The shouted voice: A pilot study of laryngeal physiology under extreme aerodynamic pressure

Lagier, Aude; Legou, Thierry; Galant, Camille; Breteque, B. Amy De La; Meynadier, Yohann

doi:10.1080/14015439.2016.1211735

Cited by 14 publications

(7 citation statements)

References 22 publications

(27 reference statements)

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“…Our study is consistent with several others in demonstrating exertional respiratory activities dramatically generate aerosols, which increase with speech loudness, greater breathing rate and volume and particularly during coughing [24][25][26][29][30][31]. From the perspective of the physiological factors involved, the increases with activities are associated with rises in subglottic pressure, aerodynamic shear stresses and vocal fold and terminal airway open-closure frequency [9,25,28,[31][32][33].…”

Section: Discussionsupporting

confidence: 91%

The effect of respiratory activity, non‐invasive respiratory support and facemasks on aerosol generation and its relevance to COVID‐19

et al. 2021

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Respirable aerosols (< 5 µm in diameter) present a high risk of SARS-CoV-2 transmission. Guidelines recommend using aerosol precautions during aerosol-generating procedures, and droplet (> 5 µm) precautions at other times. However, emerging evidence indicates respiratory activities may be a more important source of aerosols than clinical procedures such as tracheal intubation. We aimed to measure the size, total number and volume of all human aerosols exhaled during respiratory activities and therapies. We used a novel chamber with an optical particle counter sampling at 100 l.min -1 to count and size-fractionate close to all exhaled particles (0.5-25 µm). We compared emissions from ten healthy subjects during six respiratory activities (quiet breathing; talking; shouting; forced expiratory manoeuvres; exercise; and coughing) with three respiratory therapies (high-flow nasal oxygen and single or dual circuit non-invasive positive pressure ventilation). Activities were repeated while wearing facemasks. When compared with quiet breathing, exertional respiratory activities increased particle counts 34.6-fold during talking and 370.8-fold during coughing (p < 0.001). High-flow nasal oxygen 60 at l.min -1 increased particle counts 2.3-fold (p = 0.031) during quiet breathing. Single and dual circuit non-invasive respiratory therapy at 25/10 cm.H 2 O with quiet breathing increased counts by 2.6-fold and 7.8-fold, respectively (both p < 0.001). During exertional activities, respiratory therapies and facemasks reduced emissions compared with activities alone. Respiratory activities (including exertional breathing and coughing) which mimic respiratory patterns during illness generate substantially more aerosols than non-invasive respiratory therapies, which conversely can reduce total emissions. We argue the risk of aerosol exposure is underappreciated and warrants widespread, targeted interventions.

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Section: Discussionsupporting

confidence: 91%

The effect of respiratory activity, non‐invasive respiratory support and facemasks on aerosol generation and its relevance to COVID‐19

et al. 2021

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“…24–26,30–32 From the perspective of the physiological factors involved, the increases with activities are associated with rises in subglottic pressure, aerodynamic shear stresses and vocal fold and terminal airway open-closure frequency. 9,25,29,32,33 In contrast, the pressure changes and flow velocities generated during respiratory therapies are far less. 28,34,35 The slight increases with flow and pressure in emissions during breathing with HFNO may be due to turbulence within the upper airways, whereas NIPPV could generate increases through greater tidal volumes and subsequent airway open-closure, overriding our benchmark measure of ‘quiet breathing’.…”

Section: Discussionmentioning

confidence: 99%

The effect of respiratory activity, ventilatory therapy and facemasks on total aerosol emissions

