For many people, including employers, workplace violence has become sensationalized by those occasional, but dreadful headlines that scream out news of another senseless killing. Although those incidents are very real and extremely tragic, there’s a great deal about incidents of workplace violence and the effort to control it that will never make it into a headline, but remains worthy of attention.

This compliance report takes a look at the scope and severity of the problem and focuses on efforts underway to identify and reduce the risks to workers. Among those interviewed are participants in a major national conference that led to a call for a multi-agency federal government research initiative. Other experts include a consultant who advises employers on prevention and management of violent episodes, a researcher with a decidedly practical bent to her work, and a concerned union official.

Facts and figures
Experts in the field of workplace violence agree that statistics are few, which is largely due to the fact that there is inadequate research on the subject.

According to the Bureau of Labor Statistics (BLS), there were 645 workplace homicides in the U.S. in 1999, compared with 709 in 1998. The number of nonfatal assaults and violent acts committed at work sites in 1999 was 16,644, compared with 17,589 the year before. When threats of violence are factored in however, the number jumps to about two million people affected, the experts estimate.

According to OSHA, the most common type of workplace violent crime is simple assault, followed by aggravated assault, rape and sexual assault, robbery and homicide. On-the-job homicide is the second leading cause of fatal occupational injury in the U.S., and the number one cause for women’s workplace deaths. The overall cost to employers is quoted in the billions of dollars.

The National Institute for Occupational Safety and Health (NIOSH) cites the following factors that may increase a worker’s risk for on-the-job assaults:

• contact with the public;
• the handling of money;
• delivery of passengers, goods, or services;
• a mobile workplace such as a taxicab or police cruiser;
• unstable clientele including some patients and inmates;
• working alone or in small numbers;
• working late at night or during early morning hours;
• working in high-crime areas;
• guarding valuable property or possessions.

As most employers know, OSHA does not have a specific violence standard, but the general duty clause of the Occupational Safety and Health Act guarantees a workplace “free from recognized hazards that are causing or are likely to cause death or serious physical harm.” 

The agency published guidelines to prevent workplace violence in health care and social service workplaces, as well as in late-night retail establishments. These are based on the four basic elements contained in OSHA’s Safety and Health Program Management Guidelines: management commitment and employee involvement, worksite analysis, hazard prevention and control, and training and education.

From Iowa to Washington
Ground zero for the fight against job violence has lately been Iowa City, Iowa, home of the University of Iowa and its Injury Prevention Research Center. The center, one of 10 sponsored by the Centers for Disease Control throughout the U.S., became engaged in workplace violence prevention through a tragic incident. That twist of fate is described by Dr. Jim Merchant, former director of the center and current dean of the university’s College of Public Health:

“In 1991, a graduate student became upset because he hadn’t gotten a prize he was anticipating, and killed a rival student who did get the award, as well as two aerospace professors.” 

Then, Merchant continues, the young man went to the provost’s office where he killed the university vice president and shot a student secretary. The center’s first response was to hold a conference on a public health approach to firearm injuries. 

Adds Merchant: “The more we thought about it and looked into it, we recognized that nobody in the federal government had a clear mandate, nor was there a coordinated approach to workplace violence, even though it’s a multi-billion dollar program involving hundreds of deaths and has a significant impact on workplaces where incidents occur.”

In April 2000, the center sponsored the Workplace Violence Research Workshop, which brought together 37 participants representing industry, organized labor, all levels of government, and academia. 

The stated purpose of the gathering was: “to examine issues related to violence in the workplace and to develop recommended research strategies to address this public health problem.”

Fallout from the Washington, D.C., conference was significant, and included a publication (Workplace Violence: A Report to the Nation) and a congressional briefing. On Capitol Hill earlier this spring, Merchant and others laid out recommendations for a multi-agency research plan that would be led by NIOSH and include the Departments of Labor, Health and Human Services, and Justice. The hope is that possibly as early as this year, the U.S. Senate might act on a recommendation to allocate $10 million to institute such a plan.

