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This blog post is based on a presentation given by Eva Glosson at AIHce EXP 2023. An expanded version was published in AIHA's ebook, Trends and Emerging Issues in OEHS. AIHA Connect 2024 will be held May 20–22 in person at the Greater Columbus Convention Center, Columbus, Ohio, and virtually. To learn more about the keynote sessions, view the conference agenda, or register, visit the conference website.

Incidents of violence in the workplace are becoming more frequent, Eva Glosson explained in their AIHce EXP 2023 session "Last Day On The Job – Occupational Homicide and Workplace Violence." Glosson cited the United States Bureau of Labor Statistics' National Census of Fatal Occupational Injuries for 2021, which found that fatal workplace injuries had increased by 8.9 percent since the previous year's survey. "What happens in the workplace is a reflection of what is happening in the community because the workplace really is a subset of our communities as a whole," they said.

Glosson stressed that even people who survive workplace violence without physical injuries experience psychological issues that should be considered "career-ending" injuries. "People will literally leave their jobs and be permanently disabled because of the impact of workplace violence," they said.

Defining Workplace Violence

OSHA defines workplace violence as "any act or threat of physical violence, harassment, intimidation, or other threatening disruptive behavior that occurs at the work site," which encompasses threats, verbal abuse, physical assault, and homicide. Meanwhile, NIOSH considers workplace violence to be "the act or threat of violence … directed toward persons at work or on duty." It's significant that OSHA's definition emphasizes the place where violence occurs, whereas NIOSH's definition considers the person targeted for violence—especially since the definition of "workplace” is changing. Different states and individual organizations may also employ various definitions of workplace violence.

NIOSH further categorizes workplace violence into four types based on the relationship between the perpetrator and the workplace:

• Type 1 violence is perpetrated by a person with criminal intent who has no legitimate relationship with the workplace.
• Type 2 violence is perpetrated by a customer, client, or other person in the custody of the organization, such as a passenger, student, or person being detained.
• Type 3 violence occurs between peers, such as coworkers, employees and supervisors, or union representatives.
• Type 4 violence is perpetrated by a person known to an employee, often an intimate partner of the victim.

Type 1: Criminal Intent

According to Glosson, Type 1 violence is often committed in conjunction with some other crime, such as shoplifting or trespassing. "It's important that you understand, as an employer, the escalation of aggression and violence as it relates to criminality," they said, “because a lot of times when this happens, there are elements of impulsivity and desperation."

De-escalation training is one common tool organizations use to address Type 1 violence. "But we need to understand, de-escalation training means something has already happened," Glosson said. Organizations must consider what they can do to prevent people from reaching a violent, aggressive state.

"When it comes to your written safety programs, you need to make sure to address workplace violence specific to what happens in your workplace," they added. The employer must anticipate whether their workplace may attract certain crimes, such as robbery or sexual assault.

Employers may also consider applying Crime Prevention Through Environmental Design, a set of design principles commonly applied to late-night retail establishments that ensure the physical environment of the workplace doesn't invite criminal activity. Through a series of interviews conducted in the '90s, the Federal Bureau of Investigation found that many people committed crimes simply because they thought they could get away with it.

Type 2: Customer or Client

In any industry, Type 2 violence typically results from "a cycle of frustration and aggression," Glosson said. "Some sort of sense of a need, and a sense of denial." That is, the perpetrator feels that the employee is denying something they deserve to have. In healthcare settings, the perpetrator may also be experiencing somatic or psychological distress, pain, fear, or disorientation that spills over into violence. Cultural and social models or gender or class norms may also play into Type 2 violence, as people may not be able to relate with those who serve or care for them.

For healthcare workers, the Joint Commission has developed a state-by-state guide of best practices and regulations. Glosson stressed that it's especially important for healthcare employers to know the laws that apply to them, as more laws and regulations are in place regarding workplace violence for healthcare than for other industries.

In all industries, "you need to do a risk analysis to understand your high-risk tasks," they added. "Have you called police on certain areas? If so, you need to put that into your policies and your report and take care of that." Glosson also advised establishments to look at their industry peers—if an incident can happen at one workplace, it can happen at similar establishments, too.

Glosson warned that providing workers with personal protective equipment is not a solution to workplace violence. Employees must still be trained to de-escalate before violence occurs. Organizations may also take cues from programs and initiatives developed for the hospitality industry, such as by providing panic buttons or lone worker alarms for employees who work in relative isolation.

Type 3: Worker-on-Worker

Glosson noted that people intending to commit Type 3 violence may "leak" their plans to coworkers or supervisors—the shooter who killed nine coworkers at the Santa Clara Valley Transit Authority in 2021 had told his union representative—which provides a critical opportunity to intervene before workers are hurt or killed. "So, when you hear a coworker say they're going to do something violent, do something about that," Glosson emphasized. "You can prevent something like this from happening."

A critical element of Type 3 violence prevention is for employers to comprehensively enforce the commitments made in their human resources policies, employee on-boarding documents, and collective bargaining agreements with unions. For example, if a policy or document states that the workplace does not permit bullying, the employer must know what it would do if an employee approached HR with a complaint about bullying.

"It's really important that you walk the walk and talk the talk, especially when you're training workers on this," said Glosson. It reflects poorly on the employer if an investigation finds that someone has violated the workplace's policies and remained in their position.

Employers must also assess the risk of Type 3 violence in their workplaces. Workplaces where employees experience organizational injustice and unfairness, lack of support from peers and supervisors, authoritative and autocratic leadership, lack of participation in decision-making, lack of empowerment, lack of clear perception of job tasks and job control combined with high job demands, poor conflict resolution practices with lack of institutional policies, poor organizational change management, and incivility are at higher risk.

Type 4: Personal Relationship

Glosson warned that workplaces are at higher risk for Type 4 violence when employees' intimate relationships come to an end. The violence will likely be directed at the perpetrator's former partner, but not at other people.

To protect vulnerable employees from Type 4 violence, employers must take workers' off-duty conduct seriously, enforce restraining or no-contact orders, and create written policies for workplace violence. Workplaces must develop plans to assist victims. "It is not up to the victim to come up with how to protect themself at work," Glosson said, "because they are in crisis."

Related: Eva Glosson's article "Last Day On The Job: Workplace Violence and Occupational Homicide" was published in the May 2023 issue of The Synergist.

Resources:

American Journal of Industrial Medicine: "Non-Robbery-Related Occupational Homicides in the Retail Industry, 2003–2008" (February 2014).

American Journal of Preventative Medicine: "Contrasting Robbery- and Non-Robbery-Related Workplace Homicide: North Carolina, 1994-2003" (July 2009).

Glosson, Eva: "Last Day On The Job – Occupational Homicide and Workplace Violence," AIHce EXP (May 2023).

Industrial Safety & Hygiene News: "Reactions to BLS Report on Workplace Fatalities" (January 2023).

National Safety Council: "Use Technology to Prevent Workplace Violence."

OSHA: Recommendations for Workplace Violence Prevention Programs in Late-Night Retail Establishments (PDF, 2009).

Paycor: "Domestic Violence Leave Laws by State" (June 2022).

U.S. Bureau of Labor Statistics: "Workplace Homicides: Percent of Work-Related Homicides by Gender of Decedent and Assailant Type, 2015" (August 2017).