Health and Safety ReportVolume 14, Issue 02

Call a service phone number and you will likely connect with a helpful agent employed in a call centre. Though it’s just a phone call away and an industry that employs thousands of workers across Canada, the call centre is a workplace environment most of us will never physically visit or experience.  As a caller, most of us are likely unaware of the pressure that may be experienced by the staff working in the call centre; the pressure to respond to customer calls, to meet quotas, and of having your work performance electronically monitored. This pressure and intensity can increase the health risks faced by workers, and can contribute to some well-known health effects like repetitive stress injuries (RSI) and musculoskeletal disorders (MSDs), and a few that may be less well known like acoustic incidents and voice fatigue.

What is a call centre?

Call centres are found across Canada, operating as stand-alone businesses or as departments within businesses. We interact with them every time we call our credit card company, buy travel insurance, or make a customer support inquiry.

The main focus of call centres is to provide product support and information to customers by telephone. Typically call centre workers are hired to answer large volumes of phone traffic and/or electronic requests. They are trained and skilled in customer service, based at computer workstations, and equipped with a telephone (usually with a headset) and scripted product information and answers.

Call centres are typically found in industries such as banking and finance, insurance, travel services, telecommunications, road services, public utilities and agencies, and sales.

Characteristics of call centres

From a health and safety standpoint, the call centre industry is characterized by certain organizational factors that distinguish it from other office environments and which can create high pressure. These factors include:

Performance targets: Workers are often required to achieve set targets based on key performance indicators such as abandoned call rates and average speed of response.

Performance monitoring: Worker performance can be monitored by electronically recording work details or conversations with clients. This type of monitoring can be on an individual, a team, or the entire call centre.

Performance appraisal systems: Workers receive regular feedback based on the performance monitoring.

Limited task variation: Workers have limited opportunities to work on different tasks because call centre work usually requires the worker to use their workstation and telephone for most job functions.

Limited autonomy: Workers may have little or no control over work tasks and their environment.

Hot-desking: Hot-desking involves workers regularly changing workstations, sometimes on a shift-to-shift basis. This practice causes problems if the workstation doesn’t suit the worker’s physical dimensions, isn’t adjusted correctly at the start of every shift, or isn’t adjustable.

Musculoskeletal Disorders (MSDs)

MSDs affect the bones and soft tissue structures (other than organs) of the body, and occur as a result of repetitive movement or working postures. These injuries most often affect the neck, shoulders, wrists, hands and back.

Call centre workers may be at a higher risk of experiencing a workplace MSD because they often:

• use computer screens intensively
• have less opportunity to take breaks from using the computer through change in work activity
• experience repetitive or sustained awkward and/or static postures
• experience repetitive or sustained movements using the same muscle groups
• share desks with other workers (hot-desking)

Avoiding pain and discomfort

• Use adjustable furniture and equipment
• Each time a worker starts work at a new workstation, the components of the workstation—chair, desk, computer screen, document holder, footrest etc.—need to be adjusted to suit that worker.
• Provide training and regular updates on how to correctly adjust furniture and equipment to suit a worker’s needs.
• Allow time at the start of each shift for each worker to adjust their workstation.
• Consult with workers on the selection and design of workstations.
• Schedule regular breaks and encourage short breaks away from the workstation to get water, use the washroom, stretch, etc.
• Educate workers on the benefits and use of micro pauses.
• Where possible, provide workers with some variation in duties—such as administrative duties.
• Use workstations that allow workers to alternate between standing and sitting (sit/stand workstations) while they are talking.
• Place printers. fax machines and forms away from the workstation to encourage movement.
• Use headsets to prevent cradling of the phone receiver between the head and shoulder.
• Develop software or make changes to existing software to minimize keyboard and mouse use - be sure to consult with workers.
• Introduce the use of ‘hotkeys’ and keyboard shortcuts if alterations to software are not possible.

