{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,27]],"date-time":"2026-06-27T07:00:34Z","timestamp":1782543634600,"version":"3.54.5"},"reference-count":54,"publisher":"Wiley","issue":"S6","license":[{"start":{"date-parts":[[2013,10,28]],"date-time":"2013-10-28T00:00:00Z","timestamp":1382918400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["The Laryngoscope"],"published-print":{"date-parts":[[2013,11]]},"abstract":"<jats:sec><jats:title>Objectives\/Hypothesis<\/jats:title><jats:p>The impact of the disordered voice on standard work productivity measures and employment trends is difficult to quantify; this is in large part due to the heterogeneity of the disease processes. Spasmodic dysphonia (SD), a chronic voice disorder, may be a useful model to study this impact. Self\u2010reported work measures (worked missed, work impairment, overall work productivity, and activity impairment) were studied among patients receiving botulinum toxin (BTX) treatments for SD. It was hypothesized that there would be a substantial difference in work\u2010related measures between the best and worst voicing periods. In addition, job types, employment shifts, and vocal requirements during the course of vocal disability from SD were investigated for each individual, and the impact of SD on these patterns was studied.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design<\/jats:title><jats:p>A total of 145 patients with SD, either adductor or abductor, who were established in routine therapeutic BTX injections agreed to participate in a self\u2010administered questionnaire study. Seventy\u2010two participants were currently working and provided highly detailed information on work\u2010related measures. Their answers characterized the effect of SD on their employment status, productivity at work, activity impairment outside of work, employment retention or change, and whether the individual perceived that BTX therapy affected these measures. Patients were asked to complete the Work Productivity and Activity Impairment (WPAI) instrument to determine these measures for their best and worst voicing weeks over the duration since their previous BTX injection. Voice\u2010specific quality of life instruments (Voice Handicap Index\u201010) and perceptual assessments (Consensus Auditory Perceptual Evaluation of Voice) were elicited to provide correlations of work measures with patient\u2010perceived voice handicap and clinician\u2010perceived voice quality.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Cross\u2010sectional analysis using self\u2010administered questionnaire.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 108 patients reported ever working during their diagnosis and treatment of SD, and 72 patients were currently working and had undergone BTX therapy for at least 1 year at the time of the analysis. Currently employed patients reported a mean 4.4% decrease in work missed (absenteeism), a 28.1% decrease in work impairment (presenteeism), a 29.4% decrease in work productivity, and a 21.4% decrease in activity impairment (<jats:italic>P<\/jats:italic> &lt;.001) in their best, as compared to their worst voicing period over their last BTX injection cycle. Presenteeism accounted for the major component of the percent work productivity impairment calculation. There was neither apparent shift in job categories nor any change in the vocal demands of their employment over the course of their disease. Among patients that have worked during their diagnosis of SD, greater than 98% report that BTX injections helped them at work.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Patients with SD reported that their vocal dysfunction caused a significant negative effect on work productivity and increase in activity impairment. There was a significant improvement in their voice\u2010related work parameters from their worst to best voicing periods over their last BTX injection cycle. Patients undergoing long\u2010term BTX treatment report a positive effect of this treatment in their workplace. Spasmodic dysphonia is a meaningful model in which to study the effects of voice disorders on work productivity and employment patterns.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of Evidence<\/jats:title><jats:p>4. <jats:italic>Laryngoscope<\/jats:italic>, 123:S1\u2013S14, 2013<\/jats:p><\/jats:sec>","DOI":"10.1002\/lary.24292","type":"journal-article","created":{"date-parts":[[2013,7,1]],"date-time":"2013-07-01T13:14:01Z","timestamp":1372684441000},"source":"Crossref","is-referenced-by-count":32,"title":["Voice disorders in the workplace: Productivity in spasmodic dysphonia and the impact of botulinum toxin"],"prefix":"10.1002","volume":"123","author":[{"given":"Tanya K.","family":"Meyer","sequence":"first","affiliation":[{"name":"Department of Otolaryngology University of Washington Seattle Washington"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amanda","family":"Hu","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology Drexel University Philadelphia Pennsylvania U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Allen D.","family":"Hillel","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology University of Washington Seattle Washington"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2013,10,28]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005537-200002010-00010"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0892-1997(97)80002-1"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1093\/occmed\/kqg113"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/JOM.0b013e318159488d"},{"key":"e_1_2_6_6_1","first-page":"49","article-title":"Presenteeism: at work\u2014but out of it","volume":"82","author":"Hemp