Hostname: page-component-669899f699-8p65j Total loading time: 0 Render date: 2025-04-27T18:49:43.244Z Has data issue: false hasContentIssue false
  • English
  • Français

Exploring the Physical and Mental Health Challenges Associated with Emergency Service Call-Taking and Dispatching: A Review of the Literature

Published online by Cambridge University Press:  22 October 2019

Erin C. Smith ,
Lisa Holmes  and
Frederick M. Burkle Jr. Open the ORCID record for Frederick M. Burkle Jr. [Opens in a new window]
Erin C. Smith*
Affiliation:
Edith Cowan University, School of Medical and Health Sciences, Joondalup, Western Australia
Lisa Holmes
Affiliation:
Edith Cowan University, School of Medical and Health Sciences, Joondalup, Western Australia
Frederick M. Burkle Jr.
Affiliation:
Harvard University, Harvard Humanitarian Initiative, Cambridge, Massachusetts USA
*
Correspondence: Erin Smith, PhD, MPH, MClinEpi, Edith Cowan University, School of Medical and Health Sciences, 270 Joondalup Drive, Joondalup, Western Australia 6027, E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Introduction:

Emergency service (ambulance, police, fire) call-takers and dispatchers are often exposed to duty-related trauma, placing them at increased risk for developing mental health challenges like stress, anxiety, depression, and posttraumatic stress disorder (PTSD). Their unique working environment also puts them at-risk for physical health issues like obesity, headache, backache, and insomnia. Along with the stress associated with being on the receiving end of difficult calls, call-takers and dispatchers also deal with the pressure and demand of following protocol despite dealing with the variability of complex and stressful situations.

Methods:

A systematic literature review was conducted using the MEDLINE, PubMed, CINAHL, and PsychInfo databases.

Results:

A total of 25 publications were retrieved by the search strategy. The majority of studies (n = 13; 52%) reported a quantitative methodology, while nine (36%) reported the use of a qualitative research methodology. One study reported a mixed-methods methodology, one reported an evaluability assessment with semi-structured interviews, one reported on a case study, and one was a systematic review with a narrative synthesis.

Discussion:

Challenges to physical health included: shift-work leading to lack of physical activity, poor nutrition, and obesity; outdated and ergonomically ill-fitted equipment, and physically confining and isolating work spaces leading to physical injuries; inadequate breaks leading to fatigue; and high noise levels and poor lighting being correlated with higher cortisol levels. Challenges to mental health included: being exposed to traumatic calls; working in high-pressure environments with little downtime in between stressful calls; inadequate debriefing after stressful calls; inappropriate training for mental-health-related calls; and being exposed to verbally aggressive callers. Lack of support from leadership was an additional source of stress.

Conclusion:

Emergency service call-takers and dispatchers experience both physical and mental health challenges as a result of their work, which appears to be related to a range of both operational and support-based issues. Future research should explore the long-term effects of these physical and mental health challenges.

Keywords

call-takerdispatcheremergency servicehealthmental health
Type
Systematic Review
Information
Prehospital and Disaster Medicine , Volume 34 , Issue 6 , December 2019 , pp. 619 - 624
Copyright
© World Association for Disaster and Emergency Medicine 2019 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Article purchase