Acoustic Incidents

Acoustic noise or an acoustic incident is a sudden rise in noise levels through a user’s headset. These irregular occurrences may be crackles, whistles, hisses or high-pitched sounds transmitted through the telephone equipment that come from a variety of sources including customer mobile phones, feedback from cordless phones, or phone receivers being slammed or dropped.

A small proportion of headset users who have experienced acoustic incidents develop a condition known as acoustic shock. Acoustic shock may be temporary or permanent and consists of neurophysiological and psychological symptoms. Symptoms can range from a feeling of numbness in the ear, pain around the ear, nausea and vomiting, and dizziness to headaches, fatigue, problems with balance and anxiety. Hypersensitivity to sounds such as loud voices as well as being overly alert have also been reported.

Acoustic incidents can be controlled by attaching an acoustic shock protection device to headsets that prevents potentially damaging acoustic levels from reaching the wearer's ear drum. Employers should ensure that workers are trained in the proper fitting and use of headsets to reduce feedback. This training should include policies and procedures for identifying and removing faulty headsets.

Vocal Fatigue

Excessive talking can affect both the voice and the throat. Call centres where inbound and outbound calls are constant can lead to vocal fatigue in workers. Factors such as how repetitive the talking is, the consumption of coffee, tea and caffeinated soft drinks that dehydrate the body and voice, and the incorrect positioning of a call centre worker’s microphone may lead to vocal fatigue.

Symptoms of vocal fatigue can include the total or intermittent loss of voice, changes in pitch and decrease in voice volume, constant throat clearing, drying in the throat and excessive mucous, the sensation of a lump or pain in the throat, increased effort to talk, difficulty swallowing, and shortness of breath.

To ensure vocal health, employers can take steps to help minimize background noise levels and provide volume controls on headsets. Developing reasonable call targets and ensuring calls are rotated between call handlers can help prevent voice overuse. 

Resting the

Repetitive work isn’t just monotonous. Repetitive movements, such as typing or handling hundreds of parts on an assembly line, can cause painful musculoskeletal injuries. According to Statistics Canada, close to two million Canadians suffer from repetitive strain injuries (RSIs) and more than half of these injuries are caused by work related activities. February 29^th - the only non-repeating day of the year - marks International RSI Awareness Day, a time to give RSIs some extra attention. RSIs, also known as work-related musculoskeletal disorders (MSDs or WMSDs), are painful disorders in the tendons, muscles, nerves and joints in the neck, upper and lower back, chest, shoulders or arms. These disorders can be caused by frequent and repetitive activities at work, or activities that require awkward postures. A pace of work that doesn't allow breaks between movements can also contribute to RSIs, as can vibration or working in heat or cold. RSIs most often result from a combination of these factors.

The word "repetitive" is key to understanding RSIs. Movements that might normally be completely harmless, such as bending or clenching the hands, gripping a piece of paper, or twisting to flick a switch, can cause injuries when performed too frequently or too fast over a period of time.

Hazards are best eliminated at the source. Repetitive work can be eliminated through job design. Certain tasks can be mechanized. Workstations, too, must be ergonomically designed to fit the worker.  When it's not possible to eliminate the repetitive nature of a job, a well-designed workstation can help, along with ergonomic tools and equipment that save a lot of muscular effort in awkward positions. It's also possible to rethink some of the worker's tasks, arranging the worksite in a way that reduces unnecessary motion of the neck, shoulders and upper limbs, for example. What works and what feels right will often depend on the individual.

Administratively, workers can rotate between two or more tasks to engage different muscle groups rather than always straining the same ones.

Because RSIs develop slowly, workers should be trained to understand what causes these injuries and how best to prevent them. Workers need to know how to adjust workstations to fit their tasks and individual needs. Besides providing ergonomics training, employers should also encourage employees to take short, frequent rest breaks to allow their muscles to relax, and to consciously control muscle tension throughout the work shift.

Although RSIs can be prevented, they can be difficult to treat when left for too long. Knowledge and the right work conditions are the best defence against these injuries. Give it some extra thought on International RSI Awareness Day, February 29^th.

