OHS Quest 2 & 3- OHS risks for 5 people and OH&S management for 000 call takers.
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New research shows that sedentary work contributes to weight gain

New research shows that sedentary work contributes to weight gain | OHS Quest 2 & 3- OHS risks for 5 people and OH&S management for 000 call takers. | Scoop.it
Bring your body sense to work today
Alaine Burgess's insight:

For Quest 3, I will be looking at the OH&S risks associated with working in a 000 call centre.  Continue down to the bottom of this page to look at the 5 people/careers that I assessed the OH&S risks for initially - a pilot, a paramedic, a nurse, a 000 call taker, and a wine seller.  

 

It is well acknowledged that as a general population we are growing heavier and heavier with each generation.  We are eating more - and eating worse foods! - than ever before, and yet are moving less and less.   This is leading to an accumulated weight gain over years and certainly sedentary jobs like 000 call taking are not helping in the quest to maintain a healthy weight.   

 

With increased weight comes increased risk of various diseases, including but not limited to: cardiovascular disease, diabetes, stroke, some types of cancers, high blood pressure and high cholesterol.   These in turn decrease life expectancy, overall health and enjoyment of life.  

 

This article compares lifestyles from the 1950's and 1960's with today, noting various changes that are leading us to a more sedentary lifestyle.  It also comes with some great suggestions on how to reverse this trend and make some small changes that can help to lose weight or at least reduce the rate of gain.   

 

The article is featured in Psychology Today, an online journal looking at a variety of issues that impact overall health.  It is a reasonably reputable source and while anyone interested in this topic should certainly delve deeper, this is an interesting starting point that gives a broad overview of the topic.   

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» 911 Operators Vulnerable to PTSD Symptoms - Psych Central News

» 911 Operators Vulnerable to PTSD Symptoms - Psych Central News | OHS Quest 2 & 3- OHS risks for 5 people and OH&S management for 000 call takers. | Scoop.it
911 dispatchers deal with traumatic scenarios every day, but from a distance -- and it turns out that combination can make them vulnerable to symptoms of
Alaine Burgess's insight:

This is a particularly relevant article regarding the accumulative impact of taking 000 calls on the operators.   While the majority of attention focuses on the front line staff of the emergency services and the military, (and is well documented) there is very little research on the effect of taking emergency calls.  For so long it has been believed that if you don’t SEE it, you couldn’t be affected by it.  What that approach lacks is an understanding of how difficult it can be to try and maintain control of traumatic circumstances over the phone: to provide CPR instructions to a highly distraught mother whose baby has stopped breathing, to comfort an elderly person whose spouse of 60 years has just died in their arms, to gather information from people involved in a motor vehicle collision who are so shocked by the event that they are barely coherent.  

 

I believe that people who take emergency calls must have an innate desire to help people and a natural resilience to distressing and traumatic calls.  Show me a 000 operator who hasn’t burst into tears during or after a call and I’ll show you someone who is lying.  This is an incredibly difficult job and it DOES take a terrible toll on the people who do it.  I think more research is required into this field, but this article is a really good start at recognising the problem and starting to draw attention to it. 

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ErgonomicPrinciplesChecklistsForOfficeFurniture_1991_PDF.pdf

Alaine Burgess's insight:

This is a great document from Safe Work Australia, which looks at ergonomics for people sitting at work desks.   It looks at not just the appropriate height of the desk and how that should adjust depending on the person's height, but also where on the desk items should be positioned depending on how frequently they are used.   It provides information regarding the purchase of desks, chairs, and other office furniture and what sort of features should be sought.   Near the end of the document are several useful checklists, which include the user checklist for ergonomic design of adjustable chairs, document holders, footrests, non-adjustable chairs and office desks.   

 

This would be helpful for every workplace to have, as many workplaces have at least a percentage of their staff who are in an office environment.   Particularly given the long shifts and very sedentary nature of being a 000 call taker, I think this should be mandatory reading and should be enforced in the workplace. 

