Trends in workplace homicides in the U.S., 1994-2021: An end to years of decline.

Workplace and non-workplace homicides in the United States (U.S.) have declined for over 30 years until recently. This study was conducted to address the change in trends for both workplace and non-workplace homicides and to evaluate the homogeneity of the change in workplace homicides by specified categories. Joinpoint and autoregressive models were used to assess trends of U.S. workplace and non-workplace homicides utilizing surveillance data collected by the Bureau of Labor Statistics and the Federal Bureau of Investigation from 1994 through 2021. Both workplace and non-workplace homicides decreased significantly from 1994 through 2014. Workplace homicides showed no significant trend from 2014 through 2021 (p = 0.79), while non-workplace homicides showed a significant average annual increase of 4.1% from 2014 through 2020 (p = 0.0013). The large decreases in the trend of workplace homicides occurring during a criminal act, such as robbery, leveled off and started to increase by the end of the study period (p < 0.0001). Declines in workplace homicides due to shootings also leveled off and started to increase by the end of the study period (p < 0.0001). U.S. workplace and non-workplace homicide rates declined from the 1990s until around 2014. Trends in workplace homicides varied by the types of the homicide committed and by the type of employee that was the victim. Criminal-intent-related events, such as robbery, appear to be the largest contributor to changes in workplace homicides. Researchers and industry leaders could develop and evaluate interventions that further address criminal-intent-related workplace homicides.

National Estimates of Home Care Workers Nonfatal Emergency Department-Treated Injuries, United States 2015-2020.

OBJECTIVE: Home care workers (HCWs) are a critical resource contributing to the well-being of others. Presented are data on HCWs nonfatal emergency department (ED)-treated injuries. METHODS: Nonfatal injuries among HCWs were extracted from the NEISS-Work data between 2015 and 2020. RESULTS: Review of NEISS-Work data indicated 117,000 HCWs with nonfatal ED-treated injuries; female HCWs accounted for 93%. Overexertion and bodily reactions accounted for 52% of the injuries. Violence and other injuries by persons or animals accounted for 15% and falls, slips, and trips also accounted for 15% of the HCWs ED-treated injuries. CONCLUSIONS: The growing demand for home care services is increasing the number of workers at risk for injury. Future analyses should prioritize injury events among HCWs to gain a better understanding of the events contributing to injuries among HCWs.

Model-Based Meta-Analysis of Relapsing Mouse Model Studies from the Critical Path to Tuberculosis Drug Regimens Initiative Database.

Tuberculosis (TB), the disease caused by Mycobacterium tuberculosis (Mtb), remains a leading infectious disease-related cause of death worldwide, necessitating the development of new and improved treatment regimens. Nonclinical evaluation of candidate drug combinations via the relapsing mouse model (RMM) is an important step in regimen development, through which candidate regimens that provide the greatest decrease in the probability of relapse following treatment in mice may be identified for further development. Although RMM studies are a critical tool to evaluate regimen efficacy, making comprehensive "apples to apples" comparisons of regimen performance in the RMM has been a challenge in large part due to the need to evaluate and adjust for variability across studies arising from differences in design and execution. To address this knowledge gap, we performed a model-based meta-analysis on data for 17 unique regimens obtained from a total of 1592 mice across 28 RMM studies. Specifically, a mixed-effects logistic regression model was developed that described the treatment duration-dependent probability of relapse for each regimen and identified relevant covariates contributing to interstudy variability. Using the model, covariate-normalized metrics of interest, namely, treatment duration required to reach 50% and 10% relapse probability, were derived and used to compare relative regimen performance. Overall, the model-based meta-analysis approach presented herein enabled cross-study comparison of efficacy in the RMM and provided a framework whereby data from emerging studies may be analyzed in the context of historical data to aid in selecting candidate drug combinations for clinical evaluation as TB drug regimens.

Nursing student evaluation of NIOSH workplace violence prevention for nurses online course.

