Course 601 - Essentials of Occupational Safety and Health

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Preventing Workplace Violence

Woman with injured face
Workplace violence is on the increase.

The National Institute for Occupational Safety and Health (NIOSH) defined workplace violence as, "...any physical assault, threatening behavior, or verbal abuse occurring in the work setting." (NIOSH, 1996)

Nearly 2 million American workers report having been victims of workplace violence each year. Unfortunately, many more cases go unreported. Research has identified factors that may increase the risk of violence for some workers at certain worksites. Such factors include exchanging money with the public and working with volatile, unstable people. Working alone or in isolated areas may also contribute to the potential for violence.

All too frequently, employees become victims of violent acts that result in substantial physical or emotional harm. For injured or threatened employees, workplace violence can lead to medical treatment, missed work, lost wages, and decreased productivity.

For many occupations, workplace violence represents a serious occupational risk. Violence at work can take many forms: harassment, intimidation, threats, theft, stalking, assault, arson, sabotage, bombing, hostage-taking, kidnapping, extortion, suicide, and homicide. For each murder, there are countless other incidents of workplace violence in which victims are threatened or injured.

Here are some recent Bureau of Labor Statistics (BLS) for workplace violence:

  • A total of 749 workplace homicides (shootings and stabbings) and self-inflicted injuries were recorded in the United States in 2014.
  • Homicide was the leading cause of death for women at work, accounting for 42% of on-the-job fatalities.
  • Among the workplace homicides in which women were the victims, the greatest share of assailants were relatives or domestic partners (32 percent of those homicides).
  • In workplace homicides involving men, robbers were the most common type of assailant (33 percent).

Source: Workplace Violence. (2012) The National Center for Victims of Crime. Retrieved from

1. What is the greatest share of assailants among workplace homicides in which women are the victims?

a. Personal friends
b. Co-workers
c. Relatives or domestic partners
d. Robbers

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Types of Workplace Violence

Occupational health researchers have classified workplace violence into the following 4 types:

Four types of workplace violence.

Type 1: Criminal Intent

In Type 1 violence, the perpetrator has no legitimate relationship to the business or its employees, and is usually committing a crime in conjunction with the violence (robbery, shoplifting, trespassing).

Type 2: Customer/Client-on-Worker

Type 2 violence is common and deals with the customer/client relationship to include clients, patients, family members, and visitors, and is referred to as client-on-worker violence. In the healthcare industry, research shows that this type of violence occurs most frequently in emergency and psychiatric treatment settings, waiting rooms, and geriatric settings, but is by no means limited to these.

Type 3: Worker-on-Worker

Type 3 violence between coworkers is commonly referred to as lateral or horizontal violence. It includes bullying, and frequently manifests as verbal and emotional abuse that is unfair, offensive, vindictive, and/or humiliating though it can range all the way to homicide. Worker-on-worker violence is often directed at persons viewed as being "lower on the food chain" such as in a supervisor to employee though incidence of peer to peer violence is also common.

Type 4: Personal Relationship

In Type 4 violence, the perpetrator has a relationship to the employee outside of work that spills over to the work environment. For example, the husband of an employee follows her to work, orders her home and threatens her, with implications for not only this employee but also for her coworkers and visitors.

2. Which type of violence is most common in healthcare settings?

a. Type 1: Criminal Intent
b. Type 2: Customer/Client-on-Worker
c. Type 3: Worker-on-Worker
d. Type 4: Personal Relationship

Next Section

Trainer speaking to a class
Training on workplace violence ensures awareness of potential hazards and protection measures.

Training Violence Prevention

Training is a critical component of any prevention strategy. Training is necessary for employees, supervisors, and the staff members of each department who may be involved in responding to an incident of workplace violence. Training and instruction on workplace violence ensures that all staff is aware of potential hazards and how to protect themselves and their co-workers through established prevention and control measures.

While most everyone agrees there are clear warning signs before most acts of workplace violence, what action should be taken varies.

Nevertheless, making information available to employees about the potential for violence in the workplace, how to recognize the early warning signs of a troubled or potentially violent person, and how to respond to such a person, could save a life.

Not all individuals who are distraught over services (or lack thereof) or their termination of employment will become violent. The primary type of training that may be beneficial to all employees is that which concentrates on conflict resolution.

Supervisor and Manager Training

Supervisors and managers must be trained to recognize high-risk situations, so they can ensure that workers are not placed in assignments that compromise their safety. Such training should include encouraging workers to report incidents and to seek the appropriate care after experiencing a violent incident.

3. Which of the following topics must supervisors and managers be trained in violence prevention training?

a. Recognizing high-risk situations
b. OSHA violence prevention regulations
c. Zero tolerance program
d. How to confront perpetrators

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Training Topics

Red phone with the word HELP above it
All employees should have emergency phone numbers.

In general, training should cover the policies and procedures for a facility as well as de-escalation and self-defense techniques. Both de-escalation and self-defense training should include a hands-on component. The following provides a list of possible training topics:

  • The workplace violence prevention policy;
  • Risk factors that cause or contribute to assaults;
  • Policies and procedures for documenting employee changes in behavior;
  • The location, operation, and coverage of safety devices such as alarm systems, along with the required maintenance schedules and procedures;
  • Early recognition of escalating behavior or recognition of warning signs or situations that may lead to assaults;
  • Ways to recognize, prevent or diffuse volatile situations or aggressive behavior, and manage anger;
  • Ways to deal with hostile people other than employees, such as relatives and visitors;
  • Proper use of safe rooms-areas where staff can find shelter from a violent incident;
  • A standard response action plan for violent situations, including the availability of assistance, response to alarm systems and communication procedures;
  • Ways to protect oneself and coworkers, including use of the "buddy system";
  • Policies and procedures for reporting and recordkeeping;
  • Policies and procedures for obtaining medical care, counseling, workers' compensation or legal assistance after a violent episode or injury.

4. Workplace violence prevention training should include all of the following EXCEPT _____.

a. how to deal with hostile persons
b. phone numbers for quick reference
c. reporting employees who express opinions
d. how to report incidents

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Written Policies

In most workplaces where risk factors can be identified, the risk of assault can be prevented or minimized if employers take appropriate precautions. One of the best protections employers can offer their workers is to establish a zero-tolerance policy toward workplace violence. This policy should cover all workers, patients, clients, visitors, contractors, and anyone else who may come in contact with company personnel.

It is critical to ensure that all workers know the policy and understand that all claims of workplace violence will be investigated and remedied promptly. In addition, OSHA encourages employers to develop additional methods as necessary to protect employees in high risk industries.

Company programs can also be implemented without a written policy statement. In these companies, employees are often given information about the program (especially whom to call) in training sessions, on posters, in newsletter articles, or by other similar methods. Companies have an inherent right to take action against employees who engage in disruptive or threatening behavior whether or not they have issued a written policy statement.

A workplace violence policy statement should convey that:

  • All employees are responsible for maintaining a safe and healthful work environment;
  • The policy covers not only acts of physical violence, but harassment, intimidation, and other disruptive behavior;
  • The policy covers incidents involving all interactions between:
    • supervisor to employee
    • employee to employee
    • employee to supervisor
    • employee to non-employee
    • non-employee to employee;
  • The company will respond appropriately to all reported incidents;
  • The company will act to stop inappropriate behavior; and
  • Supervisors and all of the departments involved in responding to incidents will be supported by company management in their efforts to deal with violent and potentially violent situations.

5. What is one of the best protections employers can offer their workers in a violence protection program?

a. A no-fault disciplinary policy
b. A "gun-free zone" policy
c. A zero-tolerance policy
d. A total-allowance policy

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