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Workplace violence against employees providing healthcare and social assistance services is a serious and longstanding concern. The Occupational Safety and Health Administration (OSHA) issued Guidelines for Preventing Workplace Violence for Healthcare and Social Service Workers in 1996 and updated the guidelines in 2004 and 2016. OSHA has also used the general duty clause (Section 5(a)(1) of the Occupational Safety and Health Act) in enforcement cases addressing workplace violence in healthcare.

OSHA published a Request for Information on December 7, 2016, (81 FR 88147) seeking information about the extent and nature of workplace violence in the industry and the nature and effectiveness of interventions and controls used to prevent such violence. Also in 2016, a broad coalition of labor unions petitioned OSHA to issue a standard to address workplace violence in healthcare, and National Nurses United submitted a separate petition for a workplace violence standard. On January 10, 2017, OSHA granted the petitions. In accordance with the requirements of the Small Business Regulatory Enforcement Fairness Act, OSHA convened a Small Business Advocacy Review (SBAR) panel in March 2023 to consider a potential standard for prevention of workplace violence in healthcare and social assistance. The SBAR Panel issued its report on May 1, 2023.

Statement of Need:

According to the Bureau of Labor Statistics, for the years 2021-2022, 70% of all non-fatal workplace violence injuries in the U.S. severe enough to result in workers missing at least one day of work occurred in the healthcare and social assistance industry sectors. Workers at psychiatric and substance abuse hospitals experienced the highest rate of violent injuries that resulted in days away from work, with approximately 110 injuries per 10,000 full-time employees (FTEs). This is 5 times the rate for workers at nursing and residential care facilities (22/10,000 FTEs).

Summary of the Legal Basis:

The Occupational Safety and Health Act of 1970 authorizes the Secretary of Labor to set mandatory occupational safety and health standards to assure safe and healthful working conditions for working men and women (29 U.S.C. 651).

Alternatives:

One alternative to proposed rulemaking would be to take no regulatory action.  As OSHA develops more information, it will also make decisions relating to the scope of the standard and the requirements it may impose.

Anticipated Costs and Benefits:

The estimates of costs and benefits are still under development.

Risks:

Analysis of risks is still under development.