Workplace violence and body-worn camera use among emergency medical technicians in South Korea: a nationwide cross-sectional survey

Emergency medical technicians (EMTs) frequently experience workplace violence in prehospital settings; however, evidence on the role of body-worn cameras (BWCs) in this context is limited. This study examined the factors associated with frequent workplace violence, the perceived need for BWCs, and actual BWC use among South Korean EMTs, incorporating individual- and regional-level indicators. A nationwide cross-sectional survey was conducted among EMTs employed by provincial fire departments in South Korea. Survey data on sociodemographic characteristics, work conditions, workplace violence over the past year, and BWC-related perceptions and behaviors were linked to province-level assault indicators from the National 119 emergency medical services (EMS) Statistical Yearbook (2020-2024). The main outcomes included frequent workplace violence, high perceived need for BWCs, and BWC use. Regional assault burden was modeled as tertiles of a five-year mean provincial assault index and as a continuous measure per 10-unit increase. All primary outcomes were self-reported within a knowledge-attitude-practice (KAP) survey design. Multivariable logistic regression was performed to estimate adjusted odds ratios (ORs) and 95% confidence intervals (CIs). To address within-province clustering, Generalized Estimating Equations (GEE) were additionally used as a sensitivity analysis. Of 3,595 EMTs included in the descriptive analyses, 2,555 provided complete violence data. Nearly all respondents (99.7%) reported some workplace violence in the past year, and 17.3% were classified as experiencing frequent workplace violence. Overall, 64.4% reported using a BWC, and 87.9% expressed a high perceived need. Frequent violence was associated with younger age, longer EMS career, higher daily call volume, and working as an EMT rather than an ambulance driver, but not with regional assault burden. High perceived need for BWCs was more common among female EMTs and varied by age, again without clear associations with regional assault indices. In contrast, actual BWC use was associated with job position, shorter EMS career, lower call volume, and high perceived need, and was inversely associated with higher regional assault burden. Workplace violence was highly prevalent among South Korean EMTs, and the perceived need for BWCs was widespread. Individual and work-related factors, rather than province-level assault burden, were the key determinants of frequent violence and BWC-related perceptions, whereas BWC use was less common in regions with higher recorded assault indices.