Hindawi Publishing Corporation BioMed Research International Volume 2013, Article ID 316358, 9 pages http://dx.doi.org/10.1155/2013/316358 Research Article The Exploding Spark: Workplace Violence in an Infectious Disease Hospital—A Longitudinal Study Nicola Magnavita Department of Public Health, Universit` a Cattolica del Sacro Cuore, Largo Agostino Gemelli 8, 00168 Rome, Italy Correspondence should be addressed to Nicola Magnavita; nicolamagnavita@gmail.com Received 21 April 2013; Revised 6 June 2013; Accepted 11 June 2013 Academic Editor: Stephen M. Pastores Copyright © 2013 Nicola Magnavita. his is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Objectives. Workplace violence (WV) is an important occupational hazard for healthcare workers (HCWs). Methods. A longitudinal study was carried out on HCWs from an infectious disease hospital. Work-related stress, anxiety, and depression were measured at baseline in 2003, and they were reassessed in 2005, along with the assaults that occurred in the previous year. Results. One-year prevalences of 6.2% and 13.9% were reported for physical and verbal aggressions, respectively. Perpetrators were mainly patients. he professional groups most frequently attacked were physicians, followed by nurses. Workers with job strain at baseline had a signiicant risk of being subject to aggression (OR 7.7; CI 95%, 3.3–17.9) in the following year. he relationship between job strain and subsequent WV remained signiicant even ater correction for anxiety, depression, and other confounders. Conversely, experiencing WV was associated with a high risk of job strain and efort-reward imbalance in the following year. he inal levels of anxiety and depression were predicted using regression models that included physical aggression among predictive variables. Conclusions. WV is the spark that sets of a problematic work situation. Efective prevention of WV can only be achieved within the framework of an overall improvement in the quality of work. 1. Introduction he occurrence of workplace violence (WV) towards health care workers (HCWs) is a quite frequent and widespread phenomenon [1]. Workers employed in psychiatric or emer- gency services and irst aid are at greater risk of violence [2]. However, no type of health care is completely exempt from the threat of violence, as it has been shown by studies on radiologists [3, 4], one of the safer, but not entirely risk-free, specialties. he occurrence of violence in specialized centers for infectious diseases has never been studied. hese hospitals have some special features that need analyzing, because they can afect the risk of violence against staf. he irst factor concerns patients. A Canadian case- control, retrospective analysis of disruptive/aggressive behav- ior in hospital patients found that, compared with controls, they have a more than seven-fold increased risk of having been diagnosed with infectious diseases (OR 7.6; CI 95%, 1.4 to 41.7). he authors failed to give an interpretation of this inding [5]. It is well known, however, that people with infectious diseases may develop cognitive impairment [6], which may in turn promote aggression against staf [7]. Many infectious diseases, such as hepatitis C [8] and HIV/AIDS [9], are currently concentrated among vulnera- ble populations such as injecting drug users, sex workers, and their clients. Sex workers oten complain of “general hostility from public-sector providers”, “criminalization”, and “stigmatization” [10]. Whether these claims are true or not, this kind of statement is an expression of the diicult relationship with medical staf. Drug abusers, on their part, oten manifest antisocial, criminal, and violent behavior [11]. A recent international study of the efects of methadone maintenance treatment programs showed that they do reduce heroin dependence, but not opioid-related crime [12]. Even ater treatment, drug-dependent individuals frequently re- engage in criminal activity linked to their dependence [13]. Opioid dependence is now widely recognized as a mental disorder and has been shown to permanently alter brain function [13]. Compared with patients in general wards,