Author Bio ▼

Dr Helen Beers is the Technical Team Lead for the HSE’s Foresight Centre.  The Foresight Centre, based at the HSE’s Health and Safety Laboratory, helps the UK government, organisations and businesses to prepare themselves for occupational safety and health of the future.  Helen’s work focuses on demographics.  She has a PhD in Health Psychology and prior to joining HSL worked within the health, education and finance sectors.
June 16, 2021

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Work-related violence and aggression

Work-related violence and aggression: Don’t accept it. Report it. Prevent it.

In this article Helen Beers from the Health and Safety Executive and Sheena Johnson from the Alliance Manchester Business School at the University of Manchester discuss work-related violence and aggression – the importance of staff reporting incidents to their employers, and of employers understanding the problem and taking action to prevent it.

They report what is already known, comment on how COVID-19 has impacted on the problem, and outline research on work-related violence and aggression being undertaken by the Thomas Ashton Institute, HSE’s collaborative partnership with the University of Manchester to deliver research, learning and regulatory insights. Employers are invited to help make a difference and to get in touch to find out more.

What is work-related violence and aggression and why should we be concerned?

Modern slaveryThe Health and Safety Executive (HSE) defines work-related violence as: “any incident in which a person is abused, threatened or assaulted in circumstances relating to their work”. This definition includes verbal abuse and threats as well as physical attacks. Health and safety law applies where it is foreseeable that a risk of violence and/or aggression may arise out of, or in connection with, the work activity. Incidents not arising out of, or in connection with, work activity are not covered by health and safety legislation and are therefore beyond HSE’s remit.

The International Labour Organisation (ILO) recognises that everyone has the right to a world of work free from violence and harassment. According to the ILO the rates of violence and harassment (both physical and psychological) can rise during a health crisis (such as the COVID-19 pandemic). In addition, organisational change, especially where work has had to be reorganised or the physical work environment has been changed (as has happened during the pandemic) can be factors that increase risk. The World Health Organization’s guidance for health workers refers to exposure to physical and psychological violence as a hazard for front-line health workers during the COVID-19 outbreak.

Stories of members of the public throwing shopping at retail assistants and traffic cones and barriers at road workers, as well as stories of abuse such as spitting and threatening behaviour are concerning. Sadly, the problem is often ‘normalised’ as being ‘just part of the job’, for example, as discussed in a recent SHP article about assaults on NHS workers.

Work-related violence and aggression is an area of growing concern, as incidents can negatively impact on the physical and psychological health of those affected, as well as harming business performance and incurring costs to both business and society. There is more detail on this later.

What do we know about the scale of the problem?

HSE has limited evidence to demonstrate the extent of work-related violence and aggression. The most recent statistics (to March 2020) indicate that the risk of violence at work for people of working age in employment has been broadly similar over recent years, with the total number of violent incidents at work showing no clear trend, and fluctuating on an annual basis. HSE’s main source of evidence is the Crime Survey for England and Wales (CSEW). Other sources are the Labour Force Survey (LFS) and employer reports under the Reporting of Injuries, Diseases and Dangerous Occurrences Regulations (RIDDOR). However, these only reflect the most serious incidents, as most do not get reported either to the police or to HSE.

Based on the CSEW the extent of violence (threats and injuries) at work was estimated at 688,000 incidents in the twelve months to March 2020 (389,000 threats and 299,000 assaults). These incidents involved an estimated 307,000 workers, with some victims suffering more than one incident. In the year to March 2020, 1.4 % of working adults were estimated to have been the victim of one or more violent incidents at work.

Unfortunately this evidence is limited and is not believed to demonstrate the full extent of work-related violence and aggression. It was also captured prior to the COVID pandemic. Anecdotal and published evidence (e.g. from the shop workers union Usdaw) indicates that incidents are likely to be under-reported. Staff may ‘normalise’ violence and aggression towards them as ‘part of the job’ or may feel reporting is pointless as nothing will be done. This means that many employers do not fully understand the problem and are therefore ill-equipped to prevent incidents. There may, of course, be instances where employers are aware of the problem, and do not take action due to factors such as business pressures or lack of understanding about the impact on staff and the business.

Having said this, we do know that some large organisations, for example those in the retail and waste and recycling sectors, have been working hard to understand and prevent third party violence and aggression. They are engaging with staff, putting mechanisms in place for reporting incidents, supporting staff and implementing prevention strategies and interventions. To help us to gain a better understanding about the extent of the problem, and how employers are addressing it, we would like to gather as much information, and as many stories as possible, from across a wide range of industry sectors.

What do we know about the impact of COVID?

There is some evidence that work-related violence and aggression have increased during the COVID-19 outbreak. For example, Usdaw found that abuse, threats and assaults against shop workers doubled within the first month of the pandemic. Results from Usdaw’s most recent survey of over 2,700 retail workers show a continued increase in abuse over the past year. Almost nine in 10 survey respondents reported being verbally abused, 60% reported threats of physical violence and 9% said they had been physically assaulted.

The ILO has suggested that it is the restrictive measures around mobility and shortages of items that have resulted in a backlash against staff whose role is to enforce the measures.

