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Workplace Violence
Workplace violence has emerged as an important safety issue
in today's workplace. It's most extreme form, homicide, is the
second leading cause of fatal occupational injury in the United
States. On average, three workers died each day in 1993 under
violent circumstances. (1) In addition, hundreds of thousands
of workers, particularly those in the health care and service
sectors, experience some type of non-fatal violent assault on
the job. Environmental conditions associated with workplace assaults
have been identified and control strategies implemented in a
number of work settings. OSHA is developing an action plan to
reduce worker exposures to this hazard but is not initiating
rulemaking at this time.
Hazard Description
The number of workers exposed to workplace violence is thought
to be widespread and increasing as employment in retail trade
and services sectors continues to grow. Homicide is the second
leading cause of fatal occupational injury in the U.S. with 1,063
work-related homicides in 1993. (2) While homicide is the leading
cause of fatal occupational injuries among females, more men
than women are victims of work-related homicide. (3) The Department
of Justice's National Crime Victimization Survey reported that
between 1987 and 1992 approximately 1 million persons annually
were assaulted while at work or on duty including, 615,160 simple
assaults, 264,174 aggravated assaults, 79,109 robberies, and
13,068 rapes. (4)
In 1992, the Bureau of Labor Statistics' (BLS) national survey
of work-related injuries and illnesses in private industry reported
22,400 workers injured seriously enough in nonfatal assaults
in the workplace to require days away from work to recuperate.
Almost two-thirds of nonfatal assaults occurred in service industries,
such as nursing homes, hospitals, and establishments providing
residential care and other social services. Retail trade industries,
such as grocery stores and eating and drinking places accounted
for about one-fifth of these assaults. (1)
Identified risk factors for fatal injuries include exchanging
money with the public, working alone or in small numbers, working
either late at night or early in the morning, working in high-crime
areas, guarding valuable property, and working in community settings
(e.g., taxicab drivers and police). (3) Risk factors for non-fatal
injuries include contact with the public and the delivery of
services and goods; the rate of these injuries among nursing
and residential care facility employees is more than ten times
that in all private industry. (5)
In 1992, two of three nurses working in a Washington State
psychiatric hospital were assaulted by patients. (6) A 1989 study
of a maximum security forensic hospital found that nursing staff
had an injury rate of 16 injuries per 100 staff from violent
assaults (7). This compares with an overall injury rate of 8.2
per 100 workers for all industries combined and 14.2 in the construction
industry. (8)
Current Status
OSHA does not have a specific standard for workplace violence.
However, the General Duty Clause of the Occupational Safety and
Health Act of 1970, which requires employers to provide a safe
and healthful working environment to all employees, has been
cited in a few circumstances.
Several states have developed standards or recommendations
concerning violence in the workplace. For example:
- The Washington State Department of Labor and Industries adopted
requirements for crime prevention in late night retail establishments
in 1990. As part of the state's accident prevention program requirements,
late night retail establishments must implement crime prevention
measures such as crime prevention training for employees, and
implementation of some environmental design features and administrative
controls (i.e., window and door displays configured to provide
clear view inside, adequate outside lighting, drop safe or comparable
device). (9)
- The New Jersey Public Employees Occupational Safety and Health
Program adopted guidelines to assist public employees in health
care facilities in adopting measures and procedures which will
help protect the safety of employees from violent and aggressive
behavior. (10)
- The California Department of Industrial Relations, Division
of Occupational Safety and Health (CAL/OSHA) issued guidelines
for health care and community service workers in 1993 designed
to assist and support workers who may be exposed to violent behavior
from patients, clients, or the public. Recommended measures to
prevent assaults include engineering controls (i.e., alarm systems),
administrative measures (adequate staffing), appropriate work
practices, as well as training. (11)
- In March 1995, CAL/OSHA issued revised guidelines for workplace
security designed to provide information and guidance about workplace
security issues to employers and workers in the state. CAL/OSHA
recommends that employers establish, implement and maintain an
effective Injury and Illness Prevention Program to address the
hazards known to be associated with workplace violence, and provides
a model program to assist employers and workers. (12-13)
The National Institute for Occupational Safety and Health
(NIOSH) has published several technical documents on the issue
of workplace violence, including a NIOSH Update entitled "NIOSH
Urges Immediate Action to Prevent Workplace Homicide" (94-101),
a NIOSH Alert entitled "Request for Assistance in Preventing
Homicide in the Workplace" (93-109), and a document entitled
"Homicide in U.S. Workplaces: A strategy for Prevention
and Research" (92-103).