Temporarily unavailable

References

Dwyer, J. City Releases Tapes of 911 Calls from Sept. 11 Attack. New York Times. https://www.nytimes.com/2006/03/31/nyregion/city-releases-tapes-of-911-calls-from-sept-11-attack.html. Published 2006. Accessed September 19, 2018.Google Scholar
Baker, A. Dispatchers Still Haunted by the Voices of Sept. 11. New York Times. http://www.nytimes.com/2002/04/17/nyregion/dispatchers-still-haunted-by-the-voices-of-sept-11.html?mcubz=0. Published 2001. Accessed September 19, 2018.Google Scholar
Pierce, H, Lilly, MM. Duty-related trauma exposure in 911 telecommunicators: considering the risk for posttraumatic stress. J Trauma Stress. 2012;25(2):211–215.CrossRefGoogle ScholarPubMed
Lilly, M, London, M, Mercer, M. Predictors of obesity and physical health complaints among 911 telecommunicators. Saf Health Work. 2016;7(1):55–62.CrossRefGoogle ScholarPubMed
Doerner, WG. Police dispatcher stress. Journal of Police Science and Administration. 1987;15(4):257–261.Google Scholar
Tracy, SJ, Tracy, K. Emotion labor at 911: a case study and theoretical critique. J Appl Commun Res. 1998;26(4):390–411.CrossRefGoogle Scholar
Shuler, S, Sypher, BD. Seeking emotional labor: when managing the heart enhances the work experience. Manag Commun Q. 2000;14(1):50–89.CrossRefGoogle Scholar
Anshel, MH, Umscheid, D, Brinthaupt, TM. Effect of a combined coping skills and wellness program on perceived stress and physical energy among police emergency dispatchers: an exploratory study. J Police Crim Psychol. 2013;28(1):1–14.CrossRefGoogle Scholar
Burke, TW. Dispatcher Stress. FBI Law Enforcement Bulletin. Published 1995. 10;1–6.Google Scholar
Ksionzky, S, Mehrabian, A. Work settings requiring continuous rapid judgments and responses to complex information. Journal of Police Sciences and Administration. 1986;14(1):45–48.Google Scholar
Palmer, CG. Stress and coping in wildland firefighting dispatchers. J Emerg Manag. 2014;12(4):303–314.CrossRefGoogle ScholarPubMed
James, AEC, Wright, PL. Occupational stress in the ambulance service. Journal of Managerial Psychology. 1991;6(3):13–22.CrossRefGoogle Scholar
Wastell, DG, Newman, M. Stress, control and computer system design: a psychophysiological field study. Behav Inf Technol. 1996;15(3):183–192.CrossRefGoogle Scholar
Weibel, L, Gabrion, I, Aussedat, M, Kreutz, G. Work-related stress in an emergency medical dispatch center. Ann Emerg Med. 2003;41(4):500–506.CrossRefGoogle Scholar
Sprigg, CA, Armitage, CJ, Hollis, K. Verbal abuse in the National Health Service: impressions of the prevalence, perceived reasons for and relationships with staff psychological well-being. Emerg Med J. 2007;24(4):281–282.CrossRefGoogle ScholarPubMed
Gallagher, S, McGilloway, S. Living in critical times: the impact of critical incidents on frontline ambulance personnel: a qualitative perspective. Int J Emerg Ment Health. 2008;9(3):215–224.Google Scholar
Shakespeare-Finch, J, Rees, A, Armstrong, D. Social support, self-efficacy, trauma and well-being in emergency medical dispatchers. Soc Indic Res. 2014;123(2):549–565.CrossRefGoogle Scholar
Adams, K, Shakespeare-Finch, J, Armstrong, D. An interpretative phenomenological analysis of stress and well-being in emergency medical dispatchers. J Loss Trauma. 2015;20(5):430–448.CrossRefGoogle Scholar
Coxon, A, Cropley, M, Schofield, P, Start, K, Horsfield, C, Quinn, T. You’re never making just one decision: exploring the lived experiences of ambulance emergency operations center personnel. Emerg Med J. 2016;33(9):645–651.CrossRefGoogle Scholar
Gurevich, M, Halpern, J, Brazeau, P, et al. Frontline stress behind the scenes: emergency medical dispatchers. Paper presented at: Ontario Paramedic Association Conference; September 18–20, 2007; Niagara Falls, Ontario, Canada.Google Scholar
Allan, JL, Farquharson, B, Johnston, DW, Jones, MC, Choudhary, CJ, Johnston, M. Stress in telephone helpline nurses is associated with failures of concentration, attention and memory, and with more conservative referral decisions. Br J Psychol. 2014;105(2):200–213.CrossRefGoogle ScholarPubMed
Farquharson, B, Allan, J, Johnston, D, Johnston, M, Choudhary, C, Jones, M. Stress amongst nurses working in a healthcare telephone-advice service: relationship with job satisfaction, intention to leave, sickness absence, and performance. J Adv Nurs. 2012;68(7):1624–1635.CrossRefGoogle Scholar
Jenkins, SR. Coping and social support among emergency dispatchers: Hurricane Andrew. J Soc Behav Pers. 1997;12(1):201–216.Google Scholar
Forslund, K, Kihlgren, A, Kihlgren, M. Operators’ experiences of emergency calls. J Telemed Telecare. 2004;10(5):290–297.CrossRefGoogle ScholarPubMed
Dagenais, C, Plouffe, L, Gagné, C, Toulouse, G, Breault, A, Dupont, D. Improving the health and safety of 911 emergency call center agents: an evaluability assessment of a knowledge transfer strategy. Int J Occup Saf Ergon. 2017;23(1):50–59.CrossRefGoogle ScholarPubMed
Bedini, S, Braun, F, Weibel, L, Aussedat, M, Pereira, B, Dutheil, F. Stress and salivary cortisol in emergency medical dispatchers: a randomized shifts control trial. PLoS One. 2017;12(5):e0177094.CrossRefGoogle ScholarPubMed
