Acoustic shock syndrome – don’t employ nervous anxious people in your call-centre, it will cost you

The IT Skeptic takes a break from ITIL and talks about call-centre absenteeism. Call-centres are generally high-stress, low-morale environments – a recognised issue that has seen much progress in addressing it in recent times but it remains real. This is no excuse for the abuse of reason through hyped syndromes to justify absenteeism, and especially the cynical support for this by some doctors, unions and of course lawyers. The latest work-related illness is “acoustic shock”. Perhaps attention to it will encourage call-centre employers to treat staff less like cattle, but it is also growing a predatory industry.

“Employees who work in call center operations can be four times more likely than the other employees to miss work for psychiatric conditions such as stress or depression,” notes Dr. Ronald Leopold, vice president and national medical director, MetLife Disability in a recent study conducted by MetLife. And no wonder – I wouldn’t do their job.

But it is hard to show that work causes “depression”, whereas a label like “acoustic shock” attached to the condition by a recognised medical practitioner offers a causal link against which to claim compensation. According to a UK union, acoustic shock is “a devastating 21st Century industrial injury problem ruining call centre workers' lives and costing industry millions”.

For those of you who may be unaware of this syndrome, the following is from the Australian National Acoustic Laboratories

The problem
Occasionally, intense, unwanted signals accidentally occur within the telephone network… Although these high-pitched tones can affect anyone, people using a regular hand-held telephone can quickly move the phone away from their ear, thus limiting their sound exposure to a fraction of a second. Call-centre operators, however, usually use a head-set, which takes considerably longer to remove from the ear were an intense sound to occur. They thus receive a greater noise exposure than for people using hand-held phones. The problem may be exacerbated if call centres are so noisy that the operators need to have the volume controls on their telephones turned up higher than would be necessary in a quieter place.
The effects
Unexpected high-level sounds have been reported to cause a variety of symptoms. Symptoms that have been reported during the exposure include discomfort and pain. Symptoms that have been reported in the few minutes after the exposure include shock and nausea. Symptoms that have been reported to continue for some time after the exposure include headaches, nausea, tenseness, and hypersensitivity (discomfort) to loud sounds that would previously have caused no problems. In some cases, these symptoms are reported to continue for many days or weeks after the incident, although more commonly the symptoms are short-lived. Some operators who experience an acoustic shock may feel apprehensive about using the phone or about loud sounds in general.
The damage mechanism
The mechanism causing the adverse symptoms is not known with certainty. It seems highly likely, however, that the sound exposure elicits an acoustic startle reflex. (The same startle reflex can also be elicited by an unexpected touch or puff of air to the eyes). When startle occurs, numerous muscles in the upper limbs, shoulders, neck, eye and ear (the stapedius muscle and the tensor tympani muscle) are activated. If the noise exposure is loud, or if the person is in an aroused state (e.g. anxious, fearful) prior to the startle, the magnitude of the muscular response is heightened.

Note the longer term symptoms are “headaches, nausea, tenseness, and hypersensitivity (discomfort) to loud sounds” – all chronic symptoms with no clear causal mechanism (although there is plenty of speculation around muscle tension) and no objective measure of their validity (they don’t show up in blood tests, ECG etc).

Already the acoustic shock industry is gearing up: there are government inquiries, British unions have already handled more than 700 acoustic shock cases securing more than £2million in out of court settlements for workers, consultants are offering policy and process, and of course technology can be purchased to limit noise bursts.

According to the BBCBT has already paid out £90,000 to one worker. Solicitor Adrian Forden is representing another 83 BT employees who are complaining that they have suffered injury through "acoustic shock". "It could be the tip of the iceberg," he told the BBC's Today programme. "I've travelled nationwide interviewing people from all sorts of backgrounds who have experienced this problem."
I bet you have.

Dr John Welch says in the latest New Zealand Skeptic newsletter [sorry, members only] “It pays to have an employer with deep pockets… this is not an occupational disease but an attempt to attribute personal angst to the workplace”.

How does the UK government’s Health and Safety Executive view this new threat?

HSE's initial thoughts on acoustic shock syndrome were based largely on physiological evidence for hearing loss, with a strong link between an individual's exposure to noise and the level of risk to their hearing (how loud the noise was and how long it lasted).
An extensive HSE study incorporating evidence from 15 call centres in the UK indicated that call centre workers were not normally exposed to levels of noise that were considered likely to cause permanent hearing loss. Even on those occasions where operators were exposed to high-intensity noise, which might cause permanent damage to hearing (such as loud screeches and alarms being let off down the phone), such noises would be excluded by the protection built into the operators' headsets. The associated risk was therefore considered to be low.
Since HSE carried out its research, new medical evidence from Australia and Denmark has emerged. This was presented at the first ever international seminar on acoustic shock in Fremantle, Australia in September 2001.
This evidence was based on symptoms found in Australian and Danish call centre workers claiming to suffer from acoustic shock. The symptoms ranged from numbness and tenderness around the ear, to hypersensitivity to sound in extreme cases.
The research concludes that noise of high intensity and high frequency might cause symptoms at exposure levels which are lower than was previously thought to be the case. In addition to loudness and the duration of exposure, the research identifies a range of previously unconsidered variables, which may affect whether exposure to high intensity noise might cause symptoms. This includes factors such as: the sudden onset of the noise, stress, and an individual's personal susceptibility.
Initial clinical suggestions as to the physiological causes of the symptoms include muscular spasms of the middle ear region.
Over a hundred cases have been recognised in Australia, and a lesser (but still significant number) have been reported in Denmark. On the other hand there have been few reported cases in other countries. It is possible that the few reported cases in the UK could have experienced symptoms as described by the Australians.
Prior to the new evidence from Australia and Denmark, HSE had no cases of acoustic shock reported to it.

Note that factors include “… stress, and an individual's personal susceptibility”.

Based on some light Googling, the wave does not seem to have reached the USA yet, but the IT Swami says watch this space!

Though out of scope for this blog, the Metlife report referenced above offered some excellent advice on improving the well-being of call-centre workers.

• Assess the work environment.
• Screen potential employees for skill sets. […and for a nervous disposition]
• Allow for growth.
• Take advantage of technology.
• Involve everyone in health and wellness.
• Communicate the company’s vision.

Check it out. There is no reason why call-centres should not install burst-limiting filters, and the current media activity may serve to make them universal – that is a good thing. Likewise all the good people-management advice in that article would benefit call-centres that don't follow it now.

It is a shame however that prior experience with other occupational syndromes suggests that employers will have to payout because they made the mistake of offering jobs to anxious nervous people, and the valid claims for real harm will be swamped by hysterical claims from people who are tense and anxious before numbers eventually settle down to just the valid sufferers and the rorters. The final word goes to John Welch of the NZ Skeptic: “I predict that the condition will remain unheard of in India… since there is no compensation available”. Quite.