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Year : 2008  |  Volume : 17  |  Issue : 1  |  Page : 21-25 Table of Contents   

Mental, physical and social health problems of call centre workers

1 Associate Professor, Department of Community Medicine, Pad Dr D Y Patil Medical College, Pune - 411 018, India
2 Professor, Department of Community Medicine, Pad Dr D Y Patil Medical College, Pune - 411 018, India
3 Resident, Department of Community Medicine, Pad Dr D Y Patil Medical College, Pune - 411 018, India
4 Intern, Department of Community Medicine, Pad Dr D Y Patil Medical College, Pune - 411 018, India
5 Prof and HOD, Psychiatry, Ranchi Institute of Neuropsychiatry and Allied Sciences (RINPAS), Kanke, Ranchi - 834006, India

Date of Web Publication13-May-2010

Correspondence Address:
P Bhuyar
Associate Professor, Department of Community Medicine, Pad Dr D Y Patil Medical College, Pune - 411 018
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Source of Support: None, Conflict of Interest: None

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Background: Call centre workers in BPO face unique occupational hazards - mental, physical and psychosocial. Material & Method: A sample 100 call centre workers of both sexes and from two cities Pune and Mumbai were surveyed by both qualitative and quantitative methods for the above health problems. Results: A high proportion of workers faced sleep disturbances and associated mental stress and anxiety. Sleep disturbance and anxiety was significantly more in international call centres compared to domestic. There was also disturbance in circadian rhythms due to night shift. Physical problems such as musculoskeletal disorders, obesity, eye, and hearing problems were also present. Psychosocial problems included disruption in family life, use of tobacco and alcohol, and faulty eating habits. Conclusion: Better personal management, health education and more research is indicated to study the health problems in this emerging occupation.

Keywords: Call centre, Health hazards, BPO

How to cite this article:
Bhuyar P, Banerjee A, Pandve H, Padmnabhan P, Patil A, Duggirala S, Rajan S, Chaudhury S. Mental, physical and social health problems of call centre workers. Ind Psychiatry J 2008;17:21-5

How to cite this URL:
Bhuyar P, Banerjee A, Pandve H, Padmnabhan P, Patil A, Duggirala S, Rajan S, Chaudhury S. Mental, physical and social health problems of call centre workers. Ind Psychiatry J [serial online] 2008 [cited 2023 Jan 31];17:21-5. Available from: https://www.industrialpsychiatry.org/text.asp?2008/17/1/21/63059

With rapidly changing workplaces, unique occupational health hazards are emerging. Traditional industrial health concerns were related more in the physical health domain. Emerging new occupations particularly in Information Technology (IT) and IT enabled Services (ITES), pose a host of new health challenges particularly those related to mental and social health.

BPO (Business Process Outsourcing) has been the latest mantra in India today. For many employed in the call center sector, "the daily experience is of repetitive, intensive and stressful work, which frequently results in employee "burnout". Call centers are established to create an environment in which work can be standardized to create relatively uniform and repetitious activities so as to achieve economies of scale and consistent quality of customer service. This weakens employee autonomy and enhances the potential for management control. Loss of control is generally understood to be an important indicator of work related stress. Besides, the stress, the working hours of call centers may cause sleep disturbances and disturbances in biological rhythm. Physical health also may adversely affected because of irregular and sedentary working hours and unhealthy lifestyles. Job pressure at call centers also may adversely affect social health. Though India with China is in the forefront of ITES industry, occupational health research in this new industry is lagging. The present study was undertaken upon samples of call centre workers in Pune (Domestic BPO) and Mumbai (International BPO). The purpose was to carry out a pilot study of the mental, physical and social health dimensions among this new class of industrial workers.

   Material and Methods Top

The study was carried out at two sites Pune and Mumbai. It included a domestic BPO call centre located at Pune and an international call centre at Mumbai. 50 call centre employees of both sexes were randomly selected from each site giving a total study population of 100. Besides a handful of call centre workers from Pune were contacted for qualitative inputs by focus group interviews.

Both qualitative and quantitative research methods were used. Qualitative data were collected by focus group interviews of a group of 8 BPO employees by one of the senior investigators using open ended interview method. Quantitative data was collected on a pre-tested structured instrument by two medical interns one located at Pune and the other at Mumbai by face to face interview technique. No scale for anxiety or mental stress has been used. All conditions recorded were self reported or perceived.

Data entry and statistical analysis. Data was entered on Microsoft Excel spreadsheet and analyzed using EpiInfo 2002. Chi Sq and ODDs Ratio with 95% Confidence Intervals were used to explore associations between two main predictors such as gender and type of call centre (whether domestic or international) and some outcomes of interest.

   Results Top

A. Qualitative findings

Themes elicited from Focus Group Discussions.

  1. Reasons for joining BPO. Some of the reasons for joining the BPO were: to earn money while waiting for a better job, good work environment, peer pressure, good benefits, and attractive life style.
  2. Reasons for leaving BPO (attrition). Some of the reasons for attrition are: stagnation in career graph, to pursue higher education, getting better salary elsewhere, disruption in family and personal life, conflicts with peers and superiors in the office, stress and strain of work.

