OCCUPATIONAL VIOLENCE

Research on Occupational Violence and Homicide

Violence on the Job - image of shattered glass

Workplace Violence Initiative: Research and Implementation

This initiative which started in early 2002 is the result of 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 invites grant application for research to reduce the risk of injuries due to violence in the workplace. Areas of interest for the applications include 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

The intramural funding is being used in the following areas:

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 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.

Several intramural research efforts are being conducted by NIOSH’s Division of Safety Research including the following;

Community-Based Workplace Violence Intervention: The primary objective of this project was to evaluate different approaches for increasing business participation by retail establishments in and compliance to the Workplace Violence Prevention Program (WVPP), which was effective in crime reduction in a Los Angeles study. This study was conducted in Oxnard, CA with the Oxnard Police Department (OPD) and was an evolution of the OPD’s community-policing program that incorporates local business associations and local organization partnerships. A secondary objective of the project was to evaluate the program’s effectiveness in reducing the incidence of robberies and violent crimes in businesses at high-risk of workplace violence. In addition to the OPD, partners on this project include the University of North Carolina-Chapel Hill and the University of Iowa. Data collection is complete and analysis has started. Manuscripts will be completed and published in 2012.

New Jersey Healthcare Worker Legislation Project: This project will use 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 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, collection of assault injury data 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, conduct a nurse survey to evaluate the workplace violence prevention training nurses receive following enactment of the New Jersey regulations.

On-line Course - Workplace Violence Prevention for Healthcare Workers: 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 could take at their convenience while earning continuing education credits. The course curriculum, which includes text, case study videos, and personal interview videos, is almost finalized. The course will likely be released to the public in fall/winter 2012.

Pennsylvania Teacher/School Staff Workplace Violence Prevention: 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. Data collection is complete and analyses are underway. Various dissemination efforts including reports, scientific manuscripts, and formal presentations are being completed in 2012.

Taxicab Driver Violence Prevention: 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 is a binational ecological component that aggregates taxicab driver homicide counts and rates at the city level. Major cities in the U.S. and Canada are divided into cities with security cameras installed in most taxicabs (“camera cities”), cities with partitions installed in most taxicabs (“partition cities”), and comparison cities with neither security cameras nor partitions installed in most taxicabs (“comparison cities”). We will be evaluating the effect of homicide rates in camera cities compared with comparison cities over a timespan of over 15 years (1996 or earlier through 2010) and evaluating the effect of homicide rates in camera cities compared with partition cities over the same time span. Findings will be released in 2012. The Camera Evaluation Study is a laboratory-based component that will take security cameras on the market and use them to run tests on crucial security features. Ultimately, 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. Findings will be released in 2012. The Taxicab Driver Survey is designed to identify risk factors and protective factors for workplace violence incidents. This component is still in the planning phase. The overall tripartite study will play a role in shaping policies and ordinances focused on taxicab driver safety at both the city level and company level.

Veteran’s Health Administration Intervention: 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’s Division of Safety Research and the Veterans’ Health Administration. Data collection is complete and manuscripts are being submitted for publication in 2012.

Survey of Work-Related Assaults Treated in Hospital Emergency Departments

The Consumer Product Safety Commission (CPSC) maintains a database of injuries treated in a nationally representative sample of U.S. hospital emergency departments (EDs) called the national Electronic Injury Surveillance System (NEISS). Data routinely collected through NEISS 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 are also being collected in the relationship of the perpetrator to the injured person and the context (i.e., altercation, robbery, sexual assault, etc.). For work-related cases, occupation and industry information is collected.

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. This study will provide critical information for understanding the nature and impact of nonfatal assault among U.S. workers. In combination with data collected from other sources, this information will ultimately contribute to the prevention of violence in the workplace.

Employer-based Workplace Violence Prevention Survey

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, the National Electronic Injury Surveillance System, 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, The NIOSH and the BLS conducted a survey of U.S. workplaces 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 will 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. Preliminary findings from the survey are reported in detail on the BLS website.

Multi-City Study of the Magnitude and Risk Factors of Workplace Violence among Health Care Workers and Pharmacists

This study contracted with five (Illinois, Ohio, South Carolina, Tennessee, and Wisconsin) Statistical Analysis Centers (SAC) to provide data to NIOSH in the development of a study of homicides, robberies and assaults (simple, aggravated, and sexual) of healthcare workers and pharmacists. The goal was to determine the frequencies of homicides, and injuries associated with robberies, and assaults (simple, aggravated, and sexual) occurring in healthcare and pharmaceutical work environments, and to assess the risk factors and circumstances surrounding these violent events. The SACs obtained data from State and local police department public records through police crime reports and department based databases, such as the National Incident Based Reporting System (NIBRS). The information from the crime reports includes descriptions of the circumstances surrounding the incidents and when available demographic characteristics of the victims and perpetrators.