Voice disorder productivity losses comparable to chronic diseases

"The impact of vocal disorders on work productivity has not been fully appreciated," says Seth Cohen, M.D. an otolaryngologist at the Duke Voice Center. "This study further demonstrates the far-reaching impact they have on society."

The findings were presented today at the American Laryngological Association meeting in San Diego.

In recent months, well-known professional singers including John Mayer, Adele and Keith Urban have reportedly scaled back work-related responsibilities due to vocal issues. Cohen says everyone who needs their voice for their profession is at risk. According to published data, five to 10 percent of the workforce relies on their voice as the primary tool of their trade.

Cohen and colleagues examined short-term disability (STD) claims related to dysphonia, the catch-all medical term for voice disorders. The mean age of persons making claims was 45.9; more than half (53.2%) were male. The mean number of workdays absent per claim during a 12-month period was 39.2. Mean STD payments per claim in 12 months were $3408.68. Mean lost wages per claim in 12 months were calculated at $4437.89.

Prior studies have found that between 6.6% and 7.5% of adults have voice problems. In the current study, of 18,466 patients with an STD claim, 2.1% were due to a voice disorder.

By comparison, studies using similar methodology found 6.4 mean workdays lost due to STD in asthmatics, 47 STD days in individuals with heart disease, and 52.8 STD days in depressed individuals. Mean productivity loses based on lost wages per STD claim in 12 months were $719 for asthmatics, $1685 for depressed individuals, and $5867 for heart disease patients.

While the study is the largest assessment of indirect costs related to vocal disorders, Cohen says it has limitations and most likely under-estimates the true societal impact. "We could only calculate short-term disability based on individuals who filed claims related to dysphonia," he says. The data do not take into account people with dysphonia who don't have STD benefits and could not file a claim, or the impact on long-term disability, childcare, and on-the-job productivity losses.

Still, Cohen stresses the impact of vocal disorders on work productivity could be minimized if society recognized vocal disorders as a public health problem, and more emphasis was placed on raising awareness for the importance of seeking medical care when necessary.

"We know that only 5 to 20 percent of people with vocal disorders actually see a doctor," Cohen said. "People at risk for dysphonia need to understand that prevention is possible. They also need to see their doctor to obtain early detection and appropriate treatment."

Provided by Duke University Medical Center