What Are Vocally Demanding Careers?

Does your career require you to use your voice extensively? Teachers, clergy, attorneys, politicians, salespersons, public speakers, fitness instructors, and telemarketers are just a few examples of jobs which require a significant amount of time speaking throughout the day.

If your voice is one of the tools of your trade, you can think of yourself as an occupational voice user.

Why Do Some Careers Increase the Risk of Developing a Voice Problem?

Occupational voice users are at special risk for developing hoarseness simply because the job requires heavy voice use, often with little time in between to allow the voice to recover. Not only do you use your voice to communicate with family and friends, but you also depend upon your voice for your livelihood.

Hoarseness can be a common occurence for occupational voice users. You can develop muscle strain in and around the voice box (muscle tension dysphonia), or you may develop non-cancerous lesions on the vocal folds (vocal cords) from overuse of the voice.

When these changes occur in your voice, your quality of life is affected, and your livelihood may be threatened. Here are some typical comments from our patients who are occupational voice users:

• “I had to take a sick day because of my hoarseness.”
• “I may be moved to another position at work because of my hoarseness.”
• “My voice gets worse by the end of the day.”
• “I don’t feel like talking by the time I get home from work.”
• “My voice is better on the weekends and the early work week but gets worse throughout the week.”

Even if your voice recovers to normal after each episode of hoarseness, recurrent symptoms of hoarseness and vocal fatigue can lead to more permanent voice changes if not corrected.

If you are hoarse for more than three weeks, you should seek an evaluation. Early attention can help you keep your voice and safeguard your career.

Evaluation of the Voice

Our team of voice specialists will evaluate your voice with special emphasis on:

• How you are using your voice (your technique)
• Your speaking environment (room acoustics, background noise while you are speaking, dust or airborn irritants in the environment, use of amplification)
• The types of speaking you do (phone use, face-to-face conversations, large group presentations, talking in noisy situations)
• Patterns of voice use, including amount of talking time at work and outside of work, how much loud voice use is necessary in your job, as well as the times you are able to rest your voice
• Vocal hygiene -- your intake of water versus caffeine, alcohol consumption, smoking, and use of drying medications
• Medical conditions which may worsen the voice

See Appointments for more information regarding your initial evaluation.

Often occupational voice users will develop muscle strain in and around the voice box (muscle tension dysphonia). Other times, there will be noticeable changes to the structure of the vocal folds (vocal cords).

Occupational voice users sometimes develop benign, non-cancerous growths on the vocal folds, caused by inefficient voice use. These lesions (or “bumps”) on the vocal folds alter vocal fold vibration and lead to hoarseness.

The most common vocal fold lesions are nodules, polyps, and cysts. Vocal nodules (also known as nodes) can be thought of as “calluses” of the vocal folds. Vocal fold nodules, polyps, and cysts cause stiffening of the soft outer layer of the vocal folds, which affects vocal fold vibration and vocal fold closure.

Treatment

Although treatment will depend on your diagnosis and your needs, voice therapy is the backbone of treatment for almost anyone with a voice disorder. This is especially true for occupational voice users, who depend on the quality and durability of the voice to earn an income.

With muscle tension dysphonia and with most benign lesions, voice therapy will be recommended. Even if surgery is needed to remove a lesion, voice therapy can help to maximize your speaking technique before surgery, so that you know how to avoid damaging your voice after surgery.

In voice therapy, a speech pathologist will help you learn healthy, efficient voice production. You will use your lung power to produce good breath flow for talking, along with an easy, relaxed throat, and forward “placement” of the voice (in the front of the face).

Using your breath well will help you relax the throat when speaking, and your voice can be produced with greater ease.

With practice, these techniques feel very natural and become part of your daily speaking patterns. Often, you immediately begin to feel much less effort when speaking and less fatigue with speaking all day, even before your voice quality changes.

Along with learning your best voice production, the voice therapist will help you balance your voice use at work and home, working with you to find times to rest your voice, so the voice can recover after heavy use.

Problem solving together, you will look for ways to spare your voice, whether it involves using voice amplification or delegating some speaking tasks to others. Finally, prevention and maintenance of a healthy voice are emphasized with all voice therapy.

When Surgery Is Needed -- Removal of Benign (Non-Cancerous) Lesions

When vocal difficulties persist despite voice therapy and the treatment of other medical factors, microsurgery may be needed.

The goal of this surgical procedure is to delicately remove the abnormal portions of the soft outer layer of the vocal fold in order to restore the vocal fold to its normal vibratory state. Post-operative voice therapy is an essential component of vocal rehabilitation to maximize the quality and stamina of the voice.

Tips for Occupational Voice Users

People with high vocal demands should plan their day to incorporate brief periods of voice rest, and be careful not to overuse the voice outside of work. Even 15 minutes of quiet time can be very helpful in reducing vocal fatigue.

Strive for good vocal hygiene, which includes adequate hydration, managing allergies, controlling reflux, and avoiding smoking.

Teachers and other presenters can spare their voices by using a personal amplification system in the classroom (or conference room) or by having the classroom fitted with a room amplification system.

See Care Guides for more information about voice care for those with vocally demanding careers.