Resources to help raise awareness of and address RSI:

Work-related Musculoskeletal Disorders (WMSDs) Fact Sheet, CCOHS

Muscolosketal Disorders (MSD) Prevention Manual CCOHS

Office Ergonomics Safety Guide CCOHS

Musculoskeletal Disorders (MSDs): Awareness e-course, CCOHS

Reducing MSD hazards in the workplace: A guide to successful participatory ergonomics programs, Institute for Work and Health (IWH) (PDF)

This month’s Health and Safety To Go! podcasts explore considerations when designing and planning an office work space and feature an encore presentation of Preventing Musculoskeletal Injuries.

Feature Podcast: Size Matters: Work Space Requirements for Office Work

Office spaces must be designed and outfitted to enable employees to move safely and freely in the space, accommodating storage requirements and visitors where necessary, and allowing them to comfortably perform all aspects of their job. But how much space does an employee actually need? CCOHS highlights the considerations.

The podcast runs 3:27 minutes. Listen to the podcast now.

Encore Podcast: Preventing Musculoskeletal Injuries

In this episode CCOHS takes a look at work-related musculoskeletal injuries and how to prevent them.

The podcast runs 2:59 minutes. Listen to the podcast now.

CCOHS produces free monthly podcasts on a wide variety of topics designed to keep you current with information, tips, and insights into the health, safety, and well-being of working Canadians. You can download the audio segment to your computer or MP3 player and listen to it at your own convenience... or on the go!

See the complete list of podcast topics. Better yet, subscribe to the series on iTunes and don't miss a single episode

In just a few days, experts, employers, workers, and representatives from labour and government from across Canada will come together for CCOHS Forum 2016: The Changing World of Work. This national event promises two days of discussions and discovery, with sessions on topics that are shaping the future of the workplace, an innovations showcase, and numerous networking opportunities.

Canada’s Minister of Employment, Workforce and Labour, the Honourable MaryAnn Mihychuk will open the Forum, followed by a keynote from humanitarian advocate and former international president of Médecins Sans Frontières / Doctors Without Borders Dr. James Orbinski. Other speakers include human and organization performance expert Todd Conklin and acclaimed work-life balance researcher and writer Linda Duxbury.

If you can be in Vancouver on February 29 and March 1, there’s still time to register.

National Day of Mourning April 28

April 28th is National Day of Mourning in Canada.

This day is set aside to pay respect to those workers across Canada whose lives have been lost, injured or disabled on the job, or who suffer from occupational diseases. The Day of Mourning is an opportunity for employers and workers to not only remember, but also to publicly renew their commitment to preventing work-related injuries, illnesses and deaths and making workplaces safe and healthy for all.

Watch for new commemorative pins, posters and stickers available for order and download soon.

Steps for Life Walk Kicks Off April 30

On April 30, 2016 in cities across Canada, the Steps for Life 5 KM Walk will kick off Occupational Safety and Health (NAOSH) Week. The event is not only fun, it also helps spread the message that workplace injuries and illnesses are preventable. Steps for Life is the major fundraising event for Threads of Life, a national charitable organization dedicated to supporting families who have suffered from a workplace fatality, life-altering illness or occupational disease along their journey of healing.

On April 30, our CCOHS team will once again be walking in the Hamilton event. Dates and times vary across the country. Find the walk closest to you and put your team together. It will be a day to remember.

Learn more about how you can participate on the Steps for Life website.

Safety and Health (NAOSH) Week May 1-7

With the theme of Make Safety a Habit organizations all over North America are planning their activities for Safety and Health Week. It is a time in which attention turns to the importance of preventing injury and illness in the workplace, at home and in the community. CCOHS will be offering a new webinar on emotional intelligence and announcing the Focus on Safety Youth Video Contest national winners. Stay tuned for further details.

More information

Learn more about the National Day of Mourning.

Download free Day of Mourning posters and order Day of Mourning pins and stickers.

Visit the Health and Safety (NAOSH) Week website and get inspired.

Learn more about Threads of Life.

Learn more about the Focus on Safety Youth Video Contest

Register for the free webinar on emotional intelligence