Risk factors and health status among operators at a large call center in Italy

Introduction
Call centers are a rapidly growing industry in many countries. They represent environments in which the organization of the work may expose workers to a variety of health hazards, including indoor air quality, video display unit working, stress and also less investigated hazards, such as noise and vocal strain.

Methods
The aim of the study was to investigate risk factors and the health status of operators at a large call center by an integrated approach including: building assessment, environmental measurements, questionnaire survey and health surveillance data analysis. Building assessment and environmental measurements evaluated chemical pollutants, microclimatic and acoustic conditions and ergonomic factors. A self-administered questionnaire was used to collect data on the subjective perception of environmental working conditions and subjective symptoms. The subjective perception of vocal performance has been evaluated using VHI (Voice Handicap Index) questionnaire. Results from the periodical health surveillance have been collected and evaluated.

Results
The sample is represented by 222 operators at a call center in Milan. Building assessment and environmental measurements showed non optimal microclimatic and acoustic cooditions. At the questionnaire survey the most reported symptoms were related to eye symptoms (31%), musculoskeletal complaints (21%) and allergies (17%). Microclimate has been evaluated “negative” or “partially negative” by 68% of the workers; noise “negative” or “partially negative” in 51%. In the sample VHI value resulted over the limit of 30 in the 6% of the subjects (limit value of 30 is considered as a cut-off for voice performance disorders). Three subjects with dysphonia and a case of vocal cords nodules were identified.

Discussion
In this study the main issues are represented by eye symptoms, postural related musculoskeletal disorders and vocal strain. It’s necessary to develop and validate an appropriate health surveillance protocol and a specific training for the workers about the evaluated risk factors.