Prevalence of Voice Problems, Self-Reported Vocal Symptoms and Associated Risk Factors in Call Center Operators (CCOs): A Systematic Review

Chandini B. Nair, Srikanth Nayak, Santosh Maruthy, Jisha B. Krishnan, Usha Devadas

Research output: Contribution to journalReview articlepeer-review

1 Citation (Scopus)


Objective: The purpose of this study was to systematically review the available literature on the prevalence, self-reported voice symptoms, and associated risk factors for the development of voice problems in call center operators (CCO). Study Design: a systematic review Methods: An electronic search from five databases based on the guidance of preferred reporting of items for systematic reviews and meta-analysis (PRISMA) yielded 15 articles that reported the different aspects of voice problems in CCOs. The methodological quality of the studies was analyzed using the National Institute of Health (NIH) questionnaire. Results: The career prevalence of voice problems in CCOs varied from 33% to 68%, whereas point prevalence was at 27%. Hoarse/rough voice was the most prominent symptom reported by most of the studies. Vocal fatigue, effortful voice, and breaks/cracks in voice were the other reported vocal symptoms. Long working hours, short breaks between calls, noisy working environment, dry work environment, work stress, stressful calls, limited breaks, prolonged use of voice, insufficient vocal rest, throat clearing, and more caffeinated beverage intake were different risk factors having significant association with telemarketers reporting vocal symptoms. Conclusion: The present study results suggest that CCOs are at higher risk of developing voice problems. Further, the different vocal symptoms reported by CCOs are suggestive of vocal fatigue. In addition, multiple risk factors may be associated with the development of voice problems. However, the available literature is limited, and further studies with a larger sample size are required to corroborate the current findings.

Original languageEnglish
JournalJournal of Voice
Publication statusAccepted/In press - 2021

All Science Journal Classification (ASJC) codes

  • Otorhinolaryngology
  • LPN and LVN
  • Speech and Hearing


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