Prevalence of Workplace Violence Types against Personnel of Emergency Medical Services in Iran: A Systematic Review and Meta-Analysis

Workplace violence is one type of occupational hazards that is increasingly growing worldwide. In the health system, one of the important groups subject to workplace violence is emergency medical services (EMS) personnel, who provide emergency services for patients and casualties as the first responders. The aim of this study was to determine the prevalence of workplace violence and its different types among Iranian EMS personnel.

This study was conducted based on PRISMA guideline for systematic review and meta-analysis. The data were extracted from Scopus, PubMed, Web of Science, Google Scholar, MagIran and SID databases using Persian and English keywords. The search was conducted up to December 2018 without any limitation in publication year. The qualities of selected papers were assessed by STROBE checklist. I2 index was used to evaluate heterogeneity, and random effects model was used in meta-analysis. Data were analyzed using Stata14.

A total of 9 studies entered the meta-analysis. The total sample size was 1257 Iranian EMS personnel, with an average age of 32.21 ± 2.01 years. The prevalence of physical, verbal, and cultural workplace violence among EMS personnel was 36% (CI 95%: 27 – 45, P < 0.001, I2 = 90.8%), 74% (95% CI = 69-78, P = 0.046, I2 = 55.7%), and 17% (95% CI =.3- 30, p < 0.001. I2 = 94.7%), respectively.

Considering the high prevalence of workplace violence among EMS personnel in this study, more studies should be conducted to determine the underlying causes of EMS staff workplace violence in Iran. Training violence prevention methods as well as assigning national protective rules is highly suggested. Insufficient studies on workplace violence among EMS personnel and high heterogeneity were the limitations of this study.