“…High noise levels around and above 70 dBA are common in many communicationand vocally-demanding workplaces such as schools and preschools (Shield et al, 2015;Sjödin, Kjellberg, Knutsson, Landström, & Lindberg, 2012). To enhance the audibility of the voice in loud environmental noise, the speaker typically increases the voice SPL, along with increased fo which may result in hyperfunction (Garnier & Henrich, 2014;Hillman et al, 1989;Holmberg et al, 2003;Södersten et al, 2005;Titze, 1989a;Yiu & Yip, 2016). A systematic review by Cantor Cutiva et al (2013) revealed that high environmental noise levels, and the use of high voice SPL, are among the most common risk factors for voice disorders in teachers.…”