Objective. We evaluated voice acoustics and self-perceptual ratings in healthcare workers required to wear face masks throughout their workday. Methods. Eighteen subjects (11 cisgender female, 7 cisgender male; M = 33.72 years, SD = 8.30) completed selfperceptual ratings and acoustic recordings before and after a typical workday. Chosen measures were specific to vocal effort, dysphonia, and laryngeal tension. Mixed effects models were calculated to determine the impact of session, mask type, sex, and their interactions on the set of perceptual and acoustic measures.Results. The subjects self-reported a significant increase in vocal effort following the workday. These perceptual changes coincided with an increase in vocal intensity and harmonics-to-noise ratio, but decrease in relative fundamental frequency offset 10. As expected, men and women differed in measures related to fundamental frequency and vocal tract length. Conclusion. Healthcare professionals wearing masks reported greater vocal symptoms post-workday compared to pre-workday. These symptoms coincided with acoustic changes previously related to vocal effort; however, the degree of change was considered mild. Further research is needed to determine whether vocal hygiene strategies may reduce vocal symptoms in mask-wearing workers.

Objectives/Hypothesis: We investigated speech acoustics and self-reported vocal symptoms in mask-wearing healthcare professionals. We hypothesized that there would be an attenuation of spectral energies and increase in vocal effort during masked speech compared to unmasked speech.Study Design: Within and between subject quasi-experimental design.Methods: We prospectively enrolled 21 healthcare providers (13 cisgender female, 8 cisgender male; M = 32.9 years; SD = 7.9 years) and assessed acoustics and perceptual measures with and without a face mask in place. Measurements included: 1) acoustic Vowel Articulation Index (VAI); 2) cepstral and spectral acoustic measures; 3) traditional vocal measures (e.g., fundamental frequency, intensity); 4) relative fundamental frequency (RFF); and 5) self-reported ratings of vocal effort and dyspnea.Results: During masked speech, there was a significant reduction in VAI, high-frequency information (>4 kHz), and RFF offset 10, as well as a significant increase in cepstral peak prominence and perceived vocal effort. Further analysis showed that high-frequency attenuation was more pronounced when wearing an N95 mask compared to a simple mask.Conclusions: Face masks pose an additional barrier to effective communication that primarily impacts spectral characteristics, vowel space measures, and vocal effort. Future work should evaluate how long-term mask use impacts vocal health and may contribute to vocal problems.

Relative fundamental frequency (RFF) is an acoustic measure that characterizes changes in voice fundamental frequency during voicing transitions. Despite showing promise as an indicator of vocal disorder and laryngeal muscle tension, the clinical adoption of RFF remains challenging, partly due to a lack of research integration. As such, this review sought to provide summative information and highlight next steps for the clinical implementation of RFF. A systematic literature search was completed across 5 databases, yielding 37 articles that met inclusion criteria. Studies most often included adults with and without tension-based voice disorders (e.g., muscle tension dysphonia), though patient and control groups were directly compared in only 32% of studies. Only 11% of studies tracked therapeutic progress, making it difficult to understand how RFF can be used as a clinical outcome. Specifically, there is evidence to support within-person RFF tracking as a clinical outcome, but more research is needed to understand how RFF correlates to auditory-perceptual ratings (strain, effort, and overall severity of dysphonia) both before and after therapeutic interventions. Finally, a marked increase in the use of automated estimation methods was noted since 2016, yet there remains a critical need for a universally available algorithm to support widespread clinical adoption.

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