Have you followed the details of this year’s workplace shootings?
- A supervisor buys a handgun before his shift, shoots and kills a handful of coworkers, and then shoots himself.
- A gunman armed with a semiautomatic rifle enters a Buffalo, New York, grocery store, killing 10 patrons. Another enters a Colorado Springs, Colorado, LGBTQ nightclub and kills 5.
- A worker enters a manufacturing facility and opens fire on four coworkers.
Active shooter incidents in the workplace may be rare, but the consequences can be devastating. Active shooter incidents often are over within 10 to 15 minutes, according to the Department of Homeland Security (DHS), and workers and others must be prepared for an incident.
You may even face a reputational risk if your facility is portrayed as a dangerous place for customers, visitors, and workers after an active shooter incident or another instance of workplace violence. Incidents of workplace violence also can result in workers’ compensation claims, as assaults on the job can sometimes leave workers disabled. A study of workers’ compensation claims over a 5-year period in Oregon found that assault claims averaged 58 days of lost time and $12,258 in costs per claim.
Workplace violence is a recognized hazard, and the Occupational Safety and Health Review Commission (OSHRC) has reaffirmed that employers are responsible for protecting employees from assaults and homicides.
You should remain alert to warning signs of potential violence, including shootings, such as:
- Those bringing a weapon into the workplace, brandishing a weapon in the workplace, making inappropriate references to guns, or exhibiting a fascination with weapons;
- Direct or veiled verbal threats of harm;
- Drug or alcohol use;
- Intimidating, belligerent, harassing, bullying, or other inappropriate and aggressive behavior;
- Repeated conflicts with supervisors or coworkers; and
- Statements showing a fascination with incidents of workplace violence, statements indicating approval of the use of violence in certain situations or the use of violence to resolve a problem, and statements indicating identification with perpetrators of workplace homicides.
The long-standing practice for responding to active shooter incidents endorsed by the Federal Bureau of Investigation (FBI) and others in law enforcement has been “run, hide, or fight.”
Workplace homicides and suicides are the most extreme instances of workplace violence. Public-facing businesses may be the most vulnerable to workplace violence such as assault. There also are certain occupations that are more prone to workplace violence than others. According to the Occupational Safety and Health Administration (OSHA), occupations most at risk for workplace violence include:
- Corrections and law enforcement personnel,
- Customer service agents,
- Delivery drivers,
- Healthcare professionals,
- Public service workers,
- Those who work alone or in small groups, and
- Workers who exchange money with the public, especially in late-night retail.
Engineering controls in late-night retail stores include clear views for employees and police by keeping shelving low and signs high in windows and ensuring that cash registers or customer service areas are visible outside the store.
Healthcare and social assistance workers have the highest risk for workplace violence resulting in days away from work, according to the National Institute for Occupational Safety and Health (NIOSH).
A leading cause of fatalities in the past
As active as 2022 has been, workplace violence, especially homicide, has been worse in the past. From 1980 to 1989, homicide was the third leading cause of death from injury in the workplace, according to a 1995 NIOSH alert.
The Bureau of Justice Statistics (BJS), the Bureau of Labor Statistics (BLS), and NIOSH reported earlier this year that workplace homicides peaked at 1,080 annually in 1994, then declined 58% over a 25-year period to 454 in 2019. A total of 17,865 workers were victims of workplace homicide from 1992 to 2019. Despite the overall decrease in workplace homicides between 1994 and 2019, they increased 11% from 2014 to 2019. In 2019, there were 15 or more workplace homicides in 9 states: Alabama, California, Florida, Georgia, Illinois, New York, North Carolina, Texas, and Washington.
However, homicide is not the only violent crime in the workplace; an average of 1.3 million nonfatal violent crimes occur each year. Over a 5-year period from 2015 to 2019, an estimated 529,000 nonfatal injuries from workplace violence were treated in hospital emergency departments (EDs). The rate of ED-treated injuries from workplace violence was 7.1 per 10,000 full-time equivalent (FTE) workers, according to the BJS, the BLS, and NIOSH. According to the BJS’s National Crime Victimization Survey (NCVS), strangers committed nearly half (47%) of nonfatal workplace violence from 2015 to 2019.
There have been repeated calls to regulate workplace violence hazards. Following the January 6, 2021, breach of the U.S. Capitol, the AIHA (formerly known as the American Industrial Hygiene Association) called for OSHA to establish a safety standard for workplace violence prevention. The group also encouraged Congress to enact legislation compelling the agency to promulgate a workplace violence rule.
There currently is no federal workplace violence standard. However, the agency has a rulemaking in the prerule stage for a federal workplace violence standard for health care and social assistance discussed below. The agency cites employers under the General Duty Clause of the Occupational Safety and Health Act (§5(a)(1)) following instances of workplace violence.
