Predictors and consequences of voice disorders in teachers: A systematic review

Background Voice disorders are among the most frequent occupational health problems in teachers, affecting vocal performance and quality of life. Following the PRISMA 2020 statement, this systematic review identifies the main predictors and consequences of voice disorders in teachers and provides an updated synthesis of evidence published between 1993 and 2023. Methods A systematic search was conducted in Web of Science, Scopus, and EBSCOhost using terms related to “voice disorders”, “teachers”, “risk factors”, and “consequences”. Studies were included if they addressed predictors and/or consequences of dysphonia caused by maladaptive vocal behaviors, used detailed empirical designs, and focused exclusively on teachers (from preschool to university levels, including preservice teachers). Only articles in English or Spanish were considered. Exclusion criteria comprised interventional studies, reviews, book chapters, and research on other populations. Data extraction and quality assessment were performed independently by two reviewers, and only studies rated as excellent quality (100%) were included to minimize bias. Results Twenty-one studies met the inclusion criteria after screening 108 records, with sample sizes ranging from 12 to 1980 teachers. Predictors included personal risk factors, vocal symptoms, and work-related risk factors subdivided into environmental occupational and organizational work factors. Acoustic parameters (fundamental frequency, jitter, shimmer, and signal-to-noise ratio) were analyzed as vocal indicators. Consequences were mainly absenteeism, presenteeism, and reduced quality of life, although heterogeneity and potential publication bias should be considered. Conclusions Voice disorders in teachers have a multifactorial origin, highlighting the need for preventive interventions addressing both individual and work-related factors.