INTRODUCTION: As primary targets of workplace violence in health care settings, nurses may suffer negative physical and psychological consequences. NIOSH created an online course to educate nurses about violence prevention techniques. METHOD: A mixed-methods approach assessed workplace violence awareness and knowledge among nursing students. A pre/post/post-test survey and focus group discussions evaluated participant awareness and knowledge, assessed course design, and solicited recommendations for increasing participation and strategies for improving message retention. RESULTS: The mean awareness scores differed significantly between pre-course and both post-course time points (Wilk's λ=0.319, F(2, 46)=49.01, p<0.001). Post hoc tests using the Bonferroni correction revealed that course participation increased awareness of workplace violence from pre-course scores (M=0.75, SD=0.438) to immediate post-course (M=2.13, SD=0.789) and four-week post-course (M=1.96, SD=0.771) scores on a 3-item measure. Similarly, mean knowledge scores increased between pre-course and both post-course time points (Wilk's λ=0.495, F(1.57, 73.66)=37.26, p<0.001). Post hoc tests using the Bonferroni correction revealed that course participation increased knowledge of workplace violence from pre-course scores (M=6.65, SD=1.45) to immediate post-course (M=8.56, SD=1.32) and four-week post-course (M=8.19, SD=1.42) scores on a 10-item measure. Qualitative data from the focus groups reinforced the quantitative findings. Participants citing benefits from the content strongly recommended including the course in nursing curriculums. Incorporating the course early in the nursing educational experience will better prepare students to deal with workplace violence when they enter health care professions. CONCLUSIONS: The results indicate that NIOSH and its partners created an effective online workplace violence awareness and prevention course. Practical applications: Nursing students and professionals can be effectively educated about workplace violence using an online format.

Suicide in U.S. Workplaces, 2003-2010: a comparison with non-workplace suicides.

INTRODUCTION: Suicide rates have risen considerably in recent years. National workplace suicide trends have not been well documented. The aim of this study is to describe suicides occurring in U.S. workplaces and compare them to suicides occurring outside of the workplace between 2003 and 2010. METHODS: Suicide data originated from the Census of Fatal Occupational Injury database and the Web-Based Injury Statistics Query and Reporting System. Suicide rates were calculated using denominators from the 2013 Current Population Survey and 2000 U.S. population census. Suicide rates were compared among demographic groups with rate ratios and 95% CIs. Suicide rates were calculated and compared among occupations. Linear regression, adjusting for serial correlation, was used to analyze temporal trends. Analyses were conducted in 2013-2014. RESULTS: Between 2003 and 2010, a total of 1,719 people died by suicide in the workplace. Workplace suicide rates generally decreased until 2007 and then sharply increased (p=0.035). This is in contrast with non-workplace suicides, which increased over the study period (p=0.025). Workplace suicide rates were highest for men (2.7 per 1,000,000); workers aged 65-74 years (2.4 per 1,000,000); those in protective service occupations (5.3 per 1,000,000); and those in farming, fishing, and forestry (5.1 per 1,000,000). CONCLUSIONS: The upward trend of suicides in the workplace underscores the need for additional research to understand occupation-specific risk factors and develop evidence-based programs that can be implemented in the workplace.

Incidence and risk factors of workplace violence on psychiatric staff.

BACKGROUND: A study by Hesketh et al. found that 20% of psychiatric nurses were physically assaulted, 43% were threatened with physical assault, and 55% were verbally assaulted at least once during the equivalent of a single work week. From 2005 through 2009, the U.S. Department of Justice reported that mental health occupations had the second highest average annual rate of workplace violence, 21 violent crimes per 1,000 employed persons aged 16 or older. OBJECTIVE: An evaluation of risk factors associated with patient aggression towards nursing staff at eight locked psychiatric units. PARTICIPANTS: Two-hundred eighty-four nurses in eight acute locked psychiatric units of the Veterans Health Administration throughout the United States between September 2007 and September 2010. METHODS: Rates were calculated by dividing the number of incidents by the total number of hours worked by all nurses, then multiplying by 40 (units of incidents per nurse per 40-hour work week). Risk factors associated with these rates were analyzed using generalized estimating equations with a Poisson model. RESULTS: Combining the data across all hospitals and weeks, the overall rate was 0.60 for verbal aggression incidents and 0.19 for physical aggression, per nurse per week. For physical incidents, the evening shift (3 pm - 11 pm) demonstrated a significantly higher rate of aggression than the day shift (7 am - 3 pm). Weeks that had a case-mix with a higher percentage of patients with personality disorders were significantly associated with a higher risk of verbal and physical aggression. CONCLUSION: Healthcare workers in psychiatric settings are at high risk for aggression from patients.

