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International Survey of Violence Against EMS Personnel: Physical Violence Report

  • Brian J. Maguire (a1), Matthew Browne (a2), Barbara J. O’Neill (a3), Michael T. Dealy (a4), Darryl Clare (a1) and Peter O’Meara (a5)...



Each year, Emergency Medical Services (EMS) personnel respond to over 30 million calls for assistance in the United States alone. These EMS personnel have a rate of occupational fatality comparable to firefighters and police, and a rate of non-fatal injuries that is higher than the rates for police and firefighters and much higher than the national average for all workers. In Australia, no occupational group has a higher injury or fatality rate than EMS personnel. Emergency Medical Services personnel in the US have a rate of occupational violence injuries that is about 22-times higher than the average for all workers. On average, more than one EMS provider in the US is killed every year in an act of violence.


The objective of this epidemiological study was to identify the risks and factors associated with work-related physical violence against EMS personnel internationally.


An online survey, based on a tool developed by the World Health Organization (WHO; Geneva, Switzerland), collected responses from April through November 2016.


There were 1,778 EMS personnel respondents from 13 countries; 69% were male and 54% were married. Around 55% described their primary EMS work location as “urban.” Approximately 68% described their employer as a “public provider.” The majority of respondents were from the US.

When asked “Have you ever been physically attacked while on-duty?” 761 (65%) of the 1,172 who answered the question answered “Yes.” In almost 10% (67) of those incidents, the perpetrator used a weapon. Approximately 90% of the perpetrators were patients and around five percent were patient family members. The influence of alcohol and drugs was prevalent. Overall, men experienced more assaults than women, and younger workers experienced more assaults than older workers.


In order to develop and implement measures to increase safety, EMS personnel must be involved with the research and implementation process. Furthermore, EMS agencies must work with university researchers to quantify agency-level risks and to develop, test, and implement interventions in such a way that they can be reliably evaluated and the results published in peer-reviewed journals.

MaguireBJ, BrowneM, O’NeillBJ, DealyMT, ClareD, O’MearaP. International Survey of Violence Against EMS Personnel: Physical Violence Report. Prehosp Disaster Med. 2018;33(5):526531.


Corresponding author

Correspondence: Adj. Prof. Brian J. Maguire, Dr.PH, MSA, EMT-P CQUniversity, Australia 39 Bellevue Pl. New London, Connecticut 06320 USA E-mail:


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Conflicts of interest/attribution: The institution to which the work should be attributed is Central Queensland University, School of Health, Medical, and Applied Sciences, Rockhampton, Queensland, Australia. The authors declare no conflicts of interest.



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International Survey of Violence Against EMS Personnel: Physical Violence Report

  • Brian J. Maguire (a1), Matthew Browne (a2), Barbara J. O’Neill (a3), Michael T. Dealy (a4), Darryl Clare (a1) and Peter O’Meara (a5)...


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