The early identification of vocal symptoms in the workplace is critical in the prevention of a voice problem. Vocal symptoms were reported as being more common in teachers than in nonteachers (69% vs 36%).26 Munier and Kinsella20 reported that voice fatigue, dry throat, and inability to sing high notes were statistically significant vocal symptoms in primary school teachers and may be the early signs of a developing voice problem. These findings on vocal symptoms are similar to those reported by Yiu.7 Vocal strain was reported to be the most prominent physical symptom in teachers.14 Ohlsson et al27 in a study of voice symptoms and risk factors in student teachers report that those with vocal symptoms are at risk of developing voice disorders during their career. One problem with voice is the inadequate or neglected examination and treatment of early symptoms.3