Prevalence and risk factors of voice disorders among tour guides in Cappadocia

Abstract

Purpose This study aimed to determine the prevalence and risk factors of voice disorders among professional tour guides working in the Cappadocia region of Türkiye, a globally renowned tourism destination with high tourist density. Methods A cross-sectional quantitative design was employed. Eighty-five licensed tour guides (41 females, 44 males; mean age = 42.9 ± 12.2 years) participated by completing an online self-report questionnaire developed for the Cappadocia context. The 61-item survey assessed demographics, vocal symptoms, phonotraumatic behaviors, occupational, lifestyle, and health-related risk factors. Descriptive statistics, chi-square tests, and logistic regression analyses were conducted using SPSS 27. Results Voice problems were reported by 42.4% of guides during their careers (95% CI: 32.4–53.0) and 16.5% currently (95% CI: 10.1–25.8), while 23.5% experienced aphonia at least once annually (95% CI: 15.8–33.6). The most prevalent symptoms were throat dryness (77.6%), vocal fatigue (65.9%), and hoarseness (56.5%). Speaking loudly and continuing to talk despite voice problems were significantly associated with vocal complaints (p = .039 and p < .001, respectively). Environmental and health factors, including guiding noisy groups, long tour durations, and ear–nose–throat (ENT)-related conditions (sinus and other ENT disorders), increased the likelihood of voice problems. Logistic regression identified ENT disorders as an independent predictor (adjusted odds ratio [aOR] = 6.12, 95% CI: 1.33–28.17, p = .020). Conclusion Voice disorders are common among Cappadocia tour guides and are associated with both occupational and health-related factors. These findings suggest that implementing voice hygiene education, ergonomic adaptations, and occupational health monitoring may help reduce risk and support vocal sustainability in this professional group.