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Telecommunicators (e.g., dispatchers and 911 operators) experience firsthand the death and suffering of friends, family, peers, and strangers in a chaotic work environment characterized by chronic stress and lack of support. Previous research has demonstrated telecommunicators are at increased risk for negative health outcomes; however, existing research does not identify predictive pathways to posttrauma symptoms in telecommunicators. In an application of the transactional theory of stress and coping, I used structural equation modeling to examine occupational antecedents, work-family conflict, negative appraising, and coping as predictors of posttraumatic stress symptoms in telecommunicators. A convenience sample of 103 telecommunicators, recruited through agencies across the United States, completed a series of PTSD, stress, and coping surveys. Results supported three theorems from the transactional theory of stress and coping: (a) Chronic antecedents are correlated with work-family conflict (r = .54, p < .01), (b) work-family conflict predicted negative appraising (Î² = .64, p < .01), and (c) coping predicted posttraumatic stress symptoms in telecommunicators (Î² = .30, p = .01). These findings contribute to the current body of occupational health literature by expanding understanding of telecommunicatorsâ occupational experiences and appraisals and provide insights into modifiable processes and policies that can enhance and protect telecommunicator long term health. Specifically, employee-focused policies directed at preserving work-home balance and reducing chronic stressors in the workplace are recommended. Additionally, further research can be initiated to evaluate effectiveness of policy changes in telecommunicator appraising, health, and wellbeing.