Four types, three approaches
Although the University of Iowa center is focused on research, there is also a practical aspect to its work. For example, the conference report describes four primary types of violence: criminal intent, customer/client, worker-on-worker and personal relationship. A brief overview of these types of violence should prove useful for employers seeking to better understand this problem.

In criminal intent cases, the perpetrator has no legitimate relationship to the business or its employees, and is usually committing a crime (such as robbery, shoplifting and trespassing) in conjunction with the violence. About 85 percent of workplace homicides fall into this category.

The second type is customer/client crimes, those in which the perpetrator has a legitimate relationship with the business and becomes violent while being served by the business. This type of violence involves customers, clients, patients, students, inmates, etc., with many of these incidents taking place in a health care setting. Police officers, prison staff, flight attendants and teachers may be at risk as well.

In worker-on-worker incidents, the perpetrator is an employee or a past employee who attacks or threatens another employee or past employee. These account for about 7 percent of all homicides. 

The fourth type is based on personal relationships. In these cases, the perpetrator usually does not have a relationship to the business, but does have a personal connection with the intended victim. This category includes victims of domestic violence assaulted or threatened while at work.

The report also lays out three general approaches to research.

• The environmental approach includes attention to lighting, entrances and exits, security hardware and other engineering controls to discourage would-be assailants.

• The organizational/administrative approach refers to the development of programs, policies and work practices aimed at maintaining a safe working environment.

• The behavioral/interpersonal approach involves steps such as training staff to anticipate, recognize and respond to conflict and potential violence.

Conference participants concluded that there has not been adequate research into the effectiveness of these approaches for all four types of violence.

Research notes
The lack of adequate research is also echoed by Dr. Corrine Peek-Asa, a researcher and teacher at the University of California-Los Angeles' Southern California Injury Prevention Research Center and one of the participants in the 2000 conference. She is currently at work on a NIOSH-sponsored project that examines robbery-related violence in retail settings, including liquor stores, groceries, hotels and restaurants.

Asked to identify trends she’s uncovered during this and other research projects, Peek-Asa pointed to several. The first is a tendency by employers to embrace a single aspect of a prevention program, while ignoring others. 

“For example, they may purchase equipment such as an alarm or camera system or hire a security guard without making any changes in their management style or cash-handling procedures. So instead of adopting a prevention plan, they’ve implemented one tiny part of it,” she said. 

In fact, she says she’s been "amazed" that many employers are quick to spend significant sums on these single-approach responses.

Peek-Asa has also observed that many employers believe so-called worker-on-worker violence is the most prevalent problem, because it’s the one that draws headlines. Rather, she says, employers must be aware of the various types of workplace violence, and need to understand what exposures their particular type of business faces. Peek-Asa cites the example of a law office, which in addition to worker-on-worker incidents, typically faces the risk of customer/client violence.

Many workplaces are at risk for criminal-intent violence, but employees don’t realize it. She cites one instance in which a physician was severely beaten when a perpetrator attempted to steal his prescription pad. Similarly, pharmacies are at significant risk of robbery because of the potential value of drugs to a criminal. 

“Most businesses have something someone else would find of value. But they often don’t see it and don’t know what to do about it when someone does want it,” said Peek-Asa.

Another trend she notes is that employers often miss out on a valuable opportunity to implement prevention programs just after an incident or close call. She says this is especially true for small businesses that may recently have been robbed. Too often the willingness may be there, but the employers lack information and knowledge about how to implement a program while interest is high. Peek-Asa believes the research she and others are doing in the field must remain practical, “or it’s not worth doing.” She also believes that there’s no “magic program” that can be successfully applied to every business setting, preferring more individualized plans of action.

A consultant’s advice
A customized approach is also favored by Steve Kaufer, founder of the Workplace Violence Research Institute, a consulting and training organization based in Palm Springs, Calif. Kaufer says his group typically gets involved before an issue arises. 

“Employers are being more proactive about workplace violence and are trying to stay ahead of the curve to make sure things don’t happen,” he said. “One reason is that they want to maintain a safe working environment, and another reason is liability.”