B. Quantitative findings

Age, Sex, Education and marital status.. The average age of the respondents working in the international BPOs was 26.32 (SD = 3.66). The mean age of those working in domestic call centres was 25.18 (SD = 3.09). Out of the 100 workers 49 were females and 51 males. Majority 96% were graduates and only 4% had completed only school education. 60% of the call centre workers were married.

Self reported mental health problems. The main self reported mental health problems were related to sleep disturbances, anxiety, mental stress and disturbance in biological rhythms. Sleep disturbances was reported by 8% of the domestic call centre workers and 50% of the international call centre workers. This difference was statistically significant. [Table 1]. There was no association of gender and sleep disturbance.

Anxiety was reported by overall 55% of the workers. This was significantly higher in international call centre compared to domestic call centre [Table 2]. Though women reported higher prevalence of anxiety (53.1%) as compared to men (37.3%), this was short of statistical significance [Table 3].

Women reported statistically significantly more perceived mental stress compared to men [Table 4].

However, there was no association between perceived mental stress and type of call centre (domestic or international).

Overall 21% reported disturbance in biological rhythm. This was significantly more in international call centre workers compared to domestic workers [Table 5]. There was no association of gender and disturbance of biorhythm.

Physical health problems. These were mostly in form of musculoskeletal disorders, digestive disorders, eye, voice and hearing problems. Besides there were certain consequences of sedentary lifestyle such as various grades of overweight/obesity.

Proportion of workers reporting various musculoskeletal problems were as follows:

  • Backache: 58.6%
  • Pain hand/wrists: 17.3%
  • Shoulder pain: 6.9%
  • Other sites: 3.4%
  • Nil: 13.8%

Digestive problems: Only 29% did not report any digestive disturbances. Others reported various digestive disturbances such as hyperacidity, bloating, flatulence and constipation.

The most common eye problem was dryness (26.9%). Headache due to eye strain was also common (15.4%). Over 75% had varying degrees of throat problems sometime or the other affecting their voice such as hoarseness, irritating cough, inability to modulate voice and breathing difficulties. Hearing problems was reported by 24% of the respondents. Over 22% were having obesity grade 1 (BMI between 25 and 29.99) and 2% were grossly obese (BMI >30),

Psychosocial problems: The various psychosocial problems were in the form of disruptive family relations, poor recreation opportunity, vices such as alcohol and tobacco use, and faulty eating habits.

Very bad family relations was reported by only 6% of the call centre workers. 28% reported average domestic bliss, while 19% had very good family support. 60% reported that their off days/holidays did not coincide with that of spouse/other family members adversely affecting quality of family life. Off duty 36% preferred to relax and rest, while 16% went out for "de-stressing." Others reported various hobbies such as gardening, music, books, and so on. 26% (mostly males) reported use of tobacco/alcohol. 34% were found to have unhealthy eating habits in form of fast and junk foods.

   Discussion Top

Symptoms and health problems caused or aggravated by work are common (Martimo et al 2007). Other investigators have also employed the methods of self assessed health status of employees as used in the present study in industrial health research (Martimo et al 2007, Collins et al 2005). In emerging occupations such as offshoring which is just the tip of the iceberg in how globalization can transform industries (Farell 2004), for preliminary and rapid assessments of health hazards self reported stress and ill health can provide "quick and dirty" data on the basis of which more refined studies can be planned.

Disturbed sleep as reported by 29% of the workers in the present study is a sign of fatigue and occupational burn out (Ekstedt et al 2006, Akerstedt, et al, 2007). Occupational burnout is characterized by impaired sleep. Ekstedt et al (2006) suggested that impaired sleep may play a role in the development of exhaustion in burnout. Burnout patients may show pronounced sleepiness and mental fatigue at most times of the day for weekdays without reduction during weekends. Drake et al (2004), demonstrated that individuals with shift work sleep disorder are at risk for significant behavioral and health related morbidity. They further suggested that prevalence of shift work sleep disorder is approximately 10% of the night and rotating shift work population.

21% of the respondents in the present study mentioned disturbance in biological rhythms. Most people experience regular shifts in alertness, mood and energy throughout the day. Many of such fluctuations occur over the course of a single day and are therefore known as circadian rhythms. Research findings indicate that such shifts are related to changes in underlying bodily processes (Moore-Ede, Sulzman & Fuller, 1982). In occupations such as BPO industry where individuals must work at times when they would normally be sleeping this biological clock may be deranged. The resetting of the biological clock is draining, both physically and psychologically (Czeisler, Moore-Ede, & Coleman, 1982). These effects, in turn, have been linked to poorer on-the-job performance, increased industrial and traffic accidents, and adverse effects on health (Lidell, 1982, Meijmann, van der Meer, & van Dormolen, 1993). In view of these findings, efforts have been made to develop procedures for minimizing such disruptions. One approach involves keeping employees on the same shift for several weeks rather than for a short duration (Czeisler, Moore-Ede, & Coleman, 1982). This schedule give individuals more opportunity to reset their biological clocks than do weekly changes in shift. Another procedure is to expose people who must stay awake at night to bright light just before they would normally go to sleep; this resets their circadian rhythm, so they have an easier time staying awake - and alert (Houpt, Boulos, & Moore-Ede, 1996).