Physical assaults among education workers: findings from a statewide study.

OBJECTIVE: Enumerate and describe physical assaults occurring to Pennsylvania education workers. METHODS: A cross-sectional survey was mailed to a random sample of 6450 workers, stratified on gender, occupation, and region. Logistic regression was used to examine risk factors for physical assault. RESULTS: During the 2009-2010 school year, 309 of 2514 workers were assaulted 597 times. Special education teachers, urban workers, and those in their first 3 years of employment were at an increased risk. Most assaults did not lead to medical care or time away from work; however, those assaulted were significantly more likely to find work stressful, have low job satisfaction, and consider leaving the education field (adjusted odds ratio [AOR]=2.5 [95% CI=1.5 to 4.1]; AOR=2.4 [95% CI=1.5 to 3.9]; AOR=10.7 [95% CI=4.1 to 28.1]). CONCLUSIONS: Although education workers experienced few serious physical assaults, the impact of this violence was considerable.

Safe and secure at work?: findings from the 2002 Workplace Risk Supplement.

OBJECTIVE: To examine employee's perception of safety and related workplace safety and prevention issues, including their use of self-protection measures and victimization experience. PARTICIPANTS: The Workplace Risk Supplement (WRS) to the National Crime Victimization Survey (NCVS) was administered to 55,158 employed respondents who were 16 years or older. METHODS: Trained U.S. Census Bureau interviewers administered the WRS in all households selected for the NCVS during the 6-month reference period from January through June 2002. Responses from the 55,158 WRS respondents were weighted to obtain national estimates, resulting in 142,410,858 cases. RESULTS: The demographic distribution of WRS respondents is very similar to that of the U.S. labor force. Seven percent of respondents reported that they worried about someone in their workplace attacking them, while nearly 4% experienced victimization. The majority indicated that they felt that their workplace, the neighborhood around their workplace, and places they traveled to as part of their job were either "Very Safe" or "Somewhat Safe" from crime. Six percent carried some type of self protection while at work although this varied by occupation. CONCLUSIONS: Employees largely feel safe from violence while working. Differences in victimization by occupation bolster efforts to focus workplace violence prevention in high-risk occupations.

Non-fatal workplace violence injuries in the United States 2003-2004: a follow back study.

OBJECTIVE: Contribute to the prevention of workplace violence by providing information about the nature and circumstances of nonfatal assaults among U.S. workers. METHODS: Data were collected from the National Electronic Injury Surveillance System occupational supplement (NEISS-Work), a stratified probability sample of U.S. hospitals. Workplace violence victims identified from NEISS-Work voluntarily completed a followback interview detailing the nature and circumstances surrounding their workplace violence incident. RESULTS: The majority of workplace violence injuries treated in emergency departments resulted from simple assaults that did not involve any lost time from work. Almost two-thirds of these workplace violence victims filed only an internal report. Eighty percent of the victims returned to their same jobs and will not change the way they do their jobs as a result of the violent incident. CONCLUSIONS: Nonfatal workplace violence is an important risk for U.S. workers, particularly in some occupations and industries. Prevention strategies need to be tailored by occupation and work environment. Results from the healthcare section of this survey indicate high numbers of incidents during times when the healthcare workers were assisting patients with medical and non-medical needs.