Seventy-five percent of the emergency medical services and emergency department (ED) staff surveyed had witnessed workplace violence in the previous year, according to an international survey of more than 1300 healthcare professionals from 81 countries. The findings were presented at the European Emergency Medicine (EUSEM) Congress on September 25, 2026.

During a special session at the EUSEM Congress, Luis Garcia Castrillo, a retired professor of emergency medicine at Hospital Marqués de Valdecilla in Santander, Spain, noted that patients and their family members or friends were the main perpetrators of workplace violence. Alcohol or drug use is often involved, and overcrowding in EDs also contributes to violence.

“Workplace violence not only endangers the physical and mental health of healthcare professionals but also compromises the quality of care they provide. The survey found that 45.8% of participants believed that the quality of care had suffered because of violence they had experienced or witnessed,” Castrillo said.

The EUSEM Emergency Medicine Day Working Group conducted an online survey between May and June 2026, collecting 1306 responses from healthcare professionals in 81 countries. The findings were published in the European Journal of Emergency Medicine (EJEM), along with their presentation at the EUSEM Congress.

The survey found that 75.5% of participants had witnessed workplace violence in the previous year, 68.8% had experienced psychological harm, and 40.3% had experienced physical harm.

Verbal abuse 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 conflicts (4.5%), weapon-related incidents (4.1%), sexual assault (3.5%), cyberbullying (3.1%), and incidents involving firearms (2.9%).

Patients and Family Members Are the Main Perpetrators

Patients were identified as the main perpetrators of violent incidents (67.6%), followed by family members or friends (44.1%). Patients or visitors who had ingested toxic substances accounted for 44% of the cases, while patients with psychiatric disorders accounted for 35.2%.

Overall, 48.3% of participants believed that workplace violence had worsened over the previous 5 years. They ranked violent patients among the greatest workplace threats, second only to the risk for infection.

Only 51.1% of the participants received formal training in violence prevention, while 38.6% reported receiving no formal training. Psychosocial support after violent incidents was available to 57.3% of the participants, whereas 27.1% reported having no access to such support.

Women Report Greater Psychological Harm

Women were more likely than men to report psychological victimization (72.2% vs 40.4%).

Roberta Petrino, MD, head of the ED at Ente Ospedaliero Cantonale, Lugano, Switzerland, co-chaired the EUSEM Congress session and was the first author of the article published in EJEM. She highlighted the burden of verbal abuse among women working in emergency medicine.

“I would like to emphasize that the main problem for women working in emergency medicine is verbal abuse; this can include insults, sexual remarks, gender-based harassment, and discrimination. Women working in emergency services are exposed to these situations far more than men, and the consequences are primarily psychological. Survey participants called for psychological support and for the problem of violence to be addressed through preventive measures and improved safety protocols,” Petrino said.

The findings also raise concerns about emergency services’ preparedness for managing workplace violence. Participants felt that emergency services were better equipped to handle incidents involving multiple victims than to address everyday violence.

Hospital Overcrowding Increases Tension

Castrillo, Petrino, and colleagues called on emergency service providers, including prehospital services and ED, to identify and address factors that can trigger violence.

“Long wait times, limited resources, and high emotional stress increase tensions among patients, family members, and healthcare professionals. This must be addressed through organizational interventions. Hospital administrators should improve the hospital’s internal organization to reduce overcrowding — for example, by providing adequate, well-designed spaces with sufficient staff and by establishing policies on inpatient floors that facilitate the rapid transfer of patients from the emergency department,” Petrino concluded.

Organizational Measures to Prevent Assaults

Improving patient flow could help reduce overcrowding in the ED. Decision-makers should also consider targeted training in conflict de-escalation and effective communication, along with security measures, such as video surveillance and security personnel.

The authors also highlighted the need to address violence against healthcare professionals in conflict zones. A total of 258 Ukrainian physicians responded to the survey.

Study Limitations

The study’s strengths include the large number of responses and participation from 81 countries. However, participation varied across countries, potentially introducing selection bias.

The voluntary, self-reported nature of the survey may also have affected participant selection and responses. In addition, approximately 40% of the questionnaires were excluded because of missing or incomplete data, reducing the sample available for analysis.

Spanish Society of Emergency Medicine (SEMES) Calls for Greater Prevention and Protection

SEMES has called for measures to prevent physical and verbal assaults against emergency healthcare professionals and improve their protection.

Speaking with El Médico Interactivo, Rosa Pérez Losa, spokesperson for the SEMES, outlined three priorities for preventing workplace violence: collecting data to identify facilities, areas, and job positions most at risk; training healthcare professionals to respond to potential assaults; and raising public awareness.

“First, we need to collect data to identify the facilities, areas, and job positions most at risk for assaults and violence so that we can implement preventive measures. Second, we must train professionals on how to respond to potential assaults. Third, we must continue to raise public awareness to prevent these types of situations from occurring,” she said.

Pérez Losa also emphasized the importance of providing physical, psychological, and legal support to professionals who have been assaulted. To support these efforts, SEMES has launched a new support platform called #STOPagresionesYA, through which it intends to give a voice to emergency physicians who suffer attacks, demand protection measures from institutions, and even appear as a private prosecutor in those cases in which the judge determines that the attack is “very serious,” with evident effects on the professional.

“We must create a support network for professionals who have been assaulted to help them heal their physical and emotional wounds, in addition to providing legal support through professional associations and government agencies,” Pérez Losa concluded.

This article was translated from El Médico Interactivo on Univadis, part of the Medscape Professional Network.