Increased Vulnerability to Health Implications. Secondary Analysis Exploring the Association of Stress, Chronic Illness, and Absenteeism Among 9-1-1 Telecommunicators

Abstract

Introduction: Nationwide, emergency response systems depend on the interrogative and enhanced skills of 9-1-1 telecommunicators. Within minutes, telecommunicators assess complex information, prioritize, triage, and dispatch appropriate help to individuals needing assistance. Telecommunicators (TC) are challenged by acute and chronic workplace stressors, including interactions with callers in crisis and routine exposures to a variety of tense circumstances. Given this exposure, telecommunicators may have elevated levels of emotional or peritraumatic stress to duty-related experiences. While acute stress helps telecommunicators manage critical decision-making, the repeated response can become damaging or negatively impact health. Living in a chronic state of stress may weaken the body and increase vulnerability to chronic illness. Objective: This paper outlines the literary evidence around the physiological effects and psychological burden of duty-related trauma exposure. The focus of this analysis is to understand the implications of stress; Specifically, if there is an association between symptoms of stress, chronic illness (CI), and sick leave (absenteeism) in 9-1-1 telecommunicators. Methods: Secondary data analysis was conducted as a supplement to a study assessing the efficacy of an online mindfulness-based intervention in reducing stress among 9-1-1 telecommunicators. Analysis relied on data collected by the primary study during both the Baseline Assessment (T1) and 3-Month Follow-Up Survey (T3). Participants contributed data by responding to items on validated instruments measuring symptoms of stress (C-SOSI), chronic illness, sick days, and demographic characteristics. Descriptive information on participant demographics was collected during baseline, while information collected during follow-up provided outcome data. Bivariate and multivariate analyses, adjusted for cofounders, provided information on presumed associations between self-reported symptoms of stress, chronic illness, and sick days among 9-1-1 telecommunicators. Data Findings and Results: A total of 182 Telecommunicators across 29 different call centers provided data during both baseline and 3-month assessment. Results showed that symptoms of stress (C-SOSI) are associated with the number of stress-related self-reported chronic illnesses (CI) in 9-1-1 telecommunicators, though we do not know the causal direction of this association (r = 0.465, p-value = <0.001). Symptoms of stress (C-SOSI) did not appear to be associated with greater use of sick days (odds ratio = 1.1, p-value = 0.190) nor did self-report chronic illness (CI) appear to be associated with greater use of sick days among 9-1-1 telecommunicators (odds ratio = 1.1, p-value = 0.378) in this sample. Interpretation and Conclusion: Consistent with existing research, results found that symptoms of stress and number of chronic illnesses are associated. However, results of the analysis were not conclusive in supporting the model’s assumption that reported absenteeism was associated to symptoms of stress and/or chronic illness. While not supported in this sample, previous research and literature provide extensive knowledge on the implication of stress contributing to the development of chronic physiological, psychological, behavioral, psychosocial, and neurobiochemical conditions. Literature revealed a tremendous gap in research specific to 9-1-1 telecommunicators. This noticeable lack of available data highlights the importance of contributing data for telecommunicators to more extensive research among emergency health personnel occupations as a whole. Findings from these studies offer important data justifying the need for improving occupational and health services to help mitigate the interconnected job-related health consequences telecommunicators face.