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... a wine seller in the cellar door of a vineyard

... a wine seller in the cellar door of a vineyard | OHS Quest 2 & 3- OHS risks for 5 people and OH&S management for 000 call takers. | Scoop.it

This is Colin, who volunteers in the Cellar Door of Kelman Vineyard, helping to sell wine to the public.  Colin provides wine tasting to individuals or groups, and helps ensure the smooth running of the cellar door during the week.  

Alaine Burgess's insight:

Some of the OHS issues that might be a problem inside the cellar door are:

 

* Wet floors creating a slip hazard

          Due to the volume of washing up and liquids being handled in the cellar door, there is a high risk of spillage that can cause a slip hazard.  As the floor boards are wooden and polished, they don't provide much grip and when wet are very slippery.  To try and combat this, behind the counter are rubber mats with a honeycomb pattern which allow liquid to fall through but keep feet and shoes above the spills.  Away from the counter, spills are potentially a problem for customers as well as anyone working in the cellar door, particularly because people coming in to taste the wines are rarely looking at their feet and might easily slip over.  

 

* Risk of back injury from lifting heavy boxes of wine

         Given that wine is packaged in boxes of 12 bottles, they are quite heavy, and to lift each box, particularly if it is sitting on the ground, requires some exertion.  For Colin and the other people who work in the cellar door, there is a constant need to re-supply the cellar door with more wine and thus each day many boxes need to be shifted.  This creates the risk of back injury from lifting and moving heavy weights.  

 

* Possibility of assault from intoxicated patrons

          With the tightening of Responsible Service of Alcohol (RSA) laws, Colin states that he has noticed a decrease in the number of heavily intoxicated people presenting for further wine tasting.  However, because selling wine through cellar doors gives patrons the chance to sample the wines before buying, it does still have the possibility of creating situations where tipsy or intoxicated patrons can get aggressive.  Colin says that only once in his career has anyone taken a swing at him, and that was when he refused to serve someone who was intoxicated any further alcohol.  Although a relatively low risk, being assaulted by someone who is intoxicated is still an OHS risk. 

 

* Physical injury from broken glasses

          This is actually one of the most common ways to sustain an injury when offering wine tastings at the cellar door.  The fragile glasses break rather easily, and if broken the sharp shards pose a significant risk of lacerations.  The glasses can become slippery when wet, or because tipsy patrons don't have a firm hold on them, or when being loading in or out of the dishwasher after use.  The cellar door keeps a first aid kit that is well stocked with bandaids to deal with any lacerations that might occur from broken glass. 

 

* Fatigue and back injuries from standing for long period of times

          The cellar door is open between 1000-1600 each day, and particularly on the weekends when it is busy, those six hours are generally non stop moving, and standing talking to patrons regarding the wines.  As the volunteers working the cellar door tend to be older people like Colin, they often find that they are left exhausted by the end of the day, with sore feet and aching backs from the long periods spent standing.  Colin tries to wear his most comfortable shoes to combat this risk, but still finds he is tired and sore by the end of the day.  

 

* Risk of being burnt on hot glasses from the dishwasher

          Due to the high turnover of glasses during busy times, the dishwasher is often run many times a day and needs to be immediately unloaded when it is finished to allow the next load to be started.  Colin says that more than once he has scalded his fingers taking very hot objects out of the dishwasher and knows now that he needs to let the dishwasher cool down for a few minutes no matter how busy it is!   

 

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... a Paramedic

... a Paramedic | OHS Quest 2 & 3- OHS risks for 5 people and OH&S management for 000 call takers. | Scoop.it

This is my husband, Garrick, in his "home away from home".  Garrick is a Paramedic with the NSW Ambulance Service, and his role involves responding to 000 emergency calls from the public as well as the transportation of patients between hospitals and other facilities.  Garrick works shift work that comprises of a mixture of day, afternoon and night shifts, usually 12 hours long. 

 

Alaine Burgess's insight:

The OHS risks of working as a Paramedic are numerous and well documented.  

 

* Manual lifting and carrying

          By far the most common injury that occurs in the line of work as a Paramedic is physical injuries as a result of lifting and carrying people and equipment.  As a large portion of a paramedic's role is to move people from one location to another, there is an extreme amount of physical labour involved that simply cannot be avoided.  There are certainly pieces of equipment that have been introduced to try and minimize the amount of lifting involved, but the problem has not been eliminated.  It is one of the truths of the provision of emergency pre-hospital care that the working life of a paramedic is usually cut short by injury.  We live in a society where the average weight of individuals is increasing and the willingness of each person to help themselves or anyone else is decreasing.  

