Understanding and Preventing Workplace Violence
A practical, evidence-based guide to how common workplace violence is, what it looks like, and how organizations can reduce the risk.
Workplace violence is not limited to headline-grabbing incidents involving active shooters. It also includes everyday threats, harassment, intimidation, and assaults that occur in offices, hospitals, factories, schools, retail stores, and public spaces where people work. Despite long-term progress in reducing the most severe forms of workplace violence, recent data show that many workers still face a significant risk of harm, especially in certain industries. This article explains how common workplace violence is, how it is defined, who is most affected, and what organizations can do to prevent and respond to it.
What Counts as Workplace Violence?
According to the Occupational Safety and Health Administration (OSHA), workplace violence includes any act or threat of physical violence, harassment, intimidation, or other threatening behavior occurring at a work site. This broad definition covers not only physical attacks, but also behaviors that create fear or a risk of harm.
The Centers for Disease Control and Prevention (CDC) further emphasizes that workplace violence ranges from verbal abuse to physical assaults directed toward people at work or on duty. That means an aggressive customer shouting threats at a cashier, a nurse being pushed or punched by a patient, or a co-worker making credible threats of harm can all fall under workplace violence.
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Major Categories of Workplace Violence
Safety experts often group workplace violence incidents into four broadly recognized categories.
- Criminal intent – The perpetrator has no legitimate relationship to the business or its employees and usually enters the workplace to commit a crime, such as robbery.
- Customer or client – Violence occurs between a worker and someone receiving services, such as a patient, customer, or client.
- Worker-on-worker – The perpetrator is a current or former employee who attacks or threatens another worker.
- Personal relationship – The perpetrator has a personal relationship with a worker, such as an intimate partner, and brings that conflict into the workplace; this category disproportionately impacts women.
Understanding which category is most relevant for a particular workplace is critical for designing effective prevention strategies.
How Common Is Workplace Violence?
Workplace violence is more common than many people realize. Although homicides at work have declined substantially over the last few decades, both fatal and nonfatal incidents still affect tens of thousands of workers each year.
Long-Term Trends in Workplace Homicides
A joint federal study by the Bureau of Justice Statistics and other agencies reported that workplace homicides in the United States peaked at 1,080 in 1994 and dropped to 454 in 2019, a decline of roughly 58% over that period. This long-term reduction reflects changes such as improved security practices, better cash-handling procedures, and broader crime trends.
More recent data show that the number of workplace homicides has fluctuated rather than consistently declined. The Bureau of Labor Statistics (BLS) recorded 524 fatal injuries due to homicides in the workplace in 2022, representing an 8.9% increase from 481 homicides in 2021. According to injury statistics summarized by the National Safety Council, 525 workplace fatalities due to assault were reported in 2022.
| Year | Workplace homicides (approx.) | Key observation |
|---|---|---|
| 1994 | 1,080 | Peak in recorded workplace homicides. |
| 2019 | 454 | Down roughly 58% from 1994. |
| 2021 | 481 | Baseline used in recent BLS comparison. |
| 2022 | 524 | 8.9% increase over 2021. |
These numbers show that, while workplace homicides are significantly less common than they were in the mid-1990s, fatal violence at work remains a persistent risk.
Nonfatal Workplace Violence: A Much Larger Problem
Fatal incidents are only the tip of the iceberg. Far more common are assaults, threats, and other violent acts that cause injury but do not result in death.
Over the 2021–2022 period, the BLS reported 57,610 nonfatal cases of workplace violence that led to days away from work, job restriction, or transfer, corresponding to an incidence rate of 2.9 cases per 10,000 full-time equivalent employees. More than 71% of these cases resulted in at least one day away from work, with a median of seven days away.
The National Safety Council reports that in 2023–2024, assaults resulted in 54,230 injuries that required days away from work, and in 2024, 470 fatalities due to assault were recorded. Meanwhile, CDC data indicate that 20,050 workers in private industry experienced trauma from nonfatal workplace violence in 2020.
In healthcare settings, the costs and frequency of violence are especially high. The American Hospital Association has estimated that, in 2023, violence cost U.S. hospitals around $18.27 billion annually, including prevention, treatment, absenteeism, and lost productivity. Its analysis suggests that more than 146,000 hospital workers may be exposed to or victimized by violence each year, resulting in substantial direct and indirect financial impacts.
