Advocates for workplace safety know that when violence occurs in our places of employment, it isn’t just an interpersonal matter. That’s why they’re exploring the problem from all angles, connecting research with activism to create workplaces in which all employees are free from harm.

During a Tuesday session on workplace violence at the APHA 2018 Annual Meeting and Expo, presenters shed light on the troubling fact that about 2 million Americans each year are victims of workplace violence, according to the Occupational Safety and Health Administration. The health care industry, in particular, is home to disproportionate levels of workplace violence, and nurses endure a huge share of such abuse. It’s not uncommon for nurses to experience attacks from patients, with the consequences reverberating throughout the health care system.

“What nurses are striving for is to have a safe and respectable place to work where they can be valued,” said presenter Ruth Francis of the American Nurses Association.

Unfortunately, that’s not the case for far too many nurses. For one thing, many nurses report that their employers’ zero-tolerance policies against workplace violence don’t have much clout.

Besides advocating for preventive measures against workplace violence, the American Nurses Association is also harnessing the power of social media to bring more attention to the harassment that nurses face. Its #EndNurseAbuse social media campaign was used to put human faces on stories of workplace violence and raise awareness about the problem. The campaign also dovetailed with other trending hashtags, such as #MeToo and #WhyIDidntReport.

“We know that this is a social issue,” Francis said. “Workplace violence isn’t something that just happens.”

Not only that, but workplace violence — especially as it relates to the nursing field — is a systemic issue, said Jane Thomason of National Nurses United in Oakland, California. She explained the many factors beyond nurses’ control that are contributing to more dangerous workplaces — namely, hospital restructuring. System-level changes that lead to fewer resources and lower staffing levels often put nurses at higher risk of experience violence on the job.

“Employers are quick to focus on solutions that shift the onus of prevention to direct care health care workers,” Thomason said.

Her organization was instrumental in getting California to adopt an occupational health standard on workplace violence in the health care sector and that cited staffing as critical to preventing such violence. The challenge now is getting employers to actually comply, she said.

Of course, it’s not only health care in which workers are vulnerable to harassment and violence. As Suzanne Teran of the Labor Occupational Health Program at the University of California-Berkeley discussed, female janitorial workers are especially prone to sexual harassment and assault on the job. It’s a male-dominated culture, she said, and many women don’t feel safe coming forward.

“There can be this level of kind of like acceptance or is it really that serious sometimes,” Teran told attendees.

She and other workplace safety advocates are helping janitorial workers and supervisors understand what sexual harassment looks like. They’re using educational videos to ensure that employers are abiding by workplace violence laws and that employees know how to identify sexual harassment in a range of scenarios.

Among the workers most vulnerable to workplace violence are those in the agricultural industry, where sexual harassment is especially rampant among farmworkers, who often don’t have the resources to protect themselves or seek recourse.

Victoria Breckwich Vásquez of the Washington Coalition to Eliminate Farmworker Sexual Harassment and colleagues are hoping to address sexual harassment among farmworkers in the state through a spectrum of prevention activities. Their goal is to move from a mostly education-focused approach to one that addresses community-wide goals. And they’ve done an extensive amount of work toward that objective, from developing training interventions for agricultural stakeholders to a worksite training video and curriculum.

Vásquez ended her presentation with a poem from project collaborator Paula Zambrano, who wrote of workplace abuse: “¡Basta, basta, basta!” Translation: “Enough, enough, enough!”