What is the fine-grained topic of the following text: Organic Changes Due to Vocal Abuse: Damage to vocal folds and/or larynx secondary to voice abuse (for example, shouting, yelling, screaming, cheering, excessive talking, throat clearing/coughing, inappropriate use of pitch, inappropriate loudness level, talking in a high noise environment, excessive alcohol or caffeine intake, smoking, sinusitis, allergies, hormonal changes, and chemicals/dust). Only return the topic.
Vocal Damage Due to Voice Abuse