Wilson

Marks

Eckhardt

et al. 2021

Preprint

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Background Exhaled respirable aerosols (<5 μm diameter) present a high risk of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) transmission. Many guidelines recommend using aerosol precautions during "aerosol generating procedures" (AGPs) and droplet (<5 μm) precautions at other times. However, there is emerging evidence that respiratory activities such as cough and not AGPs are the important source of aerosols. Methods We used a novel chamber with an optical particle counter sampling at 100 L/min to count and size-fractionate all exhaled particles (0.5-25 μm). We compared emissions from ten healthy subjects during respiratory "activities" (quiet breathing, talking, shouting, forced expiratory maneuvers, exercise and coughing) with respiratory "therapies" designated as AGPs: high flow nasal oxygen (HFNO) and single or dual circuit non-invasive positive pressure ventilation, NIPPV-S and NIPPV-D, respectively. Activities were repeated wearing facemasks. Results Compared to quiet breathing, respiratory activities increased particle counts between 34.6-fold (95% confidence interval [CI], 15.2 to 79.1) during talking, to 370.8-fold (95% CI, 162.3 to 847.1) during coughing (p<0.001). During quiet breathing, HFNO at 60 L/min increased counts 2.3-fold (95% CI, 1.2 to 4.4) (p=0.03) and NIPPV-S and NIPPV-D at 25/10 cm H2O increased counts by 2.6-fold (95% CI, 1.7 to 4.1) and 7.8-fold (95% CI, 4.4 to 13.6) respectively (p<0.001). During activities, respiratory therapies and facemasks reduced emissions compared to activities alone. Conclusion Talking, exertional breathing and coughing generate substantially more aerosols than the respiratory therapies HFNO and NIPPV which can reduce total emissions. The risk of aerosol exposure is underappreciated and warrants widespread targeted interventions.

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“…A voice is perceived as harsh when it deviates from regular periodic phonation (Anikin et al, 2021; Fitch et al, 2002), and the production of most nonlinear vocal phenomena requires high subglottal pressure (Fitch et al, 2002; Herzel et al, 1995). Assuming that nonlinearities do not cause a noticeable drop in voice loudness (Lagier et al, 2017), high vocal effort could thus be conducive to vocal intimidation not only as a direct effect of loudness per se, but also indirectly via the production of harsh-sounding nonlinear phenomena.…”

Section: Frequency Codementioning

confidence: 99%

The role of loudness in vocal intimidation.

Anikin,

Valente,

Pisanski

et al. 2024

Journal of Experimental Psychology: General

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Across many species, a major function of vocal communication is to convey formidability, with low voice frequencies traditionally considered the main vehicle for projecting large size and aggression. Vocal loudness is often ignored, yet it might explain some puzzling exceptions to this frequency code. Here we demonstrate, through acoustic analyses of over 3,000 human vocalizations and four perceptual experiments, that vocalizers produce low frequencies when attempting to sound large, but loudness is prioritized for displays of strength and aggression. Our results show that, although being loud is effective for signaling strength and aggression, it poses a physiological trade-off with low frequencies because a loud voice is achieved by elevating pitch and opening the mouth wide into a-like vowels. This may explain why aggressive vocalizations are often high-pitched and why open vowels are considered "large" in sound symbolism despite their high first formant. Callers often compensate by adding vocal harshness (nonlinear vocal phenomena) to undesirably high-pitched loud vocalizations, but a combination of low and loud remains an honest predictor of both perceived and actual physical formidability. The proposed notion of a loudness-frequency trade-off thus adds a new dimension to the widely accepted frequency code and requires a fundamental rethinking of the evolutionary forces shaping the form of acoustic signals. Public Significance StatementSpeakers can intimidate by being loud or by lowering voice frequency: low frequency appears to work best for size exaggeration, whereas loudness is more effective for displaying strength and aggression. However, it is physiologically difficult to achieve both simultaneously, making the low-and-loud combination an honest index of physical formidability and the elusive key to vocal intimidation.

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The shouted voice: A pilot study of laryngeal physiology under extreme aerodynamic pressure

Cited by 14 publications

References 22 publications

The effect of respiratory activity, non‐invasive respiratory support and facemasks on aerosol generation and its relevance to COVID‐19

The effect of respiratory activity, non‐invasive respiratory support and facemasks on aerosol generation and its relevance to COVID‐19

The effect of respiratory activity, ventilatory therapy and facemasks on total aerosol emissions

The role of loudness in vocal intimidation.

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