Who Is Most at Risk?
Workplace violence can occur in any sector, yet some workers and industries face disproportionately higher risks.
Gender and Age Patterns
According to CDC data on nonfatal workplace violence injuries, about 73% of affected workers in one analysis were women, 62% were aged 25–54, and 76% worked in the healthcare and social assistance industry. In addition, a separate estimate showed that nearly one-quarter of injured workers required 31 or more days away from work, underscoring the severity of these incidents.
These figures reflect the concentration of women in caregiving and health-related jobs where customer/client and personal relationship violence are more common.
High-Risk Industries and Work Settings
Research consistently indicates that some types of workplaces face higher levels of violence:
- Healthcare and social assistance – Nurses, physicians, technicians, and reception staff in hospitals and clinics are frequently exposed to violence from patients, visitors, and others.
- Retail and hospitality – Convenience store clerks, bartenders, and hotel staff may experience criminal intent incidents (such as robbery) or violence from customers.
- Public-facing services – Workers in social services, public transportation, and education often have frequent contact with the public, which can increase exposure to threats and aggression.
In healthcare alone, estimates suggest workplace violence prevalence can reach between roughly a quarter and two-thirds of staff, depending on role and setting, showing that the problem is not isolated to a small minority of workers.
Warning Signs and Risk Factors
No system can completely predict which individual will commit an act of workplace violence. However, organizations can pay attention to behaviors and circumstances that increase risk and may signal the need for intervention.
Behavioral Red Flags in Co-Workers
According to safety guidance from national organizations, behaviors that may warrant concern include:
- Frequent or excessive use of alcohol or drugs.
- Unexplained absenteeism, sudden changes in behavior, or a sharp decline in job performance.
- Depression, withdrawal, or comments suggesting suicidal thinking.
- Persistent complaints about unfair treatment or resistance to changes at work.
- Repeated violations of company policies.
- Strong emotional reactions to criticism, including outbursts or mood swings.
- Paranoid thoughts or beliefs that others are “out to get” them.
These signs do not guarantee that someone will become violent, but they highlight situations where managers and human resources professionals may need to engage support services, perform risk assessments, or adjust workloads and duties.
Environmental and Organizational Risk Factors
Beyond individual behaviors, certain work conditions make violence more likely:
- Work involving cash handling, late-night hours, or isolated locations.
- Regular contact with volatile individuals, such as patients in crisis or clients under legal or financial stress.
- Inadequate staffing, which can increase wait times and frustration.
- Lack of physical security measures, such as controlled access, lighting, or surveillance.
- Weak or unclear policies for reporting threats, harassment, and assaults.
Addressing these structural risk factors is often more effective than focusing solely on identifying “dangerous individuals.”
Employer Duties and Legal Considerations
While specific legal obligations vary by jurisdiction, occupational safety agencies generally expect employers to take reasonable steps to protect workers from foreseeable violence risks. This is often framed under a general duty to provide a safe workplace.
Key Elements of a Workplace Violence Program
OSHA and related guidance documents emphasize that one of the best protections employers can offer is a zero-tolerance policy toward workplace violence. Effective programs typically include:
- A written policy defining workplace violence and stating that threats, harassment, and assaults are prohibited.
- Clear reporting procedures for employees to raise concerns or document incidents.
- Commitment to prompt investigation and corrective action when incidents occur.
- Integration with broader occupational safety and accident prevention programs.
In sectors such as healthcare, additional regulations or accreditation standards may require specific training, incident reporting, and environmental controls to manage violence risks.
Practical Strategies to Prevent Workplace Violence
Prevention efforts are most effective when they combine policy, training, environmental changes, and technology. Employers should tailor measures to the types of violence most likely in their setting.
Policy and Training Measures
- Develop and communicate a clear policy – Ensure all workers, contractors, and visitors understand what constitutes unacceptable conduct and how to report it.
- Provide safety education – Train employees to recognize early signs of aggression, de-escalate tense situations when safe to do so, and know when to disengage and seek help.
- Encourage prompt reporting – Workers should be instructed to report threats and incidents immediately and in writing, without fear of retaliation.
- Plan emergency responses – Develop an emergency action plan that covers active shooter situations, evacuations, and communication protocols with law enforcement.
