257 Adherence to voice therapy recommendations is associated with preserved fitness-for-work among teachers with occupational voice disorders

Introduction Vocal problems among teachers are considered a common professional hazard and a significant source of disability, leading to reductions in quality-of-life and professional capacities. Factors related to fitness-for-work reductions were not evaluated so far. Recommendations for voice-therapy, rest and microphone use are common interventions in occupational medicine aimed at preserving the working capability of these teachers and reducing work disability. Research on the impact of such interventions on employment capacity is lacking. The aims of the study regarding dysphonic teachers referred to occupational medicine clinic: evaluate employment outcomes following voice-therapy, voice rest and microphone use, and identify other predictors to limitations in fitness-for-work. Methods Teachers who were first referred to occupational medicine clinic due to voice disorders between 1/2007 and 12/2012 were followed-up. Data were collected from medical records and from interviews conducted in 2014. Logistic regression models were utilised to assess associations between interventions and other covariates, and employment outcomes. Survival analysis was performed to evaluate association between undergoing voice-therapy and length of retained fitness-for-work. Results A sample of 153 dysphonic teachers comprised the prospective study cohort, which was followed for 2–8 years. Thirty-four (22.2%) suffered declines in working capabilities. Voice-therapy was protective against such declines [OR=0.05(0.01–0.27)], in contrast to voice rest and microphone use. Compliance with voice-therapy recommendation was less than 50%. Most of declines in fitness-for-work among non-compliant teachers occurred within 20 months after referral. Other predictors were associated with work fitness reduction. Discussion Voice-therapy, especially when instituted early, is the strongest predictor for retaining fitness-for-work among dysphonic teachers. Pilot study with employers is warranted to estimate compliance and economic feasibility of preventive measures including voice-therapy aimed at reducing disability and preserving work capacities.