His approach is to start by meeting with a company’s senior managers to learn their concerns, get background on the business and collect copies of policies or other relevant documents. Next, he conducts small, informal focus groups with employees. These confidential sessions are quite fruitful, he said. They often reveal issues which management may not know about, such as a problem concerning a particular supervisor that’s never been brought to light. The information gathered is used to prepare a report and make recommendations; sometimes Kaufer is also called on to implement those recommendations.

What works?
Kauf said that what is group tries to do is "get people to change their mindsets and take a good look at what workplace violence really is.” 

For example, many people believe the problem is “the stranger with an AK-47 rifle who comes in and starts blasting away.” What is more important is to get employers and employees talking about what is unwanted behavior and what are its consequences. 

Also critical is early intervention. For example, some problems or potential problems are spotted by employees, long before they ever appear on a manager’s radar screen.

Kaufer’s approach is to encourage reporting and, in other than already-escalated cases, to issue a “benevolent response,” such as non-accusatory dialogue with the individual. 

He suggested something like the following: 

“Bob, you’ve always been such a great employee, but some co-workers say you’ve made a few comments that have been somewhat confrontational lately. What’s going on?” 

In many cases, what comes out is that Bob is experiencing family problems or other non-work-related concerns that are affecting his behavior.

And what doesn’t
One strategy that doesn’t work, says Kaufer and others interviewed for this article, is developing and using a profile of the about-to-snap employee.

Citing research by the FBI on those likely to make an attempt on the lives of public figures, Kaufer explains: “The danger is that if we’re looking for someone who matches a certain profile, we may ignore someone whose behavior should have attracted our attention, but we missed them.” 

On a related note, Kaufer says that it is critical that employers not let problems fester. Kaufer was called away from the interview for this article by a phone call alerting him that a woman at a client company was exhibiting extremely angry behavior, overreacting to criticism, and going “far beyond” what’s tolerable.

The woman had, in fact, been aggressive and angry for a long time, but her actions were tolerated because everyone believed it was “just part of her personality.” 

Adding to the complexity was the fact that the employer had failed to document the previous instances of anger and inappropriate behavior. Indeed, the woman had been successful in having one poor performance review altered in exchange for a promise of improved behavior. Now, company officials must decide if they will terminate her and potentially face a wrongful termination lawsuit.

Getting started
Kaufer said that launching a violence prevention program is not as difficult as employers might believe, especially because they may already have taken some of the necessary steps. He said to start with what you have, like relevant policies and procedures, such as those covering threats and harassment, or use of certain kinds of language and behavior. Bring these together under a workplace violence policy umbrella, then add the missing pieces. 

Another basic step is to define for workers what is acceptable behavior in the workplace, as well as the consequences for deviating from it. Employees also need to know what to do when they encounter threatening behavior, for example: to go to a supervisor, to Employee Assistance Program personnel, to security, etc.

He emphasizes that there’s no single best way to approach threats. Some companies train and maintain crisis management teams, while others use trained human resources personnel. Important methods to consider include the possible use of a consultant and the benefits of pre-employment screening tools or background investigations.

Kaufer urges employers to be aware of the link between domestic violence and workplace violence (the so-called type-four relationship-related assault described by the Iowa conference document).

He explained that when a woman finds herself in an abusive situation at home, she can change her residence by going to a shelter or to a family member’s home, but she can’t usually change her workplace.

“The husband or boyfriend knows where to find her. He’s angry, wants to resolve the problem, and is seeking some sort of retribution,” said Kaufer. 

Managers must be tuned in to signs like the presence of bruises, or repeated disturbing phone calls, he said. It’s often in the best interest of the worker and the company to assure that the problem does not spill over to the workplace. That may require intervention with the help of a provider of services for abused women.

A good offense …
Guarding against workplace violence is a complex undertaking. The problem is more insidious, less frequent, and potentially more devastating than many of the risks for which you’ve probably already developed programs. 

But the consequences of prevention are considerable, in terms of human lives, employee morale and productivity. According to Kaufer, an average workplace violence case might settle out of court for $545,000; if settled by a jury the average cost is $3 million. That’s why litigation avoidance is the best way for safety and health experts to justify the time and expense of developing a program.

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