The COVID-19 pandemic has accelerated trends that were already evident at work, such as lone and remote working. It has also increased levels of distress in the population. These may be indicators of an increase in vulnerability to work-related violence and aggression in the future.

What do we know about the risk to different groups?

Whilst violence and aggression can potentially affect any workplace and any worker, irrespective of company size, type of activity or form of employment relationship, certain groups and sectors are known to be more at risk. Those most likely to be at risk from violence and aggression are workers whose job requires them to deal with members of the public (i.e. third parties).

According to the ILO work situations common to a number of occupations tend to increase the risk of violence and aggression at work, especially in relation to third parties. These include working alone, working in contact with the public, working with people in distress, working with valuables and cash handling, and working in isolated or remote locations, at evening and/or night. HSE notes that whilst lone working does not always mean a higher risk of violence, it does make workers more vulnerable.

The occupational group with the highest risk of experiencing work-related violence and aggression is protective services. This group includes officers in the police service, fire service, customs and immigration. Occupations in health and health & social care have also been found to have a higher than average risk. Last week, SHP reported that England’s ambulance trusts are expected to be given body cameras by the end of June as assaults on ambulance workers rise by almost a third in five years.

The impact

Incidents are known to negatively impact at individual, organisational and societal levels.

Incidents are likely to affect overall wellbeing, sense of self-esteem and dignity. Physical health impacts might include injuries, cuts or bruises. Mental health effects may include anxiety, stress, post-traumatic stress disorder, and potential for increase in suicide risk. Individuals may feel frightened, sad, powerless, angry or helpless, incur problems sleeping and find themselves suffering from chronic fatigue. Individuals may also suffer loss of income if having to take time away from work following an incident.

Stories from retail workers provide an insight into the human impact of the problem. One retail assistant described how an incident had left them “always waiting for the next time”, and that they quit their job for a short time as they were “jumpy and always scared”. Another described feeling helpless to defend their team from “everyday verbal abuse from members of the public”.

In addition to impacting on the individual, violence and aggression can also have a detrimental effect on the wellbeing of others, such as those who witness the incident (colleagues, patients or clients) and on the victim’s family and friends (who may find it challenging to provide support).

At a business level, the problem may contribute to difficulties in recruiting or retaining staff. Staff morale, performance and productivity may reduce, business reputation may be damaged and insurance premiums may increase. The burden on society may manifest in increased health care costs for treatment or rehabilitation, as well as additional expenditure on welfare or benefits due to premature retirement from work.

Legal requirements and what employers should do to manage the problem

Violence and aggression is covered by a number of regulators; health and safety legislation, employment law and police-enforced criminal law all apply.

There are a number of pieces of legislation relevant to third-party violence and aggressions arising out of, or in connection with, work activities. These include The Health and Safety at Work etc Act 1974 (HSW Act) – where employers have a legal duty to ensure, so far as it is reasonably practicable, the health, safety and welfare at work of their employees. Under the Management of Health and Safety at Work Regulations 1999: “employers must consider the risks to employees of reasonably foreseeable third-party violence; decide how significant these risks are; decide what to do to prevent or control the risks; and develop a clear management plan to achieve this”.

Employers should provide clear policies in relation to violence and aggression, detailing their own responsibilities as well as those of their workforce, to raise awareness of related issues among the workforce, and set standards for workplace behaviour. They should create their own procedures and methods for tackling violence and aggression.

Effective management of violence and aggression requires undertaking a risk assessment to find out if there is a problem (identifying the hazard) and deciding what action to take (identify which employees are at risk, and evaluate the risk for example by checking the level of training and information provided; the environment; and design of the job), then taking action and checking what has been done.

Invitation for employers to get in touch about Thomas Ashton Institute (TAI) research

Helen and Sheena co-lead a research theme on social change and inequalities within the TAI. In addition to their work on violence and aggression, which is in partnership with Dr Kara Ng from the Alliance Manchester Business School, they have a separate strand of research planned on fatigue.

The aims of the work-related violence and aggression research are to obtain a better picture of the extent of the problem across sectors, to raise awareness, and improve reporting and prevention.

Helen, Sheena and Kara are inviting employers to share their professional insights to help raise awareness of the problem. They would like to understand what employers have done to address work-related violence and aggression and how they have done this (e.g. how workers were engaged).

If you would like to find out more, please get in touch with Helen. Please provide your name, position in the company, contact details, the name of your organisation and sector you work in.

Authors: Helen Beers and Sheena Johnson

The opinions and/or conclusions expressed in this article, are those of the authors alone and do not necessarily reflect HSE policy.

©Crown Copyright 2021, Health and Safety Executive

Dr Helen Beers, HSE

Helen Beers, PhD, leads HSE’s priority science on demographics. She has a social science and health psychology research background. Helen’s main area of research interest is demographic change, with a particular focus on the potential health and safety implications of the changing world of work and inclusive ageing in the workforce.





Sheena JohnsonSheena J. Johnson, PhD, is an occupational and chartered psychologist and is Professor of Work Psychology and Wellbeing at the University of Manchester, UK. She lectures in the Alliance Manchester Business School, where she teaches work psychology and organizational behaviour topics. She is an active researcher into the topics of health and wellbeing, and the ageing workforce and has authored numerous journal articles, books and book chapters.



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