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	Violence on the Job - image of shattered glass

Recent NIOSH Research on Occupational Violence and Homicide

Journal articles from the following field studies and surveys are available in the publications section.

Workplace Violence Initiative: Research and Implementation

This initiative began in early 2002 with a congressional appropriation of $2 million. Congress directed NIOSH “…to develop an intramural and extramural prevention research program that will target all aspects of workplace violence and to coordinate its efforts with the Departments of Justice and Labor.”

In terms of extramural research, NIOSH invited grant applications for research to reduce the risk of injuries due to violence in the workplace through Requests for Applications (RFAs) in 2002 and 2008. Areas of interest for the applications included reducing the risk of injuries due to workplace violence through the development and evaluation of new intervention strategies, the evaluation of existing interventions, and the adoption of these strategies in the workplace.

Grants awarded under the 2002 RFA were:

  • Evaluation of Workplace Violence Prevention Intervention - University of Maryland
  • Evaluation of California Initiatives to Reduce Violence in Health Care Settings - University of Iowa
  • Risks for Workplace Violence in Long-haul Truckers - University of Kentucky
  • Organizational Factors Affecting Police Victimization - Police Executive Research Forum
  • Spokane Workplace Domestic Violence Initiative - Washington State University

Grants awarded under the 2008 RFA are:

  • A Multi-site Intervention to Reduce Violence in Hospital Emergency Departments - University of Cincinnati
  • Translation of a Robbery and Violence Prevention Program to High Risk Businesses - University of North Carolina
  • Evaluation of the Oregon Protective Leave Law for Victims of Violence - Johns Hopkins University

Other recent grants awarded by the NIOSH extramural research program include:

  • Using a System-wide Database to Reduce Workplace Violence in Hospitals - Wayne State University
  • Improving Dissemination of a Retail Workplace Violence Prevention Program - University of North Carolina, Chapel Hill
  • Development and Evaluation of a Comprehensive Hospital Violence Surveillance System – University of Texas Health Science Center, Houston
  • Developing an Intervention to Reduce Workplace Violence in Healthcare Settings - Washington State Department of Labor & Industries

Intramural Research and Outreach:

A Federal Interagency Task Force on Workplace Violence Research and Prevention has been developed and the inaugural meeting was held January 23, 2003. The Task Force was formed to provide a forum for Federal agencies (including the Departments of Justice and Labor) to share information on workplace violence research and prevention efforts as well as opportunities for collaborative efforts. Several projects are being developed from partnerships established through the taskforce.

As part of the NIOSH Initiative’s outreach component, stakeholder meetings focused on four different areas of workplace violence (violence in health care settings, violence in retail trade, domestic violence in the workplace, and violence against law enforcement and security professions) were held in 2003 to provide stakeholders with an opportunity to share information about their organization; identify possible research gaps; and, identify opportunities for collaborative efforts.

In November 2004, NIOSH assembled a diverse group with representatives from various disciplines and organizations that have a stake in reducing the toll of workplace violence. This landmark conference – Partnering in Workplace Violence Prevention: Translating Research to Practice – was structured to give participants an opportunity to discuss the current state of national research and prevention efforts. Workplace Violence Prevention Strategies and Research Needs is a summary report from the conference.

Several intramural research efforts have been conducted with subsequent journal articles available in the publications section. The following are examples of recent and ongoing research:

Evaluation of Ordinances to Prevent Workplace Violence in Convenience Stores: In 2010 Houston and Dallas passed a municipal ordinance designed to reduce robberies in convenience stores by requiring the following: training in workplace violence, installation of security cameras, a cash limit policy and drop safe, alarm system with panic button, visibility through clear windows and entrance/exit doors to the cash register from 3 to 6 feet above the ground, height strips posted at all exits and signage announcing: no loitering; surveillance cameras in use; cash limits and employee cannot open safe; and alarm system in use. The goals of this project were to evaluate the compliance of convenience stores to the ordinance, describe benefits to compliance for convenience stores and determine predictors for compliance to the ordinances. A random sample of 300 convenience stores in operation at least 1 year before the ordinances became effective and still in business at the time of the study was drawn from each city. Managers of selected convenience stores were asked to respond to a 30-minute survey and a store evaluation documenting observable requirements for compliance was conducted on the premises independent of manager participation.

Workplace Violence Prevention Programs in New Jersey: This project uses a three pronged approach to evaluate the effectiveness of state-based regulations that require workplace violence prevention programs in healthcare facilities. Firstly, face-to-face interviews will be conducted with the chairs of the Violence Prevention Committees who are in charge of overseeing compliance efforts. The purpose of the interviews is to measure compliance to the state regulations (violence prevention policies, reporting systems for violent events, violence prevention committee, written violence prevention plan, violence risk assessments, post incident response and violence prevention training). Secondly, assault injury data will be collected from facility violent event reports 3 years pre-regulation (2009-2011) and 3 years post-regulation (2012-2014). The purpose of collecting these data is to evaluate changes in assault injury rates before and after enactment of the regulations. Thirdly, nurse survey will be conducted to evaluate the workplace violence prevention training nurses receive following enactment of the New Jersey regulations.

