Stress By Design: A Scoping Review of Structural Stressors Among 9-1-1 Emergency Telecommunicators

Background/Purpose: Occupational stress impacts more than three-quarters of U.S. workers. The accumulation of multiple types of stress has been found to have calamitous effects on health and well-being. Sources of stress or stressors can be the result of numerous factors and vary by occupations. One such occupation that experiences multiple types of stress are emergency telecommunicators. Emergency telecommunicators, also known as 9-1-1 call-takers and operators, are a female-dominated workforce who receive specialized training to provide rapid assessment and intervention to individuals, families, and communities during an emergency. Research on emergency telecommunicators has primarily focused on job-related stressors such as exposure to trauma, high work-load, and shift work. However, there has been a lack of examination regarding stressors that extend beyond their work environment, particularly among those who may be marginalized within their work context. Structural stressors encompass layered sources of stress ingrained in the design of work, shaped by policies, practices, procedures, and influenced organizational culture and even broader societal structures. The aim of this scoping review is to analyze broadly the research of occupational stress among emergency telecommunicators and to delineate potential structural stressors that may stem from the structure, culture and design of their work.

Methods: This scoping review utilized the methodological framework of Arksey and O’Malley’s (2005) which examines the research identifying gaps in the literature and mapping key concepts. Electronic databases of CINAHL, MEDLINE, PsychINFO, PychNET, PubMed, Social Index, and Academic Search Complete were used to identify relevant literature on occupational stress of emergency telecommunicators.

Results: 539 articles were screened for inclusion. Across 17 included articles, the following four key themes emerged from the data on workplace stressors of emergency telecommunicators: staffing problems, confinement and isolation, little to no career path, and inequity.

Conclusion and Implications: This study revealed that nearly all (94%), cited staffing shortages, a little under a third (71%), cited that emergency telecommunicators work in confined and isolated areas with little to no access to green space, just over half (53%), cited poor pay and little to no lack of career advancement opportunities, and all cited disparities and inequities related to their social position in the organization of public safety. Emergency telecommunicators are a female-dominated hidden workforce with public safety. In addition to occupational stress arising from the demands of their work, emergency telecommunicators may also face stress due to factors such as inadequate compensation, limited opportunities for career growth, and working conditions characterized by confined spaces with poor lighting and not access to green areas. The recognition of unique stressors of emergency telecommunicators may improve interventions aimed at reducing the negative effects of occupational stress. Future research on occupational stress among emergency telecommunicators can benefit by including structural stressors, particularly through design, policies, practices, and procedures or those that demonstrate the ability to marginalize work groups impact on occupational stress.