           However, it is not just the movement of people that is resulting in injuries.  As medical technology increases, more and more equipment is introduced to paramedics for them to use, and the average weight of a bag of equipment is increasing as well.  On average, when entering a scene the paramedic crew will need to carry in with them a first aid kit, drug kit, oxygen kit and defibrillator.  Each kit weighs an average of 10-15kg.  The stretcher itself is another large, heavy, awkward piece of equipment to move even when empty, and needs to be physically hefted into the ambulance many times each day.  Unfortunately, due to the amount of lifting and carrying involved, many Paramedics end up injured, often ending their careers in pre-hospital care as a result.

 

* Mental stress and PTSD

           One of the most common sayings Paramedics hear is "You must see some terrible things!"  Unfortunately, yes, they do.  Major trauma from MVA's or domestic accidents, death, children injured, families in distress, abusive patients or friends, the effects of alchol and drugs, senseless, needless events which could have been avoided and the random events which strike out of the blue.  Dealing with patients and their families often at times of crisis and grief results in an emotional toll that is unavoidable.  Sadly, the medical profession has an alarmingly high rate of suicide and PTSD caused by the cumulative effect of seeing so many distressing events. 

 

* Driving at high speeds in a variety of conditions

          As with any profession that drives for their work, Paramedics have a high risk of being involved in collisions on our roads.  The rate of Emergency Vehicle Collisions (EVC's) is alarmingly high, and as such being involved in a collision is a OHS risk that every Paramedic takes.  The fact that ambulances tend to be large, top-heavy vehicles that are driven with lights and sirens, at high speed, in all conditions including night driving, and wet weather does pre-dispose them to be involved in an undesirable number of collisions. 

 

* Infectious diseases

          The OHS risk of infectious diseases is well documented but extends well beyond what an ordinary person might initially think of.  Certainly the well publicised diseases such as AIDS/HIV and Hep C are a concern, but the risk of disease is much more than that.  By the very nature of their job, Paramedics are often exposed to unwell patients - and there are a multitude of diseases that spread by contact or airborne transmissions.  For instance, colds, respiratory infections, the flu, and gastroenteritis are diseases that Paramedics are routinely exposed to, and although precautions such as hand hygiene and PPE are used, there is still an elevated risk of transmission.   Along with contact and airborne diseases are the group of diseases spread by body fluids and the risk of needle-stick injuries with Paramedics is particularly high.  Unlike nurses and doctors who work in a controlled environment within the hospital, Paramedics use needles and other "sharps" in a variety of unstable environments, including frequently in the back of a moving vehicle.  Transmission of infectious diseases is an important OHS risk for Paramedics. 

 

* Assault

         Surprisingly, the incident of assaults on Paramedics is on the increase.  This has led to a recent campaign in the media by the NSW Ambulance Service to promote a zero tolerance approach to assaults on their staff, and a promise to vigorously prosecute those who seem to believe it is acceptable to assault a Paramedic while they are trying to help the ill or injured.  With the number of incidents of drug and alcohol fueled violence increasing, so too are the number of incidents of Paramedics facing physical assault while trying to perform their job.  This is a very real OHS risk to front line staff providing emergency medical care. 

 

* OHS risks in a variety of environments the paramedics are called to

          Paramedics work in a variety of environments and are therefore subjected to a variety of OHS risks that occur in each and every environment they enter.  Attending a patient in their own home, paramedics might face OHS risks such as slippery surfaces, physical obstructions they have to climb over or on, contamination of surfaces by infectious diseases, animal attacks, or any other of a myriad of problems.  If they attend a patient's workplace, they encounter the exact same OHS risks that the patient would encounter on a daily basis. Added to the fact that they work 24/7, Paramedics often face these OHS risks in the dark, with minimal lighting, in a variety of extreme weather conditions, and with little or no preparation.  

