Prevalence and risk factors for voice problems among telemarketers

Objectives: To investigate whether there is an increased prevalence of voice problems among telemarketers compared with the general population and if these voice problems affect productivity and are associated with the presence of known risk factors for voice problems. Design: Cross-sectional survey study. Settings: One outbound telemarketing firm, 3 reservations firms, 1 messaging firm, 1 survey research firm, and 1 community college. Participants: Random and cluster sampling identified 373 employees of the 6 firms; 304 employees completed the survey. A convenience sample of 187 community college students similar in age, sex, education level, and smoking prevalence served as a control group. Main Outcome Measures: Demographic, vocational, personality, and biological risk factors for voice problems; symptoms of vocal attrition; and effects of symptoms on work. Results: Telemarketers were twice as likely to report 1 or more symptoms of vocal attrition compared with controls after adjusting for age, sex, and smoking status (P<.001). Of those surveyed, 31% reported that their work was affected by an average of 5.0 symptoms. These respondents tended to be women (P<.001) and were more likely to smoke (P=.02); take drying medications (P<.001); have sinus problems (P=.04), frequent colds (P<.001), and dry mouth (P<.001); and be sedentary (P<.001). Conclusions: Telemarketers have a higher prevalence of voice problems than the control group. These problems affect productivity and are associated with modifiable risk factors. Evaluation of occupational voice disorders must encompass all of the determinants of health status, and treatment must focus on modifiable risk factors, not just the reduction of occupational vocal load.