In the present study an appreciable number also reported musculoskeletal problems such as backache and pain in upper limbs and hand. Risk factors for upper-extremity musculoskeletal disorders include biomechanical factors (force, repetition, posture and psychosocial factors (job stress) as stated by Morse et al (2007). Menzel (2007), also has brought out the role of psychosocial factors (job strain, social support at work, and job dissatisfaction) in musculoskeletal disorders. He suggested measures for reducing the incidence of musculoskeletal disorders and addressing psychosocial risk factors to prevent delayed recovery. William et al (2007), have carried out a systematic review of psychometric evaluation of health related work outcome measures for musculoskeletal disorders.

To tackle other problems such as hearing, eyesight, and obesity, periodic health examinations should help in early diagnosis and remedial measures. Hygiene measures such as resting the eyes every few minutes and lubricating eye drops may prevent dryness of eyes. Health education about prevention and control of obesity and other lifestyle disorders can be offered at the workplace. Promotion of healthy food habits can be facilitated by providing subsidized canteens as has been done by many IT industries.

The authors concede that this is an exploratory study only. More refined studies with need for scale development for stress in the emerging occupations in IT and ITES are indicated.

Lastly it is desirable to employ HR Professionals with knowledge of Human Psychology in BPO units/call centers. The services offered by professionals may not be felt in the initial stages. Companies like Tata, L&T, MICO and few others have employed professionals in their factories. The professionals can do wonders in BPO sectors as well. People are the backbone of BPO industry and it is certain that professional HR or Human Resource Psychologist can make inroad in this emerging organization and facilitate the growth of organization in an immense way.[14]

   References Top

1.Akerstedt T, Kecklund G, Gillberg M. (2007). Sleep and sleepiness in relation to stress and displaced work hours. Physiol behave May 21 [E-pub ahead of print].  Back to cited text no. 1      
2. Collins J J, Baase C M, Sharda C E, Ozminkowski R J, Nicholson S, Billotti G M, Turpin R S, Olson M, Berger M L. (2005). The assessment of chronic health conditions on work performance, absence and total economic impact for employers. J Occu Env Med. 47(6); 547 - 557.  Back to cited text no. 2      
3. Czeisler C A, Moore-Ede M C, Coleman R M. (1982). Rotating shift work schedules that disrupt sleep are improved by applying Circadian Principles. Science, 217, 460 - 462.  Back to cited text no. 3      
4. Drake C L, Roehrs T, Richardson G, Walsh J K, Roth T. (2004). Shift work sleep disorder; prevalence and consequences beyond that of symptomatic day workers. Sleep 27(8); 14553 - 1462.  Back to cited text no. 4      
5. Eksdedt M, Soderstrom M, Akerstedt T, Nilsson J, Sondergaard H P, Aleksander P. (2006). Disturbed sleep and fatigue in occupational burnout. Scand J Work Environ Health. 32(2); 121 - 131.  Back to cited text no. 5      
6. Farrell D. (2004). Beyond Offshoring. Harv Bus Rev, 82(12); 82-90.  Back to cited text no. 6      
7. Houpt T A, Boulos Z, Moore-Ede M C. (1996). Midnight Sun: software for determining light exposure and phase-shifting schedules during global travel. Physiology and Behaviour, 59, 561-568.  Back to cited text no. 7      
8. Liddell F D K. (1982). Motor vehicle accidents in a cohort of Montreal drivers. Journal of Epidemiological Community Health, 35, 140 -145.  Back to cited text no. 8      
9. Martimao K P, Varonen H, Husman K, Viikari-Juntura E. (2007). Factors associated with self assessed work ability. Occup Med (Lond); Jun 4 [E=pub ahead of print].  Back to cited text no. 9      
10. Meijmann T, van der Meer O, van Dormolen M. (1993). The after effects of night work on short term memory performance. Ergonomics, 36, 37 - 42.  Back to cited text no. 10      
11. Menzel N N. (2007). Psychological factors in musculoskeletal disorders. Critical Care Nursing Clin of North America. 19(2); 145-53.  Back to cited text no. 11      
12. Moore-Ede M C, Sulzman F M, Fuller C A (1982). The clocks that time us. Cambridge, MA: Harvard University Press.  Back to cited text no. 12      
13. Morse T F, Warren N, Dillon C, Diva U. (2007). A population based survey of ergonomic risk factors in Connecticut; distribution by industry, occupation and demographics. Conn Med, 71(5); 262-268.  Back to cited text no. 13      
14. Williams R M, Schmuck G, Allwood S, Sanchez M, Shea R, Wark G. (2007). Psychometric evaluation of health related work outcome measures for musculoskeletal disorders: a systematic review. J Occup Rehabil Jul 6, (E-pub ahead of print).  Back to cited text no. 14      


  [Table 1], [Table 2], [Table 3], [Table 4], [Table 5]


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