.
Occasionally it is serious and can lead to permanent voice damage.
The most common cause is shouting or speaking with a loud or raised voice for a protracted time. In music it can
be caused by long periods of singing.
There may be many reasons for frequently shouting or talking loudly. For instance, members of staff may develop
the habit of raising or lowering the pitch of their voices in order to be authoritative. They may also need to raise
their voice to overcome background noise or poor room acoustics.
Excessive throat mucus is both a cause and a symptom. Voice strain causes thick secretions of mucus. These in
turn affect voice quality and voice control. Throat clearing or coughing may help temporarily, but habitual throat
clearing will generate more mucus and make the vocal folds sore and inflamed.
Excessive mucus generation can also be caused by dehydration, food sensitivities, airborne irritants, inhalers, poor
air quality and colds or upper respiratory infections.
Chest infections and laryngitis are common complications of voice strain. Laryngitis is a severe inflammation of
the larynx which can make talking very painful.
Continuing to work with untreated severe voice strain or with laryngitis can cause long-term voice damage.
Disabled employees are protected against discrimination and the employer is under a duty to make reasonable
adjustments where any work arrangements or the physical features of the workplace put a disabled person at a
disadvantage.
For instance, in schools and early years services, reasonable adjustments could be made to reduce the strain on
the speaker’s voice.
A voice care risk assessment should be completed as necessary, especially in situations where a member of staff
complains about voice strain symptoms or where he or she experiences heavy voice use. Newly qualified teachers
may have higher risk levels than established staff as they may be less used to prolonged voice work.
If a risk is identified, appropriate preventive measures must be put in place. This can include information and
training for staff and changes to the physical environment or working arrangements. Records should be kept of
staff training.
Failure to complete a risk assessment and to take necessary action to control risk may leave the employer
vulnerable to legal action.
Staff should be encouraged to avoid excessive throat clearing and to sip water instead as this will also deal with
dehydration. They should keep a bottle of water handy and avoid things that can cause dehydration, such as
excessive consumption of alcohol, caffeine and very hot foods.
There are a number of remedies for persistent nasal congestion, including nasal sprays, oral inhalers, medications
and other treatments. Staff should use the best strategy for their own bodies. If in doubt, they should see their GP.
Staff suffering from these symptoms should visit their GP, who may refer them to a throat specialist. Medical
checks may include a microlaryngoscopy — a vocal chord examination. Treatment may include a referral for
speech therapy.
If a staff member has to take sick leave, a referral to an occupational health service may be required to advise the
employer about their return to work.
Portable personal amplification systems might help in some cases. However, they do not tackle the foundation of
voice problems and are not a substitute for prevention strategies and voice training.
Further information
The Voice Care Network (UK) is a learning and teaching organisation that brings together speech and language
therapy and voice coaching. It delivers specialist voice workshops for professional occupational voice user groups
and publishes guidance (http://www.voicecare.org.uk) on its website.
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