Health Violence Prevention On-line Best Practices Course: This project involved experts from academia, government, and nursing associations. The main objective was to develop a workplace violence prevention on-line course that healthcare workers can take at their convenience while earning continuing education credits. The course curriculum, which includes text, case study videos, and personal interview videos, is available. The course will likely be released to the public in Spring/Summer 2013.

Epidemiology and Impact of Workplace Violence in Pennsylvania Teachers and Paraprofessionals: The primary goal of this project was to measure the prevalence, risk factors, and outcomes of physical, non-physical, and electronic workplace violence (WPV) in a cohort of unionized Pennsylvania K-12 teachers and school staff. A state-wide sample of 6,450 workers was drawn using de-identified union membership lists provided by Pennsylvania’s education unions – The Pittsburgh Federation of Teachers, the Philadelphia Federation of Teachers, and the Pennsylvania Education Association. The sample was stratified on gender, occupation, and school location (rural, suburban, and urban). Occupational groups included special education teachers, non-special education teachers, professionals (nurses, counselors, psychologists, case-managers, etc.), support staff (cafeteria workers, janitorial staff, bus drivers, etc.), and teaching aides. Participants were mailed a paper-and-pencil survey on demographics, work history, and frequency of WPV.

Evaluation of Workplace Violence Safety Ordinances for Taxi Drivers: A tripartite multidisciplinary study is being conducted to address what continues to be one of the most dangerous occupations with regard to workplace violence. The Multi-City Study aggregated taxicab driver homicide counts and rates at the city level using two data sources: news clippings and crime reports. Cities were designated by the type of safety equipment installed in taxicabs: camera cities, partition cities and control cities. The study evaluated the effect of taxicab driver homicide rates in camera cities post-installation versus pre-installation in addition to taxicab driver homicide rates in camera cities compared with control cities retrospectively over a 15 year timespan (1996 through 2010). A secondary objective was to evaluate the effect of taxicab driver homicide rates in partition cities compared with control cities over the same time span. The Camera Evaluation Study is a laboratory-based component that used security cameras on the market and subjected them to a series of tests evaluating crucial security features. Recommendations will be made on key features that each security camera should have to make it as effective as possible for use by taxicab drivers. The third study is a survey of taxicab drivers that will examine risk factors and safety measures for cab drivers regarding motor vehicle incidents and violence prevention in Houston and Minneapolis.

Reducing Violence Against Nurses: The primary goal of this research is to reduce patient violence against nurses on in-patient psychiatry units through implementation of an innovative treatment program—the Violence Prevention Community Meeting (VPCM). There is currently a need to design and validate low-cost violence prevention interventions that can be widely applied in in-patient psychiatry units treating large numbers of potentially assaultive patients during brief admissions. Demonstration of the effectiveness of the VPCM would provide a new, empirically validated treatment modality to reduce violence against nurses through promotion of a culture and practice of non-violence for nursing staff and patients alike. This project is a partnership between NIOSH and the Veterans’ Health Administration.

Survey of Work-Related Assaults Treated in Hospital Emergency Departments

(Journal Articles are available in the publications section.)

The Consumer Product Safety Commission (CPSC), in collaboration with NIOSH, collects data on occupational injuries treated in a nationally representative sample of U.S. hospital emergency departments (EDs). The database is called the National Electronic Injury Surveillance System (NEISS-Work Supplement). Data routinely collected through NEISS-Work include a brief narrative description of the injury event and basic demographic information such as intent and mechanism of injury, work-relatedness, principal diagnosis, part of the body affected, location where the injury occurred, involvement of consumer products, and disposition at ED discharge. For assaults, summary data were also collected in a one-time survey on the relationship of the perpetrator to the injured person and the context (i.e., altercation, robbery, sexual assault, etc.).

The study consisted of a telephone interview survey of workers treated in NEISS hospital EDs for injuries sustained during a work-related assault. The data collection occurred over a 16 month period. The survey included an extended narrative description of the injury incident as well as items regarding general workplace organization; personal characteristics of the worker; work tasks at the time of the assault; training on workplace violence risk factors and prevention strategies; security measures in place and how they impacted the outcome of the incident; and return to work after the assault.

Employer-based Workplace Violence Prevention Survey

Findings from the survey are reported in detail on the BLS website.

The National Institute for Occupational Safety and Health (NIOSH) has been conducting research on workplace violence risk factors and prevention strategies for a number of years using data from NIOSH sources, the Bureau of Labor Statistics (BLS), the Bureau of Justice Statistics, NEISS-Work, and others. The vast majority of the knowledge regarding workplace violence is based on information about worker victims of violent incidents, both fatal and nonfatal. Very little information exists regarding policies, training, and other related issues from an employer's perspective. The employers' perspective is a critical gap in the current workplace violence prevention effort.

To help fill this gap, NIOSH and the BLS conducted a survey of U.S. workplaces in 2005 to evaluate the employers' perspectives regarding policies, training, and other related issues on workplace violence prevention, including risk factors associated with workplace violence and prevention strategies. The findings of the survey allow characterization of how the issue of workplace violence is being addressed in the United States workplaces and may be useful to identify where educational interventions are needed. Additionally, the information obtained through this survey will assist employers, decision makers, trade groups, unions, and government agencies in implementation of more comprehensive workplace violence prevention programs.