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To examine the frequency and adverse effects of voice disorders on job performance and attendance in teachers and the general population, 2,401 participants from Iowa and Utah ([n.sub.1] = 1,243 teachers and [n.sub.2] = 1,279 nonteachers) were randomly selected and were interviewed by telephone using a voice disorder questionnaire. Teachers were significantly more likely than nonteachers to have experienced multiple voice symptoms and signs including hoarseness, discomfort, and increased effort while using their voice, tiring or experiencing a change in voice quality after short use, difficulty projecting their voice, trouble speaking or singing softly, and a loss of their singing range (all odds ratios [ORs] p is less than .05). Furthermore, teachers consistently attributed these voice symptoms to their occupation and were significantly more likely to indicate that their voice limited their ability to perform certain tasks at work, and hod reduced activities or interactions as a result. Teachers, as compared with nonteachers, had missed more workdays over the preceding year because of voice problems and were more likely to consider changing occupations because of their voice (all comparisons p is less than .05). These findings strongly suggest that occupationally related voice dysfunction in teachers can have significant adverse effects on job performance, attendance, and future career choices.

information is also provided regarding additional factors that might contribute to the development of voice disorders.Over 3 million teachers in the United States use their voice as a primary tool of trade and are thought to be at higher risk for occupation-related voice disorders than the general population. However, estimates regarding the prevalence of voice disorders in teachers and the general population vary considerably. To determine the extent that teachers are at greater risk for voice disorders, 2,531 randomly selected participants from Iowa and Utah (1,243 teachers and 1,288 nonteachers) were interviewed by telephone using a voice disorder questionnaire. Prevalence--the number of cases per population at risk at a specific time--was determined. The prevalence of reporting a current voice problem was significantly greater in teachers compared with nonteachers (11.0% vs. 6.2%), [chi square](1) = 18.2, p < .001, as was the prevalence of voice disorders during their lifetime (57.7% for teachers vs. 28.8% for nonteachers), [chi square](1) = 215.2, p < .001. Teachers were also significantly more likely than nonteachers to have consulted a physician or speech-language pathologist regarding a voice disorder (14.3% vs. 5.5%), [chi square](1) = 55.3, p < .001. Women, compared with men, not only had a higher lifetime prevalence of voice disorders (46.3% vs. 36.9%), [chi square](1) = 20.9, p < .001, but also had a higher prevalence of chronic voice disorders (>4 weeks in duration), compared with acute voice disorders (20.9% vs. 13.3%), [chi square](1) = 8.7, p = .003. To assess the association between post voice disorders and possible risks, adjusted odds ratios (ORs) were estimated using multiple logistic regression. The results identified that being a teacher, being a woman, being between 40 and 59 years of age, having 16 or more years of education, and having a family history of voice disorders were each positively associated with having experienced a voice disorder in the past. These results support the notion that teaching is a high-risk occupation for voice disorders. Important