Workplace violence as a public health issue among environmental and occupational prevention technicians: a cross-sectional study in four Italian regions

BMC Public Health. 2026 Jul 21. doi: 10.1186/s12889-026-28609-1. Online ahead of print.

ABSTRACT

BACKGROUND: Workplace violence is an increasing concern in the healthcare sector, affecting not only clinical health professionals but also non-clinical ones. Among these, Environmental and Occupational Prevention Technicians- who are responsible for public health surveillance and risk prevention -may frequently encounter high-conflict situations during their activities. However, evidence on their exposure to workplace violence remains limited. This study aims to assess the prevalence, characteristics, and associated risk factors of workplace violence among Prevention Technicians in Italy.

METHODS: A cross-sectional survey was conducted between May and July 2024 among all registered Environmental and Occupational Prevention Technicians in four Italian regions (Piedmont, Campania, Sicily, and Aosta Valley). Data were collected through an anonymous online questionnaire covering sociodemographic characteristics, work setting, workplace violence, psychological impact, and organizational factors. Descriptive statistics, chi-square tests, and Poisson regression models with robust variance estimation were used to identify factors associated with workplace violence. Associations were reported as prevalence ratios (PRs) with 95% confidence intervals (95% CIs).

RESULTS: Out of 2,380 eligible professionals, 566 completed the questionnaire (response rate: 23.8%). Among public-sector employees, 37.5% reported workplace violence compared with 29.1% among private-sector employees and self-employed professionals. In the public sector, a higher prevalence of workplace violence was associated with age 41-50 years (PR1.55; 95% CI 1.06-2.26; p = 0.023), age 61-67 years (PR2.02; 95% CI 1.42-2.86; p < 0.001) compared with participants aged 22-30 years, and high perceived risk of workplace violence (PR 2.76; 95% CI 1.63-4.66; p < 0.001). Registration with professional boards in Southern Italy and the presence of workplace procedures were associated with a lower prevalence of workplace violence (PR 0.57; 95% CI 0.47-0.70; p < 0.001 and 0.70; 95% CI 0.52-0.95; p = 0.022, respectively). Among private-sector employees and self-employed professionals, high perceived risk was associated with a higher prevalence of workplace violence (PR 8.84; 95% CI 1.22-63.95; p = 0.031), as was the presence of workplace procedures (PR 2.92; 95% CI 1.69-5.03; p < 0.001).

CONCLUSIONS: Workplace violence represents a relevant occupational issue also among Environmental and Occupational Prevention Technicians. The high prevalence observed and the associations identified with individual and organizational factors highlight the need for both further research to disentangle the causal relationship and potential preventive initiatives aimed at improving safety in non-clinical healthcare settings.

PMID:42481981 | DOI:10.1186/s12889-026-28609-1