You could call it 'call-centritis'. That's what the doctors diagnosed after Meenakshi Ray suffered a massive asthma attack during a shift at the call centre where she worked.

Ray was immediately rushed to a nursing home, where the diagnosis said the attack had been triggered by stress.

Shibashish Chatterjee's experience wasn't very different. He has just quit his call centre job and is now looking for work with the marketing division of a leading bank.

Says Chatterjee, who worked with a leading Gurgaon-based business process outsourcing company: "I felt physically sapped. After coming back from office, I used to sleep the whole day. The work started to affect my health and I lost weight drastically in the last couple of months."

Business process outsourcing may be the hottest business in town but its employees clearly have mixed feelings about the entire business. The result: high attrition rates that refuse to go down.

Now the BPO companies are looking for ways to counter these problems. Many of the top companies have started reviewing their recruitment policies. Some have even started hiring older people with different expectations from their jobs.

"Over the last few months, we have been targeting retired people and housewives in our recruitment ads," says the human resources chief of a leading call centre. He says this has helped lower attrition levels by 5 per cent to 7 per cent.

The fact is that the BPO companies are performing a risky tightrope walk. To retain talent they are being forced to pay higher salaries.

One industry estimate is that labour costs are up by 15 per cent to 20 per cent since last year. This is not only threatening to erode the competitive advantage of these companies but also biting into their profit margins, which are already wafer thin.

"Today, the biggest threat to the industry is the high rate of attrition," says Vikram Talwar, chief executive officer, EXL.

Working in a call centre can be a tough proposition. Most call centre professionals fail to cope with the physical and mental demands of working on night shifts for months at a stretch. This is particularly true for those working on voice processes.

Though voice employees draw 12 per cent to 15 per cent higher wages than their non-voice counterparts, it is hardly compensation enough for the kind of stress they handle.

In fact, call centre professionals are increasingly being diagnosed with a host of symptoms, ranging from depression to spondylitis and sleep disorders. Many BPO companies have tie-ups with healthcare centres, which provide medical cover to their employees.

Moreover, abnormal duty hours mean that call centre agents hardly have anything that can be described as a social life.

Many companies attempt to compensate for this by organising frequent parties and picnics where employees can interact and let their hair down.

Additionally, many call centres are also offering a host of performance-based incentives to boost staff morale and ensure higher efficiency.

Others are also trying to make life easier by providing employees company-leased accommodation near the office.

What's the long-term solution for all these problems? For a start, the companies are taking a second look at the type of people they should be hiring and they've tightened the screening process for new recruits.

On one hand, they are slowly coming round to the view that it may be better not to hire youngsters who are overly ambitious.

At another level, they are catering to ambitious employees by giving them time for higher studies.

"At the hiring stage we lay a lot of stress on getting the right kind of profiles by doing a fitment on the basis of certain set criteria, which are specific to any given position," says Aniruddha Limaye, vice-president (human resources and training), Daksh.

Alternatively, some call centres are encouraging employees to look at in-house career opportunities.

"We have internal job postings which help people move laterally or vertically. One can become a subject matter expert and move into training," says Limaye.

The fact is that many youngsters join call centres to make a bit of quick money. So they join for a few months and then quit to pursue higher studies. One such example is Alpana Sharma, a graduate in English from Delhi University.

"I plan to do my MBA from a reputed institution, in the meantime, however, I plan to join a call centre so that I can earn enough money to fund my studies," says Sharma.

There are, of course, other initiatives taking place at different levels. In Andhra Pradesh, a handful of BPO companies have come together and decided on a set of criteria for hiring. Limaye says the industry must initiate more changes like these to ensure the growth of the sector.

But in an industry, which is growing so rapidly, such initiatives can only have a limited effect. New players are entering the market all the time and poaching is, therefore, inevitable.

"Unless we stop poaching employees from each other, there will be no solution to this problem," says Talwar.

Faced with a shrinking talent pool in the metros, some call centres are now trying to start operations in smaller towns.

"Cities like Vishkapatanam, Indore, Lucknow, Chandigarh can also supply the workforce needed for manning a call centre," says Devashish Ghosh, chief operating officer, Wipro Spectramind.

Ghosh, however, confesses that there are hurdles to be overcome in the smaller cities. Firstly, it's tougher to get large numbers of good English speakers in these cities. Also, basic infrastructure like electricity and roads need to be improved.