P","year":"2004","journal-title":"Harv Bus Rev"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/job.630"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.2165\/00019053-200927050-00002"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.brs.0000249521.61813.aa"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1097\/00043764-200206000-00013"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1097\/YIC.0b013e328339fbcf"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcomdis.2005.03.003"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0892-1997(98)80042-8"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/mds.20674"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1468-1331.2010.03047.x"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.21872"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1177\/000348940010900215"},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.1080\/09638280701568296"},{"key":"e_1_2_6_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.otohns.2005.09.008"},{"key":"e_1_2_6_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/0022-510X(71)90129-8"},{"key":"e_1_2_6_21_1","doi-asserted-by":"publisher","DOI":"10.1177\/000348940611500203"},{"key":"e_1_2_6_22_1","doi-asserted-by":"publisher","DOI":"10.1097\/MLG.0b013e31814684fa"},{"key":"e_1_2_6_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.otc.2005.10.005"},{"key":"e_1_2_6_24_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.moo.0000145959.50513.5e"},{"key":"e_1_2_6_25_1","doi-asserted-by":"publisher","DOI":"10.1097\/MOO.0b013e32832aef6f"},{"key":"e_1_2_6_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.otohns.2008.10.033"},{"key":"e_1_2_6_27_1","doi-asserted-by":"publisher","DOI":"10.2165\/00019053-199304050-00006"},{"key":"e_1_2_6_28_1","doi-asserted-by":"publisher","DOI":"10.1370\/afm.1260"},{"key":"e_1_2_6_29_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11136-009-9462-6"},{"key":"e_1_2_6_30_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.fertnstert.2011.04.095"},{"key":"e_1_2_6_31_1","doi-asserted-by":"publisher","DOI":"10.1002\/alr.20008"},{"key":"e_1_2_6_32_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1524-4733.2002.52101.x"},{"key":"e_1_2_6_33_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clinthera.2008.02.016"},{"key":"e_1_2_6_34_1","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/kep457"},{"key":"e_1_2_6_35_1","doi-asserted-by":"publisher","DOI":"10.1186\/ar3141"},{"key":"e_1_2_6_36_1","unstructured":"Research RAHO. Website:http:\/\/reillyassociates.net"},{"key":"e_1_2_6_37_1","volume-title":"Standard Occupational Classification 2010","author":"Statistics USBoL, Budget USOoMa, Committee USSOCRP","year":"2009"},{"key":"e_1_2_6_38_1","doi-asserted-by":"publisher","DOI":"10.1044\/1058-0360.0603.66"},{"key":"e_1_2_6_39_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0892-1997(00)80017-X"},{"key":"e_1_2_6_40_1","unstructured":"BiddleA WatsonL HooperC et al.Criteria for Determining Disability in Speech\u2010Language Disorders. Evidence Report\/Technology Assessment No. 52 (Prepared by the University of North Carolina Evidence\u2010Based Practice Center under Contract No 290\u201097\u20100011) AHRQ Publication No. 02\u2010E010. Rockville MD: Agency for Health Research and Quality; January 2002."},{"key":"e_1_2_6_41_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005537-200409000-00009"},{"key":"e_1_2_6_42_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvoice.2011.04.006"},{"key":"e_1_2_6_43_1","doi-asserted-by":"publisher","DOI":"10.1044\/1058-0360(2008\/08-0017)"},{"key":"e_1_2_6_44_1","volume-title":"Employment and Disability: Characteristics of Employed and Non\u2010Employed People with Disabilities","author":"Kruse D","year":"1997"},{"key":"e_1_2_6_45_1","doi-asserted-by":"publisher","DOI":"10.1016\/0021-9924(79)90022-4"},{"key":"e_1_2_6_46_1","doi-asserted-by":"publisher","DOI":"10.1016\/0021-9924(86)90005-5"},{"key":"e_1_2_6_47_1","doi-asserted-by":"publisher","DOI":"10.1044\/jslhr.4303.782"},{"key":"e_1_2_6_48_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvoice.2006.01.007"},{"key":"e_1_2_6_49_1","doi-asserted-by":"publisher","DOI":"10.1001\/archotol.1994.01880270056010"},{"key":"e_1_2_6_50_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0892-1997(01)00060-1"},{"key":"e_1_2_6_51_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005537-199810000-00003"},{"key":"e_1_2_6_52_1","doi-asserted-by":"publisher","DOI":"10.1177\/000348940111001009"},{"key":"e_1_2_6_53_1","doi-asserted-by":"publisher","DOI":"10.1001\/archotol.130.4.415"},{"key":"e_1_2_6_54_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.jom.0000091694.62216.64"},{"key":"e_1_2_6_55_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0304-3959(00)00305-5"}],"container-title":["The Laryngoscope"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Flary.24292","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/lary.24292","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/lary.24292","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/lary.24292","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,19]],"date-time":"2023-08-19T12:39:35Z","timestamp":1692448775000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/lary.24292"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2013,10,28]]},"references-count":54,"journal-issue":{"issue":"S6","published-print":{"date-parts":[[2013,11]]}},"alternative-id":["10.1002\/lary.24292"],"URL":"https:\/\/doi.org\/10.1002\/lary.24292","archive":["Portico"],"relation":{},"ISSN":["0023-852X","1531-4995"],"issn-type":[{"value":"0023-852X","type":"print"},{"value":"1531-4995","type":"electronic"}],"subject":[],"published":{"date-parts":[[2013,10,28]]}}}