 

I truly believe that Paramedics do an incredibly difficult job and face a plethora of risks each and every day that most of us would consider intolerable.  They have a high incident of injury, illness, fatigue and mental distress, and yet continue to go above and beyond what would be expected of them on a daily basis.  

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how_to_manage_shiftwork_guide_0224.pdf

Alaine Burgess's insight:

This is a really short, succinct document produced by WorkCover NSW about the hazards and management of shift work.   It talks about the body clock and sleep cycles and why people have so many problems adjusting to night shifts.   It also looks at on-the-job fatigue and why work performance decreases as the shift progresses, particularly on night shifts.   Interestingly, one of the most important parts of the document is the section on health-related effects of shift work, where it is acknowledged that shift work can cause physical problems such as gastrointestinal upsets, mental health problems such as susceptibility to depression, and complications with pregnancy and the older shift work.  

 

The latter part of the information goes through management of shift work and fatigue related problems, and suggests solutions including sleeping, scheduling, diet, temperature, fitness, and social life.  

 

This is an easy to read document that presents the information clearly and concisely.  WorkCover NSW is an authoritative government body and this source is a good one for people needing a starting point to handle the basic concepts of shift work and fatigue related issues.   

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Computer Eye Strain: 10 Steps for Relief

Computer Eye Strain: 10 Steps for Relief | OHS Quest 2 & 3- OHS risks for 5 people and OH&S management for 000 call takers. | Scoop.it
10 easy steps to help with computer eye strain relief.
Alaine Burgess's insight:

For people sitting at desks for extended periods of time, particularly with heavy computer usage as 000 call takers do, eye strain is common and many people complain of symptoms such as headaches, deteriorating vision, red and irritated eyes, and fatigue.   This was one of the best web sites I was able to find about solutions for this problem, and 10 steps are listed that can help control the symptoms.   

 

These possible solutions include things such as using proper lighting, minimizing glare, upgrading the computer display and changing the setting so the font and colours are easier to read, blinking, doing eye exercises, taking frequent breaks, modifying the workstation, considering computer eyewear and of course, having regular eye exams by an optomitrist.   

 

I found these possible solutions sensible and helpful, particularly as several of them could be done on a regular basis with minimum of fuss or effort.   With the amount of time that people spend on computers and in front of TV screens in today's life, I think this is a really valuable website that would benefit everyone to read and think about.  

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...a pilot and flight nurse from Air Ambulance

For some reason, I cannot upload this photo despite trying approximately 100 times.  The photo shows Phil, the pilot of the aircraft, and Mark, the flight nurse, re-loading the empty stretcher into the aircraft after dropping off a patient at Williamtown airport in NSW.  Phil has worked for NSW Ambulance Service for 16 years and reckons he has the best job in the world.  He flies an average of 9 hours a day each day he is at work, although some days are certainly busier than others.  He loves the freedom of flying and of not having  boss watching his every move.  Mark has been a flight nurse for 5 years, and before that he was a registered nurse and midwife.  He likes the fact that working for Air Ambulance means he can look after a variety of patients, rather than just work in one speciality on a ward in a hospital.  He says he gets a chance to practice a lot of skills he otherwise would use, and likes the autonomy of his practice.

Alaine Burgess's insight:

OH&S risks in this environment:

 

* Moving propellers

          All the aircraft in use by NSW Ambulance Service are prop planes, and often if a rapid load of a critically ill patient is required, the props are kept moving without turning the engines off.  This poses a significant risk of having either the crew of the plane or one of the people on the ground assisting to load the plane coming in contact with the propellers.   All the staff working for air ambulance are given specialised training to deal with the risks they encounter during their work around the aircraft, and safety around the propellers is a major component of this.

 

* Aviation fuel

          As the planes are relatively small, they need frequent re-fuelling.  This is normally done each time the plane lands to ensure adequate fuel for the next leg of the journey.   Although the pilot and flight nurse are not directly responsible for re-fuelling the plane, they do work in the vicinity of the fuel trucks and are often nearby while the ground staff are filling the aircraft up.   The two main hazards presented by aviation fuel are chemical hazards and ignition hazards.  The fuel itself is a chemical, and the vapours can cause headaches, CNS disturbances, dizziness and impaired coordination.  If contacted with the skin, it can cause a rash or skin irritations.   As aviation fuel is highly flammable, care has to be taken around the fuel to prevent ignition.