Lilly, M, Allen, CE. Psychological inflexibility and psychopathology in 9-1-1 telecommunicators. J Trauma Stress. 2016;28(3).CrossRefGoogle Scholar
Golding, SE, Horsfield, C, Davies, A, et al. Exploring the psychological health of emergency dispatch center operatives: a systematic review and narrative synthesis. PeerJ. 2017;5:e3735.CrossRefGoogle Scholar
Fong, N, Taylor, I, MacFarlane, A. Review of St John Ambulance: Health and Wellbeing, and Workplace Culture. http://www.stjohnambulance.com.au/docs/default-source/corporate%20publications/independent-oversight-panel-report-160908.pdf?sfvrsn=2. Published 2016. Accessed September 9, 2018.Google Scholar
Safe-Work-Australia. Most at risk occupations with the highest rate of claims for mental disorders. https://www.safeworkaustralia.gov.au/topic/mentalhealth#mostriskoccupations. Published 2015. Accessed September 8, 2018.Google Scholar
Bentley, M, Crawford, J, Wilkins, J, Fernandez, A, Studnek, J. An assessment of depression, anxiety, and stress among nationally certified EMS professionals. Prehosp Emerg Care. 2013;17(3):330–338.CrossRefGoogle ScholarPubMed
Hom, MA, Matheny, NL, Stanley, IH, Rogers, ML, Cougle, JR, Joiner, TE. Examining physical and sexual abuse histories as correlates of suicide risk among firefighters. J Trauma Stress. 2017;30(6):672–681.CrossRefGoogle ScholarPubMed
Simpson, K. Post-traumatic stress disorder among ambulance personnel: a review of the literature. Journal of Paramedic Practice. 2013;5(11):638–645.CrossRefGoogle Scholar
Wild, J, Smith, KV, Thompson, E, Béar, F, Lommen, MJJ, Ehlers, A. A prospective study of pre-trauma risk factors for post-traumatic stress disorder and depression. Psychol Med. 2016;46(12):2571–2582.CrossRefGoogle ScholarPubMed
Buzga, M, Zdenek, J, Buzgova, R. State of physical health and fitness of paramedics in Czech Republic. Wulfenia, 2015;22(3).Google Scholar
Tsismenakis, AJ, Christophi, CA, Burress, JW, Kinney, AM, Kim, M, Kales, SN. The obesity epidemic and future emergency responders. Obesity. 2009;17(8):1648–1650.CrossRefGoogle ScholarPubMed
Gamble, RP, Stevens, AB, McBrien, H, Black, A, Cran, GW, Boreham, CA. Physical fitness and occupational demands of the Belfast ambulance service. Br J Ind Med. 1991;48(9):592.Google ScholarPubMed
Batt, AM, Kent, G, Mason, P. Eat, sleep and be healthy - a paramedic’s guide to healthier shift work. Canadian Paramedicine. 2016;39(2):31–33.Google Scholar
Burke, TW. “Dispatch (Vol. 1).” In: Sullivan, LE, Simonetti, M, (Eds.). Encyclopedia of Law Enforcement. California USA: Sage Publications; 2005:137–139.Google Scholar
Burke, TW. “Computer Aided Dispatch (Vol. 1).” In: Sullivan, LE, Simonetti, M, (Eds.). Encyclopedia of Law Enforcement. California USA: Sage Publications; 2005:87–89.Google Scholar
Harrington, JM. Health effects of shift work and extended hours of work. J Occup Environ Med. 2001;58(1):68–72.CrossRefGoogle Scholar
KivimÄki, M, Kuisma, Pä, Virtanen, M, Elovainio, M. Does shift work lead to poorer health habits? A comparison between women who had always done shift work with those who had never done shift work. Work Stress. 2010;15(1):3–13.CrossRefGoogle Scholar
Wright, KP, Bogan, RK, Wyatt, JK. Shift work and the assessment and management of shift work disorder (SWD). Sleep Med Rev. 2013;17(1):41–54.CrossRefGoogle Scholar
Wisetborisut, A, Angkurawaranon, C, Jiraporncharoen, W, Uaphanthasath, R, Wiwatanadate, P. Shift work and burnout among health care workers. Occupational Medicine. 2014;64(4):279–286.CrossRefGoogle ScholarPubMed
Proper, KI, Van de Langenberg, D, Rodenburg, W, et al. The relationship between shift work and metabolic risk factors: a systematic review of longitudinal studies. Am J Prev Med. 2016;50(5):147–157.CrossRefGoogle ScholarPubMed
McCammon, S, Durham, TW, Allison, EJA, Williamson, JE. Emergency workers’ cognitive appraisal and coping with traumatic events. J Trauma Stress. 1988;1:353–372.CrossRefGoogle Scholar
Morris, JA, Feldman, DC. The dimensions, antecedents, and consequences of emotional labor. Acad Manage Rev. 1996;21(4):986–1010.CrossRefGoogle Scholar
Fjeldheim, CB, Nöthling, J, Pretorius, K, et al. Trauma exposure, posttraumatic stress disorder and the effect of explanatory variables in paramedic trainees. BMC Emerg Med. 2014;14(11).CrossRefGoogle Scholar
Lin, C-Y, Peng, Y-C, Wu, Y-H, Chang, J, Chan, C-H, Yang, D-Y. The psychological effect of severe acute respiratory syndrome on emergency department staff. Emerg Med J. 2007;24:12–17.CrossRefGoogle ScholarPubMed
Adriaenssens, J, De Gucht, V, Maes, S. Determinants and prevalence of burnout in emergency nurses: a systematic review of 25 years of research. Int J of Nurs Stud. 2015;52(2):649–661.CrossRefGoogle ScholarPubMed
Van Mol, MMC, Kompanje, EJO, Benoit, DD, Bakker, J, Nijkamp, MD. The prevalence of compassion fatigue and burnout among healthcare professionals in intensive care units: a systematic review. PLoS One. 2015:10(8):e0136955.CrossRefGoogle ScholarPubMed