Purpose: The purpose of this document is threefold: (a) review the uses of the terms “vocal fatigue,” “vocal effort,” “vocal load,” and “vocal loading” (as found in the literature) in order to track the occurrence and the related evolution of research; (b) present a “linguistically modeled” definition of the same from the review of literature on the terms; and (c) propose conceptualized definitions of the concepts.Method: A comprehensive literature search was conducted using PubMed/MEDLINE, Embase, Cochrane Central Register of Controlled Trials, and Scientific Electronic Library Online. Four terms (“vocal fatigue,” “vocal effort,” “vocal load,” and “vocal loading”), as well as possible variants, were included in the search, and their usages were compiled into conceptual definitions. Finally, a focus group of eight experts in the field (current authors) worked together to make conceptual connections and proposed consensus definitions.Results: The occurrence and frequency of “vocal load,” “vocal loading,” “vocal effort,” and “vocal fatigue” in the literature are presented, and summary definitions are developed. The results indicate that these terms appear to be often interchanged with blurred distinctions. Therefore, the focus group proposes the use of two new terms, “vocal demand” and “vocal demand response,” in place of the terms “vocal load” and “vocal loading.” We also propose standardized definitions for all four concepts.Conclusion: Through a comprehensive literature search, the terms “vocal fatigue,” “vocal effort,” “vocal load,” and “vocal loading” were explored, new terms were proposed, and standardized definitions were presented. Future work should refine these proposed definitions as research continues to address vocal health concerns.

Previous studies on the influence of noise and acoustics in the classroom on voice symptoms among teachers have exclusively relied on self-reports. Since self-reported physical conditions may be biased, it is important to determine the role of objective measurements of noise and acoustics in the presence of voice symptoms. To assess the association between objectively measured and self-reported physical conditions at school with the presence of voice symptoms among teachers. In 12 public schools in Bogotα, we conducted a cross-sectional study among 682 Colombian school workers at 377 workplaces. After signed the informed consent, participants filled out a questionnaire on individual and work-related conditions and the nature and severity of voice symptoms in the past month. Short-term environmental measurements of sound levels, temperature, humidity, and reverberation time were conducted during visits at the workplaces, such as classrooms and offices. Logistic regression analysis was used to determine associations between work-related factors and voice symptoms. High noise levels outside schools (odds ratio [OR] = 1.83; 95% confidence interval [CI]: 1.12-2.99) and self-reported poor acoustics at the workplace (OR = 2.44; 95% CI: 1.88-3.53) were associated with voice symptoms. We found poor agreement between the objective measurements and self-reports of physical conditions at the workplace. This study indicates that noise and acoustics may play a role in the occurrence of voice symptoms among teachers. The poor agreement between objective measurements and self-reports of physical conditions indicate that these are different entities, which argue for inclusion of physical measurements of the working environment in studies on the influence of noise and acoustics on vocal health.