 

* Mechanical failure of the aircraft in flight

           Given that the working environment for Phil and Mark is high up in the air, there is the risk that should a mechanical failure occur or the aircraft sustain damage whilst in flight - for example from a bird strike - that the aircraft could lose flight capability and crash.  I thought this would likely be the most concerning risk for both men, but both agreed that it is not really something that they worry about much.  Phil says that even if they lost the use of the engine for some reason, there is still a very good chance he would be able to glide the plane until he could find a flat surface to land on.  Mark also told me that he runs more risk driving to the airport each day than actually flying!

 

* Lifting injury from loading and unloading patients

          This is a significant OH&S risk due to the volume of patients that are moved, and the tight space inside the aircraft.   To actually lift a patient in or out of the aircraft, Phil and Mark demonstrated the use of the hoist they use that does the actual lifting.  However, in order for the stretcher to be loaded into the hoist, it needs to be physically hauled down the interior of the plane to reach the doorway and the hoist.  The required Mark to pull the stretcher over a series of sliding rollers, whilst bent in the aircraft.  The risk of back injuries in particular is significant.

 

* Slipping and falling on the stairs into the aircraft

           Mark says he has slipped going up the stairs and stubbed his toes more times than he can count, and both Phil and Mark admit to slipping down "one or more" stairs, particularly in wet weather.  Although the stairs have a sand-paper like texture on them and yellow painted lines delineating the edges, because the tread of the stairs is small and the stairs are suspended off the ground, there is still risk of physical injury from slips and falls.  

 

* Bumping into parts of the plane if not looking when you are going

            Phil says he has bumped his head on the underside of the wing when he ducks underneath, and Mark says he has done the same on the door frame when getting into the plane.  Due to the degree of movement in and around the aircraft, unless concentrating carefully at all times, it is easy to contact parts of the plane with parts of the human body - the head in particular.  Interestingly, the Ambulance Service does not require the use of a helmet when exiting or working around the exterior of the aircraft. 

 

* Working in confined spaces/claustrophobia

            I was amazed at how small the interior of the aircraft was.  There is literally only room for 2 stretchers down one side of the interior, and two seats - one for the flight nurse and one for another patient or an escort.   There is very little room to work, and particularly if a patient requires on-going monitoring or invasive procedures, there is almost no space to work.  There is a fair amount of storage for medical equipment, which further cuts down the space inside the cabin and the cramped conditions for hours at a time must get uncomfortable.  Mark is philosophical about the lack of space and simply says that you get used to it.  He did tell a story of a patient that started becoming agitated and upset whilst the plane was in flight which led to an emergency landing and chemical sedating of the patient as they posed a threat to him in the aircraft.   For this reason, it is policy that Air Ambulance will not transport mental health patients, due to the potential risk whilst at altitude.  

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... a registered nurse in an emergency department

... a registered nurse in an emergency department | OHS Quest 2 & 3- OHS risks for 5 people and OH&S management for 000 call takers. | Scoop.it

Meet Deborah, a Registered Nurse at one of the largest hospital in the Newcastle area of NSW.   Deborah has been an RN for 11 years, and for the last 7 years has specialised in Emergency Nursing.  She works 8 hour shifts over a rotating roster, and is often required to work over weekends and public holidays.  

Deb says that she can't imagine doing anything else except being a nurse, and she loves the fact that she gets to wear scrubs and comfortable shoes to work - she says it's like going to work in your pajamas every day!  

On the day I spoke with Deb, she was rostered to work in the resuscitation area of the emergency room.  I found her first thing in the morning before it started to get too busy, when she was running through her equipment and check lists in the empty resus room.  I would imagine that by the end of the day, it wouldn't look this neat and tidy!  

Alaine Burgess's insight:

Although nursing has the benefit of being in a relatively controlled environment, there are still many OHS risks that are associated with the profession.

