Impact of masks on voice in COVID-19 era: a vocal hygiene protocol to reduce voice fatigue in a population of speech therapists. (A proposal by G.I.Vo.C.)

Background: To assess the effects of prolonged face mask usage on vocal emission in a sample of speech therapists and to identify potential intervention and prevention strategies. Methods: We recruited 250 speech therapists who used face masks daily for work at the time of the study (August-September 2021). Participants completed a self-assessment voice questionnaire, which included the Voice Fatigue Index (VFI), and provided information on demographic data, type of mask used, average time and method of use, symptoms, and any sensory deficits perceived as related to mask usage. Subsequently, participants received a handbook containing vocal hygiene guidelines to follow for one month. After this period, the self-assessment voice questionnaire was administered again.
Results: 111 speech therapists completed the study and responded to the second questionnaire. Results showed an improvement in phonasthenia and reported symptoms following the adherence to vocal hygiene standards. In particular, there was a statistically significant improvement in VFI scores in both the first and second parts. Concerning symptoms, a significant reduction was observed in both perceptual and sensory symptoms during the second questionnaire administration, particularly in phonasthenia, dryness of the mouth, air hunger, difficulty in communication, and oral breathing/sensation of a blocked nose.
Conclusion: The use of face masks has a substantial impact on vocal emission, and incorporating simple vocal hygiene practices into daily routines can be a valuable preventive measure for improving phonasthenia and reported symptoms. Further specific studies are needed for different job tasks and work environments to determine appropriate voice protection tools for diverse contexts.