Occupational Injuries, Near-Miss Events, and Underreporting Among Emergency Department Workers: A Cross-Sectional Online Survey Study

Background: Emergency department (ED) workers face occupational hazards including sharps injuries, workplace violence, musculoskeletal strain, and near-miss events. This study aimed to assess the prevalence of occupational injuries and near-miss events, formal reporting rates and barriers, and factors associated with formal reporting.Methods: This cross-sectional online survey included ED healthcare workers between March 25 and April 4, 2026. The questionnaire assessed demographic and occupational characteristics, occupational injuries and near-miss events in the preceding 12 months, reporting behaviors, and barriers to reporting. The primary outcome was the 12-month prevalence of at least one occupational injury. Descriptive analyses and logistic regression were Results: Among 414 ED workers, median age was 30 years (IQR 26–37), and 211 (51.0%) were female. In the preceding 12 months, 352 (85.0%) experienced at least one occupational injury, yet 47.4% formally reported at least one event. Verbal violence (63.8%) was most prevalent, while needlestick injuries had the highest reporting rate (50.4%). Near-miss events were experienced by 317 (76.6%) participants. The most common barriers were perceiving the event as insufficiently serious, and believing reporting would provide no benefit. Formal reporting was independently associated with experiencing an acute event type (aOR 6.63, 95% CI 3.56–12.36), an injury with medical consequences (aOR 2.59, 95% CI 1.55–4.33), and occupational health and safety training (aOR 3.24, 95% CI 1.54–6.80).Conclusion: Occupational injuries and near-miss events are highly prevalent but substantially underreported among ED workers. Occupational health and safety training may improve reporting behavior and strengthen workplace safety culture.