Prevalence and risk factors of voice disorders among Palestinian university faculty: impact on voice-related quality of life

Abstract

Voice disorders represent a significant occupational hazard for individuals in vocally demanding professions, particularly educators, adversely affecting their quality of life (QoL) and job performance. Although extensive research has focused on voice disorders among primary and secondary school teachers, university teaching faculty represent a distinct group warranting dedicated study, particularly in Palestine, due to the unique linguistic and cultural context, financial challenges, psychological stress, and educational barriers associated with the region’s prolonged political conflict and instability. This study aims to fill this gap by investigating various aspects of voice disorders among Palestinian university faculty, including measuring the prevalence of perceived voice disorders (PVDs), identifying risk factors, examining vocal tract discomfort (VTD) symptoms, and investigating their impact on QoL. A cross-sectional survey was conducted using an online self-reported questionnaire completed by 502 faculty members from 14 West Bank universities, recruited via convenience sampling through institutional email invitations. Data were collected using a newly developed, content-validated vocal risk factor questionnaire and three standardised instruments: the Voice Handicap Index-10 (VHI-10), Vocal Tract Discomfort (VTD), and Voice- Related Quality of Life (V-RQOL). Participants were categorised into two groups based on their VHI-10 scores: those with perceived voice disorders (PVDs, VHI-10 > 11) and those with non-perceived voice disorders (NPVDs, VHI-10 ≤ 11). Findings revealed that nearly one-third of Palestinian faculty had PVDs, experiencing significantly higher frequency and severity of VTD symptoms and markedly poorer QoL, especially in the functional and physical domains, compared to those with NPVDs. Key occupational risk factors identified include high background noise, large class sizes, high weekly teaching hours, increased vocal loudness, exposure to air pollutants, and engagement in additional careers. Behavioural factors such as stress and anxiety, alongside health conditions like nasal allergies, were also significant contributors. This study offers valuable insights into the occupational vocal health challenges faced by Palestinian faculty, highlighting the need for universities to recognise these issues and for faculty to increase awareness. It emphasises the urgent need for targeted voice care interventions and policy measures to mitigate voice disorder risks, ultimately promoting vocal health and enhancing QoL.