2021 Yes https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6015274/ Putus, Tuula Europe Observational Teachers Elementary (K-5) Middle/Jr High (6-8) High School (9-12) Stress/Anxiety Hoarseness Voice problems Work-related stress Work environment School n the pilot study (2007–2008), the reported work-related stress was on a very low level (3%) and the prevalence of hoarseness was 10%. After the economic crisis in 2008, the stress was observed to have increased. During the follow-up (2008–2017), the reported stress had continued to increase and in the latest surveys it was 21% and the prevalence of hoarseness 34%. Indoor air factors correlated significantly with hoarseness even when controlling for age, gender, owning pets and job satisfaction in a logistic regression model. In the school buildings where the remediation of the building was completed, the prevalence of hoarseness decreased but the level of stress increased. In general, the proportion of respondents reporting stress was lower than the proportion of respondents with hoarseness. Additionally, the reported stress also correlated with factors other than health in the education branch, especially economic resources and major changes in the core curriculum.