OSHA provides employer guidance and resources to address workplace violence, including the agency’s workplace violence health and safety topic page and its “Recommendations for Workplace Violence Prevention Programs in Late-Night Retail Establishments,“ as well as healthcare and social services guidelines discussed below.
In addition to its active shooter booklet, DHS resources include a Web portal compiling resources for countering violent extremism and active shooters.
Private sector resources include the American Society of Safety Professionals’ (ASSP) report on developing and implementing active shooter/armed assailant plans. Aspects of an effective active shooter plan the ASSP recommends include risk assessment, employee communication and training, incident response, post-incident procedures, and ongoing program audits.
Additionally, the National Fire Protection Association (NFPA) has a “Standard for an Active Shooter/Hostile Event Response (ASHER) Program” (NFPA 3000).
The National Safety Council (NSC) also offers an active shooter “Safety Check” fact sheet and recommends a version of “run, hide, or fight,” saying incapacitating a shooter should only be a last resort.
Focus on health care, social services
There has been a special focus on addressing workplace violence hazards in health care and social services. Workplace assaults ranged from 23,540 and 25,630 annually over a 3-year period, and 70% to 74% of those occurred in healthcare and social services settings.
High-risk work settings include hospitals and large institutional care facilities; residential treatment facilities, such as alcohol and drug addiction treatment facilities, nursing homes, psychiatric facilities, and other long-term care facilities; and fieldwork, including home health care or social services home visits.
OSHA has a rulemaking in the prerule stage for a federal workplace violence standard for health care and social assistance; there is no federal workplace violence standard. OSHA currently cites employers following indents of workplace violence under the General Duty Clause of the OSH Act (§5(a)(1)).
The agency issued a request for information for its rulemaking in the final weeks of the Obama administration. This spring, the agency revealed plans for a Small Business Regulatory Enforcement Fairness Act (SBREFA) review of the rulemaking.
OSHA also issued voluntary guidelines in 2016 for preventing workplace violence in healthcare and social services employment (“Guidelines for Preventing Workplace Violence for Health Care & Social Service Workers”). Recommended elements of an effective workplace violence prevention program include management commitment and employee participation, worksite hazard analysis, hazard prevention and control methods, safety and health training, and recordkeeping and regular program evaluation.
OSHA’s guidelines conform to the traditional industrial hygiene “hierarchy of controls”—elimination, substitution, engineering controls, and administrative controls and work practices—for addressing shootings and other workplace violence hazards.
Engineering controls can be some of the most effective measures, according to OSHA, and some of these controls in a hospital or residential care facility can include:
- Closed-circuit video inside and outside a facility, curved mirrors, and glass panels in doors and walls for better monitoring;
- Installed or hand-held metal detectors (wands), with staff properly trained in using equipment and removing weapons;
- Lockable doors to limit access to unused rooms;
- Proper placement of nurses’ stations to allow visual scanning of corridors and other areas;
- Silent or other security alarm systems like panic buttons or paging systems at workstations and personal alarm devices worn by employees;
- Reception desks enclosed in bulletproof glass, deep counters at nurses’ stations, and secure bathrooms for staff members—separated from patient/client and visitor facilities—with locks on the inside; and
- Two exits from patient or treatment rooms, wherever possible; furniture arranged to allow clear exit routes for employees; and employee “safe rooms” for emergencies.
Engineering controls that are useful in all industries include door locks and physical barriers like enclosures with bulletproof glass, monitoring systems and panic buttons, and accessible exits and additional lighting.
However, sometimes engineering controls are infeasible or not wholly protective, and you may need to implement administrative controls and safe work practices.
Hospitals and residential treatment facilities should have properly trained security officers and counselors who can respond to aggressive behavior and disarm and de-escalate patients or visitors if necessary.
Patients with a known history of violence should be supervised throughout the facility, and staff should be informed of violent histories or incidents during shift changes.
In 2014, a federal interagency group released guidance, “Incorporating Active
Shooter Incident Planning into Health Care Facility Emergency Operations Plans,” that outlined ways healthcare facilities can incorporate prevention, mitigation, response, and recovery capabilities into their emergency operations plans.
The Quality, Safety & Oversight Group of the Centers for Medicare and Medicaid Services (CMS) recently issued a memorandum urging healthcare industry leaders to take steps to protect workers from workplace violence, especially hazards posed by patients or residents likely to harm themselves and others. Recommended steps included ensuring workers receive adequate training, having sufficient staffing levels, providing ongoing assessment of patients and residents for aggressive behavior, and appropriately adapting patients’ or residents’ care interventions and environment.
Whether you’re in health care or social services; a cash-based, public-facing business like late-night retail; or manufacturing, workplace violence, including an active shooter, is a potential, if an unlikely, hazard.
Therefore, you may want to incorporate engineering controls into your facility and take advantage of training and work practices to prepare your staff for active shooter incidents or other instances of workplace violence.