Preventing workplace violence: Advice for occupational medicine physicians

More than 400 people were murdered on the job last year, according to the U.S. Bureau of Labor Statistics (BLS). That’s roughly eight individuals per week. Many more workers are the victims of assault: In 2013, BLS reported more than 14,000 instances of nonfatal assault in private industry in which the attacked had to take days off of work.

“Workplace violence is a huge issue in the U.S.,” said Elizabeth Clark, DO, MPH, at a Saturday OMED presentation that covered ways occupational medicine physicians can help reduce and prevent on-the-job violence.

During the presentation, Dr. Clark, who has written workplace violence policies for Boeing, described the major risks of workplace violence as well as several prevention strategies, many of which apply across multiple industries.

Workers most at risk of violence include those that:

• Handle money or safeguard valuable property.
• Deliver passengers, goods or services.
• Work with unstable people in health care or social service settings.
• Work alone or in small numbers.
• Work during late-night or early-morning hours.
• Work in high-crime areas.
• Source: The National Institute for Occupational Safety and Health.

Prevention

To prevent workplace violence, Dr. Clark mentioned a number of things occupational medicine physicians can encourage companies to do.

Dr. Clark recommended assessing workplace entrances and exits: How accessible are workplace areas to nonemployees? Are there spaces near doors where potential attackers can easily hide?

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In addition, companies should establish an escape plan for employees and make sure they understand their safety is the top priority, Dr. Clark noted.

“For most workplaces, the most valuable thing you have is the worker,” she said. “So it’s really important that they can get out of dodge and leave everything behind if something bad happens. We need to give people permission to take care of themselves.”

Occupational medicine physicians should also examine a workplace’s landscaping, parking lot and outdoor lighting and make recommendations for safety improvements if necessary, Dr. Clark said.

Health care facilities can enhance safety by prohibiting unsupervised movement within and between different areas of the clinic, Dr. Clark noted.

Dr. Clark also recommended that workplaces establish a policy for assessing and reporting threats, which would allow employers to track them to see whether prevention strategies are working. Involving the police should be part of the policy, she noted, adding that many workplaces prefer to keep reports of incidents in house, but that this practice can compromise worker safety.

“A lot of companies have policies that say everything stays in house,” she said. “That’s a good way to get somebody killed or injured.”

For instance, a woman whose husband repeatedly comes to her office and screams at her may have trouble taking action if the police are unaware of her husband’s behavior.

“How can this person file for a restraining order if nothing has been reported to the police?” Dr. Clark said.

The policies should also advise staff on recognizing situations in which violence might occur, de-escalating scenarios, and obtaining medical care if a violent incident takes place, she noted.