The economic impact of vocal attrition in public school teachers in Miami-Dade County

David E. Rosow, Mikhaylo Szczupak, Sandra Saint-Victor, Julia D. Gerhard, Carl Dupont, Kaming Lo

Research output: Contribution to journalArticlepeer-review

19 Scopus citations


Objectives/Hypothesis Teachers are a known at-risk population for voice disorders. The prevalence and risk factors for voice disorders have been well studied in this population, but little is known about the associated economic cost. The purpose of this study is to assess the economic impact of voice dysfunction in teachers and understand the difference between the cost of absenteeism and presenteeism as a direct result of voice dysfunction. Study Design Cross-sectional analysis via self-administered online questionnaire. Methods A total of 14,256 public school teachers from Miami-Dade County, Florida, were asked to participate. Questions were formatted based on the previously validated Work Productivity and Activity Impairment: Specific Health Problem questionnaire adapted for hoarseness and voice disorders. Additional demographic questions were included in the questionnaire. Results A total of 961 questionnaire responses were received. The demographic characteristics of respondents closely matched known statistics for public school teachers in Miami-Dade County. Economic calculations were performed for each questionnaire respondent and summed for all respondents to avoid bias. Per week, absenteeism-related costs were $25,000, whereas presenteeism-related costs were approximately $300,000. These figures were used to extrapolate annual cost. Per year, absenteeism-related costs were $1 million, whereas presenteeism-related costs were approximately $12 million. Conclusion The economic impact of voice dysfunction on the teaching profession is enormous. With the above calculations only including lost wages and decreased productivity, the actual figures may in fact be larger (cost of substitute teachers, impact on nonwork activities, etc.). Research investigating preventative measures for voice dysfunction in teachers is necessary to reduce this costly issue. Level of Evidence 2C. Laryngoscope, 126:665-671, 2016

Original languageEnglish (US)
Pages (from-to)665-671
Number of pages7
Issue number3
StatePublished - Mar 1 2016


  • Teachers
  • absenteeism
  • cost
  • economic
  • hoarseness
  • presenteeism
  • voice disorders

ASJC Scopus subject areas

  • Otorhinolaryngology


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