#WorldVoiceDay: How to Handle a Vocally Demanding Job with a Voice Disorder
When your livelihood depends on a functional voice, the presence of a voice disorder requires a collective effort to adapt and accommodate to keep you productive.
Lesley F. Childs, MD, on behalf of the Voice Committee
Lesley F. Childs, MDMany occupations rely on the voice as the primary communication tool. When your livelihood depends on a functional voice, the presence of a voice disorder necessitates a collective effort to adapt and accommodate to keep you productive. The negative consequences of an unrecognized voice disorder are endless. An otolaryngologist (ENT doctor) is in a unique position to not only diagnose and treat voice disorders but, equally importantly, to help you advocate for optimal vocal health conditions in your place of work.
Voice disorders are known to impair productivity in the workplace by reducing efficiency—meaning workers keep doing their jobs, but less effectively (“presenteeism”).1 In a study examining the economic impact of vocal dysfunction in public school teachers in Miami-Dade County, Florida, costs related to missing work (“absenteeism”) were $1 million, while related costs related to presenteeism totaled about $12 million dollars per year.2 Voice-related disabilities are also associated with poorer general health, even when researchers take a patient’s other health conditions into account.3 The impact of voice disorders on physical, mental, and social health is immense and sometimes has serious consequences, especially for those who rely on their voice to make a living.
If you have a voice disorder that might be directly related to the vocal demands of your job, hoarseness should be considered an occupational hazard. If that is the case, it is important to educate yourself and take steps to protect yourself from voice injuries. Regardless of the cause of the voice disorder, many are unaware that these can be legally classified as disabilities, entitling individuals to workplace accommodations and time off for medical treatment (such as voice therapy appointments).
Examples of accommodations according to the Job Accommodation Network include restructuring job duties to reduce the total amount of speaking required and allowing the use of a portable voice amplifier.4 More specific examples of accommodations include more frequent voice rest breaks (e.g., for every X minutes of continuous talking/phone use, you should be allowed to have Y minutes of voice rest) throughout the workday or temporary shifts in work assignments to ones that are less vocally intensive. Often a voice therapist can help create individualized recommendations for accommodation purposes.
The role of the otolaryngologist as both a “scholar and advocate” for those with voice disorders in the workplace cannot be understated.5 By speaking to your doctor and learning more about the national and local disability legislation surrounding voice disorders, you can help foster a more vocal health-centered workplace environment for yourself and others.
In honor of World Voice Day 2024, remember to ask an otolaryngologist about accommodation options in the workplace to prioritize better vocal health.
World Voice Day Resources for You and Your Patients
For more information on maintaining vocal health, check out these other articles from the AAO-HNS Voice Committee in this issue of the Bulletin:
Giliberto JP, Zhu Q, Meyer TK. Development of a voice disorder work productivity inventory utilizing cognitive interviewing technique. Laryngoscope Investig Otolaryngol. 2016 Nov 22;1(6):180-184.
Rosow DE, Szczupak M, Saint-Victor S, Gerhard JD, DuPont C, Lo K. The economic impact of vocal attrition in public school teachers in Miami-Dade County. Laryngoscope. 2016 Mar;126(3):665-71.
DeVore EK, Carroll TL, Rosner B, Shin JJ. Can voice disorders matter as much as life-threatening comorbidities to patients' general health? Laryngoscope. 2020 Oct;130(10):2405-2411.
Isetti D, Eadie T. The Americans with Disabilities Act and Voice Disorders: Practical Guidelines for Voice Clinicians. J Voice. 2016 May;30(3):293-300.
Allen L, Hu A. Voice Disorders in the Workplace: A Scoping Review. J Voice. 2022 Apr 9:S0892-1997(22)00075-3.
Lesley F. Childs, MD
