Characteristics of 9-1-1 Calls Associated with an Increased Risk of Violence Against Paramedics in a Single Canadian Site

Violence is a pressing occupational health issue for paramedics; however, underreporting complicates efforts at risk mitigation because of a lack of event level data. Leveraging a novel, point-of-event violence reporting process, our objective was to identify characteristics of 9-1-1 calls associated with an increased risk of violence in a single paramedic service in Ontario, Canada. We retrospectively reviewed all violence and electronic patient care reports filed by paramedics in Peel Region over a two-year period and used logistic regression modelling to identify covariates associated with the risk of any violence and (more specifically) of a physical or sexual assault. In all, 374 paramedics filed a total of 974 violence reports, of which 40% documented an assault, corresponding to a rate of 4.18 violent encounters per 1,000 9-1-1 calls. In our adjusted models, we found that calls occurring in non-residential locations (such as on a street or at a hotel or bar), occurring during afternoon or overnight shifts, and involving young or working-age males were associated with an increased risk of violence. We also found that primary presenting problems related to mental health or substance use posed an increased risk of violence and an especially increased risk of assault.