Infections,smoking and using your voice too much, too loudly or just incorrectly can all cause hoarseness.

VOA: special.2009.09.02

He took off his mask and called loudly, "Beatrice! Come help me!"

VOA: special.2009.05.23

He urges the Obama administration to promote democracy more loudly and clearly.

VOA: standard.2010.05.19

"I think this will reverberate very loudly in the region, and you will see it perceived especially by our enemies, by the Taliban and al-Qaida, as an admission that America is losing its will and is not committed over the long term, and they will be able to convince their recruits to wait the U.S.out,"

VOA: standard.2009.12.06