Abstract

Work-related violence is consistently ranked among the leading causes of occupational death in the USA. In addition, approximately 2 million non-fatal work-related assaults are reported annually. A case-control study design was used to investigate risks of work-related physical assault (PA) associated with a history of violent victimisation among educators. A total of 6469 state-licensed educators (Kindergarten Grade 12) worked in the previous 12 months and were eligible to participate. Exposure data were collected from cases (reporting a PA event in previous 12 months, n=290) for the month before PA, and from controls (no work-related PA in previous 12 months; n=867) for a randomly selected working month. Potential confounders were identified for multivariable logistic regression from directed acyclic graphs; re-weighting adjusted for potential biases. OR and 95% CI identified increased risks for educators with any prior history of work-related (17.3, 11.4 to 26.3) or non-work-related PA (2.0, 1.2 to 3.5). In addition, PA risk in the previous 12 months increased with the number of previous victimisations. Using zero prior work-related PA as a reference, risks increased for those with number of prior events: 1–3 (15.0, 9.7 to 23.1); 4–10 (21.5, 10.5 to 44.2); and more than 10 (43.7, 17.1 to 111.3). Risk also increased for those with non-work-related PA prior events: 1–3 (1.8, 1.0 to 3.1) and 4 or more (7.8, 1.7 to 36.7). In addition, risks also increased for educators with histories of non-physical violence (threats, sexual harassment, verbal abuse, bullying) – both work- and non work-related. The results present a compelling case for targeted interventions and further research.