OSHA, in consultation with NIOSH,
OSHA, in consultation with NIOSH, is developing guidelines
for two industries--health care and night retail. In addition,
NIOSH is preparing an educational document to define the problem
of workplace violence and to review available interventions,
focusing on all sectors of employment.
The National Advisory Committee on Occupational Safety and
Health (NACOSH) recommended workplace violence as an OSHA/NIOSH
priority in November 1994. They specifically recommended that
OSHA and NIOSH appoint a Workplace Violence Task Force; publish
guidelines and other forms of compliance assistance; prepare
a plan for appropriate consultation and technical assistance
for small businesses, state and municipal workers, and high hazard
groups; and conduct additional research in the area.
In December 1994, the Advisory Committee on Construction Safety
and Health (ACCSH) adopted a report from the Workgroup on Health
and Safety of Women in Construction (HASWIC) which included the
issue of "hostile workplaces/sexual harassment" as
an example of gender-related issues which they feel should be
addressed.
Rationale
Workplace Violence meets several of the criteria for designation
as an OSHA priority. A very large number of workers are potentially
exposed to a hazard with very serious consequences. The quality
of data on fatalities and, in some cases, on non-fatal assaults
is good. Existing surveillance data has identified a number of
preventable environmental risks associated with workplace violence.
A number of promising environmental design features and administrative
controls have been suggested in several types of high risk workplaces.
References
- Toscano G, Weber W (1995). Violence in the Workplace, Patterns
of Fatal Workplace Assaults Differ From Those of Nonfatal Ones.
Compensation and Working Conditions, Bureau of Labor Statistics.
April 1995.
- Bureau of Labor Statistics (1994). National Census of Fatal
Occupational Injuries, 1993.
- NIOSH (1993). Alert: Request for Assistance in Preventing
Homicide in the Workplace. (Publication No. 93-109).
- U.S. Department of Justice, Bureau of Justice Statistics
(1994). Violence and theft in the workplace.
- Bureau of Labor Statistics (1995). Survey of Occupational
Injuries and Illnesses, Work Injuries and Illnesses by Selected
Characteristics, 1993.
- Washington State Department of Labor and Industries (1993).
Study of Assaults on Staff in Washington State Psychiatric Hospitals.
- Carmel H, Hunter M (1989). Staff Injuries from Inpatient
Violence. Hospital and Community Psychiatry 40(1):41-46.
- Bureau of Labor Statistics (1991). Occupational Injuries
and Illnesses in the U.S. by Industry, 1989. (Bulletin No. 2379).
- Washington State Department of Labor and Industries (1990).
Late Night Retail Workers Crime Protection. WAC 296-24-102, 296-24-10203.
- New Jersey Department of Labor. Guidelines on Measures and
Safeguards in Dealing with Violent or Aggressive Behavior in
Public Sector Health Care Facilities. New Jersey Department of
Labor, Public Employees Occupational Safety and Health Program.
- Simonowitz, Joyce A. (1993). Guidelines for Security and
Safety of Health Care and Community Service Workers. California
Department of Industrial Relations, Division of Occupational
Safety and Health, Medical Unit.
- CAL/OSHA (1995). CAL/OSHA Guidelines for Workplace Security.
California Department of Industrial Relations, Division of Occupational
Safety and Health. Revised March 30, 1995.
- CAL/OSHA (1995). Model Injury and Illness Prevention Program
for Workplace Security. California Department of Industrial Relations,
Division of Occupational Safety and Health. March 30, 1995.
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