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Workers in a great variety of industries and occupations face the serious problem of workplace violence (WV). A basic definition of workplace violence is any physical assault or threat that a worker experiences associated with their job. The perpetrator of such violence may be a stranger, a client/patient, a coworker, or an intimate partner. The probability of a worker experiencing workplace violence at the hands of one of these classes of perpetrators varies by industry and occupation. Workplace violence directed at health care and social assistance workers are at high risk of workplace violence, in part due to the fact that they are often required to provide care to anyone seeking such services, including those patients or clients who have or develop behavioral problems that place workers at risk of violence. However, many of the risk factors and prevention strategies for these workers can be applied across industry sectors.

The occupational health provider has a role in evaluating and preventing injuries arising from physical assaults and threats of assaults. These clinical encounters may occur in employee health clinics, primary care settings, urgent/emergent care, injury compensation clinics, and in settings evaluating return to work and ability to work. Occupational health providers often provide consultation and oversight to large workplaces and health systems and may not clinically evaluate the employee. Evaluating the work environment and employer safety program, as with any other hazardous exposure, is critical to determine if other employees are at risk and to evaluate the effectiveness of prevention programs, security activities and safety services for returning the injured employee to the work environment.

Victims of workplace violence must be treated with considerable care and concern for their long-term well-being and ability to return to work. Particularly for victims of severe assaults, sexual assaults, or repeat victimizations, serious psychological problems often result.

Occupational health providers should have the expertise to ensure that these injured workers do not return to the same unmitigated hazards when they return to work. As with other occupational diseases and injuries, the clinician must assess whether the patient can return to the work environment. This is a decision based both on their fitness to return and on whether the same risk factors remain at the workplace. Similarly, the clinician should consider whether coworkers are at similar risk to the presenting patient/worker.


WV is any act or threat of physical violence, harassment, intimidation, or other threatening disruptive behavior that occurs at the work site, or during the course of work. It ranges from threats and verbal abuse to physical assaults and even homicide. As with most occupational injuries and illness, less severe injuries are under-reported, so the best data by industry exist for homicides, followed by Occupational Safety and Health Administration (OSHA) recordable incidents and data from the Department of Justice’s National Crime ...

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