Joint Programme Launches New Initiative Against

Workplace Violence in the Health Sector

Thursday 24 October 2002

( ILO/02/49 )

GENEVA (ILO News) - Faced with a mounting toll of violence afflicting on average one of every two health workers worldwide, a joint programme of labour, health and public service organizations today launched a new initiative aimed at helping health professionals fight fear, assault, humiliation and even homicide where they work.

The joint task force - comprising the International Labour Office (ILO), the World Health Organization (WHO), Public Services International (PSI) and the International Council of Nurses (ICN) - has launched a set of "Framework guidelines for addressing workplace violence in the health sector" during a meeting at ILO headquarters in Geneva.

The initiative comes in the face of a mounting problem in hospitals and other health workplaces worldwide, both in developed and developing countries. Research* shows that nearly 25 per cent of all violent incidents at work occur in the health sector and that more than 50 per cent of health care workers have experienced such incidents.

"The current knowledge is only the tip of the iceberg", adds international safety and health specialist Vittorio di Martino, who has studied violence in the workplace for the task force. "The enormous cost of violence at work for the individual, the workplace and the community at large is becoming increasingly apparent."

The study notes that violence in the health sectors goes well beyond assaults or affronts to the individuals,

threatening the quality of health care as well as productivity and development. Says di Martino: "The consequences of violence at work in the health sector have a significant impact on the effectiveness of health systems, especially in developing countries."

Women are especially vulnerable. While ambulance staff are reported to be at greatest risk, nurses are three times more likely on average to experience violence in the workplace than other occupational groups. Since most health workers are women, the gender dimension of the problem is evident.

In accordance with the European Commission, the guidelines define workplace violence as "incidents where staff are abused, threatened or assaulted in circumstances related to their work, including commuting to and from work, involving an explicit or implicit challenge to their safety, well-being or health". Although workplace violence has become a serious problem in all service sectors,

reports* show that health workers are among those particularly at risk:

a.. In the United States, health care workers face a 16-times greater risk of violence than other service workers. More than half of the claims of aggression in the workplace in the US come from the health sector.

b.. In the United Kingdom, nearly 40 per cent of the National Health Service (NHS) staff reported being bullied in 1998.

c.. In Australia, 67.2 per cent of health workers have experienced physical or psychological violence in 2001.

d.. Widespread violence at work against health personnel is not limited to the industrialized world. More than half of the health personnel in Bulgaria (75.8 per cent), South Africa (61 per cent) and Thailand (54 per cent) and 46.7 per cent of health workers in Brazil have experienced at least one incident of physical or psychological violence in 2001.

e.. Research also shows that psychological violence in the health sector - including verbal abuse, bullying and mobbing - is more frequent than physical violence and between 40 and 70 per cent of the victims report significant stress symptoms.

f.. Workplace violence affects all professional groups, genders and work settings in the health sector. The highest rates of offences, however, were reported by ambulance staff, nurses and doctors. Large hospitals in suburban, densely populated or high crime areas, as well as those located in isolated areas, are particularly at risk.

g.. In many countries, reporting procedures are lacking and perpetrators are not persecuted. Strategies to combat workplace violence in the health sector still have a long way to go, starting with raising awareness and building understanding among health personnel and other parties

concerned at all levels.

The guidelines are intended to support all those responsible for safety in the workplace, be they governments, employers, workers, trade unions, professional bodies or the general public. In particular, the guidelines show how health workers can approach the problem of violence in the health sector while considering all types of intervention and involving all parties concerned in a coherent, non-discriminatory, culturally and gender sensitive manner; identify, assess and reduce the risks through preventive

action; and minimize the impact of violence and prevent its recurrence.

The guidelines prioritize the development of a human-centred workplace culture based on dignity,

non-discrimination, equal opportunity and cooperation, including a clear policy statement on violence at work from the top management and awareness raising initiatives at all levels. The ILO is expected to adopt a Code of Practice on Violence and Stress at Work in Services - A Threat to Productivity and Decent Work in October 2003.

* * * * *

*Cary L. Cooper and Naomi Swanson, Workplace violence in the health sector - State of the Art, ILO, WHO, ICN and PSI 2002. ISBN 92-2-113237-4; Vittorio di Martino, Workplace violence in the health sector - Country case studies (Brazil, Bulgaria, Lebanon, Portugal, South Africa, Thailand, and an additional Australian study), Synthesis report, ILO, WHO, ICN and PSI 2002. ISBN 92-2-113441-5.

For more information, contact International Labour Office, Department of Communication,

Tel: +4122/799-7912,

W. Barry Nixon

Executive Director

National Institute for the

Prevention of Workplace Violence, Inc.

Phone: 949-770-5264

Fax: 949-597-0977



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