 

* Manual lifting and moving

           Patients need to be moved from ambulance stretchers to the Emergency Dept beds, which is often achieved using a PatSlide (essentially a large flexible board of plastic that is slid under the patient and they are then "slippery-dipped" across to the other bed)   Although these board lessen the workload, the patient still needs to be rolled and moved manually in the bed by the nurses.   

           In addition to moving patients, there is also equipment to move and the beds will need to be pushed around the department as well.  Having a controlled environment with ergonomic beds makes a huge difference to the rate of injury in the workplace and although the injuries may still occur, it is much less than the rate of injuries outside the hospital.

 

* Fatigue

          Nurses in the emergency department work 8 hour shifts, and will often be rostered on a sequence of mornings, afternoons, and night shifts.  The rotating roster and volume of shifts combined with the busy workload contributes to fatigue, which in turn can increase the rate of errors or injuries within the workplace. 

 

* Infectious diseases/needlestick injuries

          Working with ill or injured patients increases the potential for diseases to be spread.  Deb mentioned several methods that the hospital has introduced to reduce the transmission of infectious diseases, including hand hygiene, self-capping needles, plentiful "Sharps" containers and protocols for disposal of contaminated waste.  In the photo with Deb, on the left hand side a hand washing facility is visible, with several types of hand wash, paper towel to dry hands, alcoholic hand rub, disposable gloves in several sizes, and a chart for detailing correct hand-washing procedure.  Also visible is a Sharps container on the bench.  The hospital is vigilant about reducing the spread of diseases wherever possible. 

 

* Slippery floors

          One of the biggest risks in the emergency department is that the floors are frequently wet and slippery.  Whether it is body fluids like blood or vomit, or spilt water from the sinks, dripping medicine or IV fluids, or the cleaners mopping the floors frequently, there is the risk of staff or visitors slipping over.   To combat this risk the hospital has a plethora of "Wet Floor" signs that are required to be used, and all the staff are required to wear sturdy, enclosed footwear with good grips on the sole.  Hospital staff are encouraged to alert management to any potential risks and if possible either fix it themselves or notify someone else to mop up the spill. 

 

 

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... a 000 call taker and dispatcher

... a 000 call taker and dispatcher | OHS Quest 2 & 3- OHS risks for 5 people and OH&S management for 000 call takers. | Scoop.it
This is Donna, who is a call-taker and dispatcher with the NSW Ambulance Service.  It's Donna's role to answer the 000 emergency calls that are received, get as much information as possible regarding the problem and circumstances of the situation, then dispatch the most appropriate ambulance resource to the location.   Donna works in one of four control rooms across NSW, where the rooms are manned 24 hours a day, 365 days a year and average an emergency call every 15 seconds. 
Alaine Burgess's insight:

Although this role is in an office environment, there are still OH&S issues that must be addressed.  

 

* Fatigue - working 12 hour shifts, with two day shifts then two night shifts, creates a high level of fatigue that is a problem in a role where staying mentally alert and able to respond to changing circumstances is required.  There is no chance to rest whilst on shift and some of the staff face commutes of up to an hour each way between shifts.  Sleeping between shifts can be problematic for some people who might have families to distract them or obligations to attend between shifts. 

 

* Ergonomics - Given the extended times spent sitting at a desk, it is very important that the ergonomics of the desk and chair are properly adjusted for each person.  During busy times, breaks can be minimal and it is not unusual for one of the dispatchers to not move from their desks for up to 6 hours straight.  Unless the desk and chair are set up correctly, there is a risk of poor posture, back pain, and soft tissue injuries. 

 

* Health problems - eye strain from staring at computer screens for 12 hours straight per day is not uncommon.  Many of the 000 call takers or dispatchers end up wearing glasses to deal with the sight problems caused by long hours in front of the computers.   Headaches are another frequent health complication, where the constant noise, lights and stress result in persistent headaches. Soft tissue or muscular problems can also occur, with RSI causing carpal tunnel syndrome being one of the most common problems.  Due to the sedentary nature of the work, many call takers and dispatchers put on weight persistently and there are many associated health risks associated with being overweight or obese.  

 

* Mental distress - the very nature of 000 calls means that some of the calls are highly distressing and it is understood that the cumulative effect of so many upsetting calls has a negative impact on the call takers.   

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