When Adele took the stage at the 54th annual Grammy Awards in February, signaling a remarkable recovery from vocal surgery, she sparked worldwide interest in what has become an epidemic in the music industry: the increasing threat to singing voices of today’s biggest music stars.

The British pop diva represented just the tip of what seems to be a massive iceberg. Sidelined in recent months: John Mayer, Kiss’s Paul Stanley; the Who’s Roger Daltrey; Celine Dion, Steven Tyler, country-rocker Gary Allan and classic rocker Meatloaf. And the list keeps growing weekly.

But what is the real reason for this sudden rash of injured voices? It can be explained in one word: economics.

“(It’s) about the financial strain,” says Meatloaf, who is carefully guarding his voice before launching an extensive tour to promote his latest album, “Hell in a Hand Basket.” “It used to be, artists could sell records and they got publishing and they made money. And now, apparently no one gets money from royalties anymore; records don’t sell. And you have to work so much more.”

Today’s musicians have been forced into increased touring schedules, but that’s not all. To develop revenue streams or pump up moribund disc sales, they’re required to participate in continual meet ‘n’ greet sessions with fans and corporate sponsors, in-store signings, pay-per-view online tour video diaries and, in short, more interviews than ever before. All these factors have led to the current epidemic.

While the high-profile tour cancellations of Adele and Mayer have brought attention to the problem, the medical community’s response has allowed a new industry to emerge: the business of voice preservation.

“Just as with many things in medicine, what has led us to this is because we now have a heightened sense of recognition that there is actually a problem,” says Dr. Gaelyn Garrett, director of the Vanderbilt Voice Center in Nashville, a division of the medical school’s department of otolaryngology. “I think artists before would push on through and if they couldn’t do it they would do it regardless, and because of that their careers may have been shortened.”

Garrett has treated vocal injuries of all types, but is best known for her work with singers, particularly country artists, most of whom live near the Center. Emmylou Harris, Jack White, Trisha Yearwood, Martina McBride, and Wynonna Judd are among those who visit the Voice Center regularly to prevent further injury to their vocal cords.

According to Garrett, the recent wave of damaged vocal cords has prompted both record labels and management companies to take a pro-active stance, checking the durability of their artist’s voice before tours launch.

“No. 1, we have to make sure their voice technique is not going to be injurious to them,” says Garrett. “A lot of the young artists have untrained voices. They have been singing since they were teenagers or younger, and they have not developed healthy habits. Secondly, 90% of the time they are using their voice it is not singing. They need to be trained to curb this use.”

Garrett recommends management visit the center with the artist. “They get a good feeling of what we do and what the artist is going through and what healthy things we are recommending.”

Garrett adds that the center works with voice samples and performs a stroboscopy, “which allows us to look for any abnormalities on the vocal cords. We regularly check the artists to see if there is any change.”

The issue of ruptured vocal cords is particularly severe with heavy metal or hard alternative bands. Dr. Steven Zeitels, the director of the Center for Laryngeal Surgery and Voice Rehabilitation at Massachusetts General Hospital who treated Adele, Daltrey and Tyler has become one of the most in-demand surgeons in this growing field. Zeitels uses fiber-optic cameras to search for hemorrhages, repairing them with laser surgery, which can remove a mass without damaging the vocal cord.

“I hold myself to a higher standard than others do,” says Stanley, who had corrective surgery to repair vocals ravaged by decades of touring. “With that in mind, I wanted to remedy a few minor issues that come with 40 years of preaching rock ‘n’ roll.” Stanley had no choice; KISS will soon embark on its biggest and most ambitious worldwide tour ever to support its new CD, “Monster,” and was told the surgery was necessary to keep his voice from being permanently damaged.

Meatloaf who has had voice problems in both 2008 and last fall, adheres to a strict discipline of vocal warm-ups before sound check and the show, itself, as well as a mandatory vocal warm-down, performed to a voice exercise tape, in his dressing room immediately after each show. “The warm down is an absolute key,” says Meatloaf. “You have to warm down; if you don’t, you can never really de-stress your vocal cords.”

Voices can also be damaged due to environmental or bacteria issues. Celine Dion was recently forced to cancel a series of shows in Las Vegas, when her voice was attacked by a rare virus.

“We thought that after a few days’ rest I would improve but it wasn’t getting any better,” says Dion. Laryngeal physiology expert Gerald Berke “identified what was causing the problems I was having, and he assured me that with the amount of rest he prescribed, I would be back to 100%.” Dion has been ordered not to sing or speak unnecessarily for eight weeks.

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