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

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.