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Updated: May 26, 2026

The Resident-intruder Paradigm: A Standardized Test for Aggression, Violence and Social Stress
Published on: July 4, 2013
Risk assessment of aggression toward emergency health care workers
A Martini1, S Fantini, M C D'Ovidio
1INAIL-Italian Workers' Compensation Authority RESEARCH, Department of Occupational Medicine, formerly ISPESL (National Institute for Occupational Safety and Prevention), Via Fontana Candida, 1, Monte Porzio Catone, Rome 00040, Italy. agnese.martini@ispesl.it
Background:
Health care and social service workers face a significant risk of job-related violence.
Aims:
To develop a method for quantitative evaluation of the risk of violence, as required by Italian and European regulations, against extra-hospital emergency health care workers employed by the Regional Emergency Healthcare Service (ARES 118) in the Lazio Region in Italy.
Methods:
Violence to the ARES 118 workers during working hours was examined by analysing injuries reported by them between 2005 and 2007. The assessment method proposed should give a numerical indicator of the risk of violence for each homogeneous group. The quantitative risk was evaluated on the basis of variables such as the days off work for each episode, the total number of aggressive attacks, the type of health intervention involved, etc.
Results:
The rate of accidents related to aggression during working hours at the ARES unit was 6.3%, which is significantly higher than the figure of 2% reported for the entire health care sector.
Conclusions:
The present evaluation is largely based on analysis of the Injury Register. To increase the sensitivity of the method so that it closely reflects active reporting of events, it would be necessary to implement a procedure for reporting events in a 'company register of acts of violence' and to make workers more aware of the need to report all such episodes.
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