# Dysphonia in Occupational Voice Users: Risk Factors, Causes and Socioepidemiological Profiles

## TL;DR

This study examines dysphonia in professional voice users in Serbia, identifying risk factors and socioepidemiological patterns.

## Contribution

The study provides insights into the causes and treatment of dysphonia among occupational voice users with moderate vocal demands.

## Key findings

- Dysphonia is more common in female occupational voice users.
- Smoking is highly prevalent and associated with certain vocal fold parameters.
- Treatment for dysphonia varies by gender, with males more likely to undergo surgery.

## Abstract

Background and Objectives: Professional voice users (PVUs) are individuals for whom the voice is the primary tool of work, and whose professional success and income largely depend on its quality. This paper’s study population predominantly consisted of occupational voice users with moderate vocal demands and the study aimed to identify risk factors and causes of voice quality and production disorders, as well as the socio-epidemiological characteristics of affected patients. Materials and Methods: A retrospective study was conducted in Serbia, including 145 occupational voice users aged 20–70 years who were treated for dysphonia between August 2019 and July 2024. Data collected included demographics, symptom duration, tobacco exposure, throat and nasal swab results, gastroenterological and endocrinological evaluations and information on treatment for allergic rhinitis, asthma, and dysphonia. Patients were stratified by age, profession, and cause of dysphonia into the appropriate groups. Results: Dysphonia is significantly more common among female occupational users. There is a significant association between the cause of dysphonia and both age and hyperthyroidism. Smoking was highly prevalent in the study population and showed associations with selected videolaryngostroboscopic parameters; however, causal inferences could not be made due to the lack of a non-smoking comparison group. No statistically significant association was observed between positive nasal or throat swabs and dysphonia, nor between allergic rhinitis or asthma and the onset of dysphonia in occupational voice users. Treatment modality varies by gender, with male occupational voice users more likely to undergo surgery and female occupational voice users more often receiving conservative therapy. Symmetric vocal fold vibrations were observed in 85.5% of participants, while regular vibrations were present in 53.1%, and insufficient glottal closure in 10.3%. Regular vocal fold vibration was significantly less frequent in patients with structural disorders and more common in individuals aged 30–39 years. Male sex showed a borderline association with reduced likelihood of symmetric vocal fold vibrations. No independent predictors of insufficient glottal closure were identified. Conclusions: These results support the implementation of systematic otolaryngologic examinations, combined with mandatory education on proper voice use, vocal hygiene, and the harmful effects of tobacco smoke, as measures to prevent voice disorders in occupational voice users.