Physical and Technological Controls
Engineering controls and technology can significantly reduce exposure to violence risks.
- Securing entrances and exits with controlled access systems.
- Installing cameras in high-risk areas.
- Using panic buttons or other rapid-alert systems.
- Designing workspaces to provide escape routes and limit contact with potentially aggressive individuals.
- Implementing weapons detection technologies where appropriate.
Run, Hide, Fight: Responding to Active Assailant Incidents
For extreme events involving an armed attacker, the U.S. Department of Homeland Security promotes a “Run, Hide, Fight” framework adopted by many safety organizations. In broad terms:
- Run – If a safe escape route is available, evacuate immediately, leave belongings behind, and help others escape if you can do so safely.
- Hide – If evacuation is not possible, find a hiding place where you will not be trapped if discovered, lock and barricade doors, and silence your phone.
- Fight – As a last resort, when your life is in imminent danger, attempt to incapacitate the attacker using improvised weapons and coordinated resistance.
Organizations should adapt these principles to their facilities and train staff on how to apply them in realistic scenarios, preferably in coordination with local law enforcement.
Supporting Workers After an Incident
Violence at work has consequences that go beyond physical injuries. It can contribute to anxiety, post-traumatic stress, absenteeism, and turnover. A comprehensive response plan should support recovery and learning.
Post-Incident Actions for Employers
- Medical care and evaluation – Offer prompt medical treatment and follow-up assessment.
- Legal and reporting obligations – Report violent incidents to local police when appropriate, and inform victims of their legal rights.
- Psychological support – Provide access to counseling, stress debriefing sessions, or employee assistance programs.
- Incident review – Investigate all incidents and threats, analyze trends, and implement corrective actions to reduce future risk.
- Communication with staff – Discuss the circumstances and changes in procedures in regular meetings, encouraging staff to share ideas for prevention.
In high-risk sectors, investing in recovery support can also help reduce long-term costs related to absenteeism and productivity loss.
FAQs About Workplace Violence
Is workplace violence only about physical attacks?
No. Workplace violence includes threats, harassment, intimidation, and other behaviors that create fear or risk of harm, not just physical assaults or homicide.
Which workplaces are most affected?
Healthcare and social assistance settings have some of the highest rates of nonfatal workplace violence, especially among women. Retail, hospitality, social services, and other public-facing roles also face elevated risks.
Are workplace homicides increasing or decreasing?
Compared with the peak in the mid-1990s, workplace homicides have declined substantially. However, recent data show increases between 2021 and 2022, indicating that fatal workplace violence remains a serious concern.
What is the most important step employers can take?
Establishing a clear, zero-tolerance workplace violence policy and backing it up with training, reporting systems, engineering controls, and consistent enforcement is considered one of the most effective foundational steps.
How does workplace violence affect organizations financially?
Costs include medical care, legal liabilities, absenteeism, turnover, lost productivity, and security investments. In hospitals alone, the annual cost of workplace violence has been estimated in the tens of billions of dollars.
References
- Federal Agencies Release Joint Study on Workplace Violence — Bureau of Justice Statistics, U.S. Department of Justice. 2022-07-21. https://bjs.ojp.gov/press-release/federal-agencies-release-joint-study-workplace-violence
- Workplace Violence: 2021-2022 — U.S. Bureau of Labor Statistics. 2024-04-18. https://www.bls.gov/iif/factsheets/workplace-violence-2021-2022.htm
- Workplace Violence — National Safety Council Injury Facts. 2024-06-01 (last updated, approximate). https://www.nsc.org/workplace/safety-topics/workplace-violence
- Violence and Work — National Institute for Occupational Safety and Health, CDC. 2023-03-10 (last updated, approximate). https://www.cdc.gov/niosh/violence/about/index.html
- Workplace Violence — Occupational Safety and Health Administration, U.S. Department of Labor. 2023-11-01 (last updated, approximate). https://www.osha.gov/workplace-violence
- The Burden of Violence to U.S. Hospitals — American Hospital Association. 2023-10-01. https://www.aha.org/costsofviolence
- OSHA Fact Sheet: Workplace Violence — University of California Office of the President (summarizing OSHA guidance). 2010-01-01 (foundational OSHA guidance). http://www.osha.gov/workplace-violence
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