Paris, France: Seventy-five percent of workers in emergency medical departments and services have witnessed violence in the past year, according to a survey of over 1,300 health professionals in 81 countries worldwide.
In a special session at the European Emergency Medicine Congress today (Friday), Luis Garcia Castrillo, a professor in emergency medicine, now retired, at the Hospital Marqués de Valdecilla, Santander, Spain, said that while patients and their friends or relatives were the main perpetrators, often because of alcohol or drug consumption, overcrowding in emergency medical departments was an equally important contributor to the violence.
Prof. Castrillo said: “Workplace violence not only jeopardises the physical and mental health of healthcare professionals but also negatively impacts the quality of care they provide. The survey reveals that 45.8% of respondents thought that the quality of care was diminished as a result of the violence they encountered.”
The international, online survey, conducted by the EUSEM Emergency Medicine Day Working Group, received responses from 1,306 healthcare providers in 81 countries between May and June 2026. A paper is published in the European Journal of Emergency Medicine ( EJEM ) at the same time as its presentation to the Congress [2].
It found that 75.5% of respondents had witnessed violence in their workplaces in the previous year, 68.8% had experienced psychological harm and 40.3% had experienced physical harm.
Verbal aggression was the most common form of violence (87.8%), followed by physical assault (42.3%), property damage (26.4%), sexual harassment (14.6%), race-related violence (14.5%), armed conflict (4.5%), weapon-related incidents (4.1%), sexual assault (3.5%), cyber harassment (3.1%), and firearms incidents (2.9%). Patients were the principal perpetrators (67.6%), followed by relatives or friends (44.1%). Intoxicated patients or visitors accounted for 44% and psychiatric patients for 35.2%.
Nearly half of the respondents (48.3%) thought workplace violence had worsened over the previous five years, and they perceived violent patients as one of the greatest occupational threats, second only to the risk of infection. Only half (51.1%) had received formal violence prevention training, 38.6% reported no formal training, 57.3% had access to psychosocial support after violent incidents, whereas 27.1% had no access. Women were more likely to report psychological victimisation than men: 72.2% versus 40.4%.
Dr Roberta Petrino, director of the Emergency Department at Ente Ospedaliero Cantonale, Lugano, Switzerland, co-chaired the EUSEM Congress session and is the first author of the EJEM paper. She said: “I would like to underline that the major problem for women working in emergency medicine is the verbal violence; this could be insults, sexual references, gender-related harassment and discrimination. Women emergency workers are subjected to this far more than men, and it has mainly psychological consequences. Respondents to the survey wanted psychological support, and the problem of violence to be addressed through prevention and better safety processes.
“Another important point is the perception of scarce preparation to tackle the problem of violence; respondents thought the emergency services were more prepared for a mass casualty event than for everyday violence.
Prof. Castrillo, Dr Petrino and the other authors of the report issued a call to all providers of emergency services – pre-hospital services and emergency medical departments – to consider ways to reduce the possible triggers for violence.
Dr Petrino said: “Prolonged waiting times, limited resources and high emotional stress all escalate tensions among patients, relatives and healthcare professionals. This needs to be tackled through organisational interventions. Hospital managers should improve the internal organisation of the hospital so as to reduce overcrowding, for instance, by providing good, well-designed spaces that are well-staffed, and setting up policies in the wards to facilitate patients transferring to them quickly from emergency departments. This would allow emergency departments to improve patient flow. Managers should consider specific education about how to de-escalate situations and how to communicate well, and they should provide safety systems such as video cameras and security personnel.
“Finally, the question should be addressed about violence against healthcare providers in war zones: a large number of Ukrainian doctors, 258, responded to our survey.”
A strength of the study is the large number of responses from so many countries, although there was more participation from some countries than others, which could have introduced bias in the responses. Other limitations include the voluntary and self-reported nature of the survey, which could have introduced bias in the selection and responses of the participants; and the sample size was reduced as about 40% of questionnaires were excluded due to missing or incomplete data.
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[1] “How our colleagues feel about: results from the survey“, presented in the ‘No safe space for emergency medicine teams? End violence everywhere’ session by Luis Garcia-Castrillo, Friday 25 September, 15.45-17.15 hrs CEST, Amphitheatre. https://eusem.floq.live/event/eusem-2026/search?objectClass=timeslot&objectId=69aab6a8fc86e8dca2720cda&type=detail
European Journal of Emergency Medicine
Survey
People
Workplace violence and safety perception in emergency medicine system: the Emergency Medicine Day International survey across 81 countries
25-Sep-2026