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Ann Epidemiol. 2009 Feb;19(2):125-33. doi: 10.1016/j.annepidem.2008.10.009.

Hospital employee assault rates before and after enactment of the california hospital safety and security act.

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Department of Epidemiology, University of North Carolina at Chapel Hill, NC, USA.



This study examines changes in violent event rates to hospital employees before and after enactment of the California Hospital Safety and Security Act in 1995.


We compared pre- and post-initiative employee assault rates in California (n = 116) emergency departments and psychiatric units with those in New Jersey (n = 50), where statewide workplace violence initiatives do not exist. Poisson regression with generalized estimating equations was used to compare assault rates between a 3-year pre-enactment period (1993-1995) and a 6-year post-enactment period (1996-2001) using New Jersey hospitals as a temporal control.


Assault rates among emergency department employees decreased 48% in California post-enactment, compared with emergency department employee assault rates in New Jersey (rate ratio [RR] = 0.52, 95% confidence interval [CI]: 0.31, 0.90). Emergency department employee assault rates decreased in smaller facilities (RR = 0.46, 95% CI: 0.21, 0.96) and for-profit-controlled hospitals (RR = 0.39, 95% CI: 0.19, 0.79) post-enactment. Among psychiatric units, for-profit-controlled hospitals (RR = 0.41, 95% CI: 0.19, 0.85) and hospitals located in smaller communities (RR = 0.44, 95% CI: 0.21, 0.92) experienced decreased assault rates post-enactment.


Policy may be an effective method to increase safety to health care workers.

[Indexed for MEDLINE]

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