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F2.1 History and Status of NIOSH Research on Workplace Violence-Jenkins EL

NIOSH has been conducting research on workplace violence since 1988. A number of studies have been published, focusing first on workplace homicide and then expanding to include nonfatal workplace assault. NIOSH has focused on improving surveillance data, integrating information from multiple sources, and identifying risk factors and prevention strategies. A hallmark of these activities has been outreach and collaboration-bringing together government and academic researchers in both public health and criminal justice, along with labor, industry, human resources, legal, and employee assistance professionals.

Violence is indeed a substantial contributor to death and injury on the job. Homicide has become the second leading cause of occupational injury death overall and is the leading cause of occupational injury death for women. Estimates of nonfatal workplace assault vary depending on the data source, but data from the National Crime Victimization Survey indicate that each year from 1992-1996, more than 2 million workers were victims of a violent crime while working or on duty.

Risk factors for workplace violence include dealing with the public, the exchange of money, and the delivery of services or goods. Prevention strategies for minimizing the risk of workplace violence include (but are not limited to) cash-handling policies, physical separation of workers from customers/clients, good lighting, security devices, escort services, and employee training. A workplace violence prevention program should include a system for documenting incidents, procedures to be taken in the event of incidents, and open communication between employers and workers. Because no single prevention strategy is appropriate for all workplaces, workplace violence prevention efforts should be tailored to the risks in particular workplaces. NIOSH, along with others in the occupational safety and health community, is beginning to evaluate the effectiveness of various strategies in high-risk settings, so that intervention efforts can be most effectively targeted.


F2.2 Evaluation of Risk Factors for Robbery and Employee Injury and Compliance to a Workplace Violence Intervention in High-Risk Business Settings-Casteel C, Peek-Asa C

Introduction: Homicide is the second leading cause of U.S. workplace death. The majority of these deaths are robbery-related, and although many businesses are at risk, risk factors have been described only for convenience stores. Robbery and violence prevention programs have been implemented in convenience stores and have generally been effective. The extent to which these programs are effective in other business settings depends on similarities in risk profile and program compliance.

Objectives: Identify risk factors for robbery and employee injury in retail and service businesses, and describe compliance to a workplace violence intervention introduced into these businesses.

Methods: Liquor, grocery and convenience stores, restaurants, and motels in Los Angeles were eligible, and 400 businesses enrolled. Baseline assessments were conducted to identify risk factors for robbery and violent injury. Businesses received a workplace violence prevention program composed of low-cost measures found to decrease violence in convenience stores. Follow-up interviews were conducted to document changes due to the program.

Results: Many risk factors for violence analogous to those in convenience stores were found. At baseline, 89% maintained large cash amounts in the registers, 56% had obstructed visibility into the business, and 75% had insufficient interior lighting. Although robbery training was offered in 58% of the businesses, most of these programs were found to be inadequate. Two-thirds of the businesses had video cameras and 72% had burglary alarms. Comprehensive security programs were almost non-existent.

Following program implementation, 66% of the businesses introduced training programs, 65% introduced cash handling procedures, 57% increased lighting, and 41% cleared window obstructions.

Conclusions: Most businesses lacked adequate prevention measures to reduce robbery-related violence. However, many had equipment systems, which focus less on robbery and violence prevention and more on suspect apprehension and merchandise protection. Compliance levels indicate that implementation of low-cost program components is feasible in small businesses.


F2.3 Evaluation of OSHA Guidelines on Preventing Violence in Mental Health Settings-Lipscomb JA, Rosen J

Workplace violence is pervasive in the mental health care setting. In 1996, Federal OSHA published violence prevention guidelines for health and community workers. These performance-based guidelines, although based on sound principles of safety and health, have never been formally evaluated in the field. Following the publication of the Guidelines, a joint labor/management initiative was launched within New York State Office of Mental Health (OMH) to implement the OSHA guidelines. The University of Maryland and New York State labor and management seized the opportunity of this initiative to evaluate the effectiveness of the OSHA guidelines in four NYSOMH facilities: two adult psychiatric, one child psychiatric and one forensic facility. The team of researchers and facility-based project advisory teams are using participatory research methods to implement and evaluation the effectiveness of the intervention. Each facility's intervention includes the key elements of the OSHA guidelines. Management Commitment and Employee Involvement are inherent in the design of the study and include the formation and work of joint labor-management advisory groups. A Hazard Analysis includes review of existing data, focus groups, a pre-intervention survey, risk mapping and walk-through evaluation. Hazard Prevention and Control will be accomplished by implementing recommendations from the hazard analysis. The advisory groups in consultation with project staff will review and make recommendations for policies and procedures on Medical Management and Post-incident Reporting and Training and Education. Training on a comprehensive violence prevention program will be offered annually. Formative evaluation of the project will be on-going. Evaluation of the Program, will be accomplished through analysis of a post-intervention survey and existing data one year following the implementation of the intervention. An in-depth analysis of the cost and benefit of the intervention will be conducted. Work to date in forming the various facility-level advisory groups and implementing the intervention will be presented.


F2.4 Workplace Violence Intervention Research: An Agenda for Action-Merchant J, Lundell J, Zwerling C

A workshop was held on April 5-7, 2000 in Washington, DC with the primary goal of developing a workplace violence prevention and intervention research agenda. Approximately forty invited representatives from federal and state agencies, employers, unions, the insurance industry, law enforcement and security groups, professional societies, and universities participated. Selected workshop participants developed white papers on the topics of (1) surveillance and epidemiologic data; (2) laws, regulations, and enforcement efforts; (3) industry-based programs; and (4) community and union-based programs. These served as the starting point for workshop discussions. As well, the typology of workplace violence that distinguishes between four distinct types of events helped to organize workshop discussions. The four categories of workplace violence are: Type I-The perpetrator has no legitimate relationship with the workplace and is committing a criminal act prior to the violence (e.g., robbery, shoplifting); Type II-The perpetrator has a legitimate relationship to the workplace and becomes violent during a transaction or delivery of goods/services (e.g., customers, clients, students, patients); Type III-The perpetrator is an employee or past employee and threatens or attacks another employee(s) or past employee(s); and Type IV-The perpetrator does not have any relationship to the workplace but has a personal relationship with the intended victim. Both large and small group discussions were employed and served to facilitate brainstorming as well as refinement of ideas. Several overarching themes emerged such as the need for improved surveillance in order to better inform intervention efforts, the need for participatory research approaches that involve all interested parties in the development, implementation and evaluation of interventions, the need for different approaches for the four different categories of workplace violence, and the critical need for evaluation research of all kinds (process, impact and outcome).



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Page last updated: March 2001
Page last reviewed: March 2001
Content Source: National Institute for Occupational Safety and Health (NIOSH) Division of Safety Research