{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,21]],"date-time":"2026-07-21T21:01:32Z","timestamp":1784667692474,"version":"3.55.0"},"reference-count":48,"publisher":"Springer Science and Business Media LLC","issue":"7","license":[{"start":{"date-parts":[[2026,5,28]],"date-time":"2026-05-28T00:00:00Z","timestamp":1779926400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,5,28]],"date-time":"2026-05-28T00:00:00Z","timestamp":1779926400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100023316","name":"Cappadocia University","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100023316","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Eur Arch Otorhinolaryngol"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>This study aimed to determine the prevalence and risk factors of voice disorders among professional tour guides working in the Cappadocia region of T\u00fcrkiye, a globally renowned tourism destination with high tourist density.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A cross-sectional quantitative design was employed. Eighty-five licensed tour guides (41 females, 44 males; mean age\u2009=\u200942.9\u2009\u00b1\u200912.2 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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Voice problems were reported by 42.4% of guides during their careers (95% CI: 32.4\u201353.0) and 16.5% currently (95% CI: 10.1\u201325.8), while 23.5% experienced aphonia at least once annually (95% CI: 15.8\u201333.6). 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 (\n                      <jats:italic>p<\/jats:italic>\n                      = .039 and\n                      <jats:italic>p<\/jats:italic>\n                      &lt; .001, respectively). Environmental and health factors, including guiding noisy groups, long tour durations, and ear\u2013nose\u2013throat (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]\u2009=\u20096.12, 95% CI: 1.33\u201328.17,\n                      <jats:italic>p<\/jats:italic>\n                      = .020).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00405-026-10328-3","type":"journal-article","created":{"date-parts":[[2026,5,28]],"date-time":"2026-05-28T19:32:32Z","timestamp":1779996752000},"page":"4553-4568","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Prevalence and risk factors of voice disorders among tour guides in Cappadocia"],"prefix":"10.1007","volume":"283","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7155-3591","authenticated-orcid":false,"given":"Nam\u0131k Y\u00fccel","family":"Birol","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0499-073X","authenticated-orcid":false,"given":"Esra","family":"Ya\u015far G\u00fcnd\u00fcz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2450-0213","authenticated-orcid":false,"given":"Ferhat","family":"Alkan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9092-7728","authenticated-orcid":false,"given":"Z\u00fcbeyir","family":"Tutu\u015f","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,5,28]]},"reference":[{"issue":"1\u20133","key":"10328_CR1","doi-asserted-by":"publisher","first-page":"120","DOI":"10.1159\/000021519","volume":"52","author":"E Vilkman","year":"2000","unstructured":"Vilkman E (2000) Voice problems at work: A challenge for occupational safety and health arrangement. 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