Introduction: Workplace violence (WPV) is a significant occupational hazard in healthcare, with emergency departments (EDs) recognized as high-risk environments. Although globally significant, data from Latin America remain scarce. In this study we aimed to evaluate the prevalence and effects of WPV on healthcare workers in Brazilian EDs.
\nMethods: We conducted a cross-sectional survey of healthcare workers in Brazilian EDs. Respondents indicated verbal and physical violence experienced within the preceding six months, along with associated psychological and occupational impacts. Univariable models identified significant associated factors, followed by multivariable models to determine independent associated factors of WPV. We reported results as adjusted odds ratios (aOR) with 95% confidence intervals. Statistical analyses were performed in R v4.4.1, and significance was defined as P < .05.
\nResults: The response rate was 19.1% (1,255/6,570), Of those responses, 61.3% (769/1,255) met the inclusion criteria and were included in the analysis. Of all respondents, 84.0% were physicians. Respondents indicated 79.6% (612/769) occurrence of WPV, including verbal abuse (79.5%) and physical assault (12.1%). Physical assaults against co-workers were witnessed by 40.3% of respondents. Perpetrators included visitors (85.3%), patients (80.7%), and co-workers (35.8%). The absence of institutional preventive measures was associated with increased WPV (aOR, 2.47; 95% CI, 1.71-3.57; P < .001), while the presence of security staff reduced WPV (aOR, 0.61; 95% CI, 0.42–0.89; P = .01). Indicated impact included post-traumatic stress symptoms (88.4%), considering leaving their job (49.5%), impaired workplace performance (75.2%), and time off work (10%), including 11.5% permanently leaving.
\nConclusion: Workplace violence is highly prevalent in Brazilian EDs, with substantial psychological and occupational consequences. The absence of protocols or preventive measures may increase WPV risk, emphasizing the urgent need for public policies to protect healthcare workers in emergency settings.
","language":"eng","license":{"name":"Creative Commons Attribution 4.0","short_name":"CC BY 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by/4.0"},"keywords":[{"word":"Emergency departments; Workplace violence; Multivariable analysis; Risk factors; Physical assault; Verbal violence."},{"word":"Emergency Departments"},{"word":"Workplace violence"},{"word":"Multivariable analysis"},{"word":"Risk factors"},{"word":"Physical assault"},{"word":"Verbal violence"}],"section":"Original Research (Limit 4000 words)","is_remote":true,"remote_url":"https://escholarship.org/uc/item/2t10j5pc","frozenauthors":[{"first_name":"Julia","middle_name":"M.","last_name":"Dorn de Carvalho","name_suffix":"","institution":"Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Department of Emergency Medicine, São Paulo, Brazil","department":""},{"first_name":"Sarayna","middle_name":"S.","last_name":"McGuire","name_suffix":"","institution":"Mayo Clinic, Department of Emergency Medicine, Mayo Clinic, Rochester, Minnesota","department":""},{"first_name":"Lucas","middle_name":"","last_name":"L. R. Oliveira","name_suffix":"","institution":"Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Department of Emergency Medicine, São Paulo, Brazil","department":""},{"first_name":"Fernanda","middle_name":"","last_name":"Bellolio","name_suffix":"","institution":"Mayo Clinic, Department of Emergency Medicine, Mayo Clinic, Rochester, Minnesota","department":""},{"first_name":"Otávio","middle_name":"T.","last_name":"Ranzani","name_suffix":"","institution":"ISGlobal, Barcelona, Spain; Institut de Recerca Sant Pau (IR SANT PAU), Barcelona, Spain; Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Heart Institute, Faculty Medicine, Pulmonary Division, São Paulo, Brazil","department":""},{"first_name":"Bruno","middle_name":"A. M Pinheiro","last_name":"Besen","name_suffix":"","institution":"Faculdade de Medicina, Universidade de São Paulo, Internal Medicine Department, Medical Sciences Postgraduate Programme, São Paulo, Brazil; IDOR Education and Research Institute, São Paulo, Brazil","department":""},{"first_name":"Helio","middle_name":"","last_name":"Penna Guimarães","name_suffix":"","institution":"Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Department of Emergency Medicine, São Paulo, Brazil","department":""},{"first_name":"Maria","middle_name":"Camila","last_name":"Lunardi","name_suffix":"","institution":"Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Department of Emergency Medicine, São Paulo, Brazil","department":""},{"first_name":"Aidan","middle_name":"F","last_name":"Mullan","name_suffix":"","institution":"Mayo Clinic, Department of Quantitative Health Sciences, Rochester, Minnesota","department":""},{"first_name":"Ludhmila","middle_name":"A.","last_name":"Hajjar","name_suffix":"","institution":"Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Department of Emergency Medicine, São Paulo, Brazil","department":""},{"first_name":"Ian","middle_name":"","last_name":"Ward A. Maia","name_suffix":"","institution":"Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Department of Emergency Medicine, São Paulo, Brazil","department":""}],"date_submitted":"2025-02-28T15:29:56.999000Z","date_accepted":"2025-06-06T15:01:22.138000Z","date_published":"2025-10-17T14:34:00Z","render_galley":null,"galleys":[{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/westjem/article/45138/galley/43168/download/"}]}