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Risk factors for voice disorders among Fado singers

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Oral communication at PEVOC 19 (Copenhagen, Denmark)
28/8/2019

Published in: Health & Medicine
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Risk factors for voice disorders among Fado singers

  1. 1. Risk factors for voice disorders among Fado singers Pedro Melo Pestana 1,2 Susana Vaz-Freitas 2,3 Maria Conceição Manso 2, 4, 5 1 PMP terapia – Esposende - Portugal 2 University Fernando Pessoa - Faculty of Health Sciences – Porto - Portugal 3 Speech Pathology Unit of Otolaryngology Service – Centro Hospitalar do Porto 4 Fernando Pessoa Energy, Environment and Health Research Unit (FP-ENAS), University Fernando Pessoa 5 LAQV, REQUIMTE, University of Porto, Portugal
  2. 2. Risk factors for voice disorders among Fado singers Furthermore, a waitress!! Different sleep-awake cycles No formal training/learning!! 7 hours of singing per week 60 minutes of singing per day 10 songs per performance 2 to 3 performances/venues per day (afternoon and late at night) Simple calculations of a living example (still no boring statistics!!)
  3. 3. Risk factors for voice disorders among Fado singers Introduction • Fado is a genre of urban folk music from Portugal (UNESCO, 2011) • Singing is a professional occupation that increases the risk of voice disorders – conflicting evidence! (Kwok & Eslick, 2018; Mori, Francis, & Song, 2017) • Epidemiological research (prevalence and risk) in singers is scant but promising (Garzón García, Muñoz López, & y Mendoza Lara, 2017) • Self-perception mirrors the impact and the importance each one gives 1
  4. 4. Risk factors for voice disorders among Fado singers Introduction • Fado singers – unique demands and routines • Hints for an increased risk for voice disorders (hazards) (Ibrahim et al., 2017; Kahle, 2012; Mendes et al., 2014; Mendes et al., 2014; Mendes et al. 2013) • Vocal health thresholds near pathological levels • Unhealthy lifestyles • Performing under poor acoustic conditions • Prevalence of voice disorders among Fado singers: 39.6% (Pestana et al., 2018) 1
  5. 5. Risk factors for voice disorders among Fado singers Goal To determine the associated risks and protective factors of voice disorders in relation to the act of singing Fado and voice. 2 (Pestana et al, 2018) Population Expected sample Final sample 411 199 111
  6. 6. Risk factors for voice disorders among Fado singers
  7. 7. Risk factors for voice disorders among Fado singers Methods3 Cross-sectional design A. Sample • Convenience/Snowball sampling • Criteria: singers of Fado de Lisboa substyle; older than 18 years old; an active singer B. Customized and self-administered questionnaire 55 questions / 6 groups 111 completed 9.3% incomplete 21.7% no answer 168 recruited 1. Personal and demographic data 2. Musical experience and knowledge 3. Performance demands and habits 4. Personal and social habits 5. Vocal health and well-being 6. Strategies
  8. 8. Risk factors for voice disorders among Fado singers Methods (cont.) 3 C. Questionnaire fulfillment • Online; private server; individual tokens • 21 February 2017 → 2 March 2018 D. Data analysis • Confidence levels – 95% • Risk and protection factors • Associations with voice problems → univariate logistic regression (OR) • Predict association (risk and protection) → multivariate logistic regression (OR)
  9. 9. Risk factors for voice disorders among Fado singers Results4 A. Sample characterization 42 yo (18-74) Past or present voice problems 40.5% (95% CI – 31.9%-49.9%)
  10. 10. Risk factors for voice disorders among Fado singers Results (cont.) • Multivariate logistic regression analysis of risk factors independently associated with Voice Problems 4 5.552 (1.481-20.817) 4.955 (1.210-20.293) 3.955 (1.488-10.515) 2.868 (1.157-7.109) 0.219 (1.210-20.293) Nose related disorders, Decongestants or Antihistamines Oral contraception or hormone replacement therapy Previous smoking habits Vocal fatigue after performances Corticosteroids
  11. 11. Risk factors for voice disorders among Fado singers Discussion5 Nose related disorders, Decongestants or Antihistamines 5x • Disorder or the medication intake? • “Post nasal dripping”? • Allergic rhinitis is commonly associated with voice changes • Environmental hazards: stage fog/smoke, curtains dust, etc
  12. 12. Risk factors for voice disorders among Fado singers Discussion5 Oral contraception or hormone replacement therapy 5x • Primarily applied to female singers • Hormonal fluctuation • Contradictions are found in literature
  13. 13. Risk factors for voice disorders among Fado singers Discussion5 Previous smoking habits 4x • Highly destructive effect on vocal folds • Burning effect
  14. 14. Risk factors for voice disorders among Fado singers Discussion5 Vocal fatigue after performances 3x Lack of vocal endurance High vocal load Vocal sign that suggests a broad clinical event
  15. 15. Risk factors for voice disorders among Fado singers Discussion5 Corticosteroids 0.2x • Protective !? • Who’s taking has already an established pathology → it reduces the symptomatology • Due to other reasons → positive effects on vocal and/or respiratory tract
  16. 16. Risk factors for voice disorders among Fado singers Conclusion5 • Some predictable variables were not identified (eg, amplification systems, voice warm-up, strategies adopted to overcome voice problems) • Demystifies some preconceptions associated with singing folk and popular music • Based ONLY on self-reported data → should be interpreted in the context • FUTURE: instrumental voice analysis, vocal load assessment, suitability of the repertoire, individual study of risk factors To sing Fado (only Fado?) significantly increased the risk of developing voice disorders
  17. 17. Risk factors for voice disorders among Fado singers Obrigado! ppestana@pmpterapia.pt

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