Every shift, nurses and healthcare professionals across the UK walk into a workplace where they face risks most people outside of healthcare rarely ever consider. One of the major risks that healthcare workers face every day is the threat of being bitten by a patient. It happens all the time; in psychiatric units, dementia wards, A&E departments, and residential care homes. It can leave physical wounds, psychological scars, and in many cases, it goes completely unreported.
Patient biting is not a fringe incident. It is a regular, largely unacknowledged occupational hazard, and the healthcare workforce is bearing the cost in silence.
This blog explores the scale of the problem, why so many incidents go unreported, the serious health consequences of human bites, and what healthcare employers and professionals can do to better protect frontline staff.
The statistics surrounding workplace violence in healthcare are, frankly, alarming. A joint survey conducted by UNISON and Nursing Times in February 2025, drawing on responses from more than 1,000 nursing and midwifery staff across the UK, found that more than nine in ten nurses and midwives had experienced physical violence while doing their jobs.
The abuse saw nurses being punched, bitten, spat at, choked, and headbutted, with violence occurring daily for one in eleven respondents (9%). Around one in six had experienced violence in the previous week alone, and more than six in ten had been attacked within the preceding 12 months.
Biting is specifically named among the forms of assault. Among those who reported being attacked, almost nine in ten said the perpetrators were patients, while almost a fifth had been victims of attacks by patients’ families or other visitors.
One respondent’s account captures the everyday reality many nurses face:
“I was punched and bitten last year because there weren’t enough staff on shift to restrain safely a woman who was attacking me and my colleague. This led to concussion and a bite on the arm that punctured the skin. I had to be tested for blood-borne viruses and was off work with stress for two months.” – The Nursing Times, February 2025
Globally, healthcare professionals are five times more likely to be assaulted and injured than workers in other sectors, accounting for 73% of all nonfatal workplace injuries and illnesses due to violence in 2018, according to the U.S. Bureau of Labour Statistics.
This isn’t just an isolated issue within the UK, worldwide we have seen a marked rise violent incidents and physical assault on staff within the healthcare sector. According to the World Health Organization (WHO), it is estimated that between 8% and 38% of health workers suffer physical violence at a certain point in their career.
Looking at the broader picture of violence in healthcare, biting occupies a particularly troubling category. According to a 2010 survey from the American Journal of Public Health, 35% of nursing assistants reported physical injuries resulting from aggression by residents and a further 12% of nursing assistants reported injuries from human bites during the previous 12 months. Separately, data from the Minnesota Department of Health found that among assaults on nursing staff resulting in injuries requiring medical treatment, biting accounted for 13.6% of incidents caused by direct patient contact.
The wounds from human bites are typically located on the hands, arms, neck, torso, and face, areas that are often exposed and difficult to protect during routine patient care.
These severely underreported incidents are, in fact, traumatic events that have often been seen as taboo in nature and brushed off as occupational hazard or simply part of the job.
In 2015, a case study was conducted on the Human Bite of a Staff Nurse on a Psychiatric Unit, where the author discussed their concerns around occupational violence among healthcare professionals, especially nurses in underdeveloped countries.
The study focused on a 22-year-old woman who was hired to work as a staff nurse at a care hospital in India. The nurse had been bitten by a psychiatric patient who had a history of repeated admission to the same hospital for alcohol withdrawal syndrome.
During her hospital rounds, the nurse and her colleagues attempted to intervene in a dispute between the patient and another nurse on duty, which resulted in a severe bite wound to her right hand that began bleeding excessively and required emergency treatment. The wound was dress and a tetanus injection was giving to prevent infection, however, due to an allergic reaction to the antibiotic prescribed the wound became swollen and the nurse admitted to Intensive Care.
As a result of this incident; the bite wound, the inflicted trauma, and the unfortunate allergic reaction, caused the young nurse in training to resign her position within a month of the event, and the incident was never documented as a workplace injury.
The conclusion of this case study highlights three key points about workplace injuries from human bites. Firstly, the occupational violence healthcare workers experience daily needs to be more transparent. Healthcare workers and non-healthcare staff alike need to be better educated on the significant toll workplace violence can have on staff and patients.
Secondly, employers need to recognise how the impact of workplace violence, even in its the most innocuous form, can massively affect the financial loss of a healthcare organisation. Whether that be through insurance claims, legal expenses or staff retention, the potential cost of not addressing the problem is huge.
And thirdly, and possibly the most pernicious point, is that all healthcare facilities must directly address a workplace culture where violent assault is not reported or documented as a workplace incident. Violence in the workplace should not be tolerated.
Cultivating a culture of accountability and duty of care, where it is set policy to properly report incidents and support staff, is the most important step for both educating healthcare workers and actively promoting violence prevention.
One of the most dangerous misconceptions about bite injuries is that they are minor. They are not. Human bite wounds can contain as many as 100 million organisms per millilitre of bacterial inoculum, comprising up to 190 different species, according to Medscape.
Human bites have been documented as capable of transmitting hepatitis B, hepatitis C, herpes simplex virus (HSV), syphilis, tuberculosis, actinomycosis, and tetanus. There is also evidence, though considered unlikely, of possible HIV transmission via bites.
According to the Cleveland Clinic, healthcare providers treat approximately 250,000 human bites each year, and 10–15% develop infections resulting from bacteria in human saliva. That is a significant rate, and the consequences can be severe when treatment is delayed.
Even what appears to be a minor bite injury can damage underlying joints, tendons, or bones, or lead to a rapidly spreading infection. Infections associated with human bites are often far advanced by the time they receive appropriate medical care, as victims frequently delay seeking treatment.
A particularly serious pathogen to be aware of is Capnocytophaga canimorsus. In human tissue, this bacterium releases a substance that inactivates neutrophils, the white blood cells responsible for fighting bacterial infection, which can result in serious infections, up to and including generalised blood poisoning.
Put simply: a patient bite is never “just a bite.” It requires immediate medical attention and proper incident reporting.
The harm from a bite does not end with the wound itself. The psychological impact on healthcare workers who have been bitten can be profound and long-lasting.
Jessica Anderson’s case is again instructive. After a series of attacks, including multiple bites and other physical assaults, she developed PTSD and required trauma therapy. Despite twelve years of dedicated service, she concluded that she would probably never return to mental health nursing.
The UNISON/Nursing Times survey reinforced this pattern on a systemic scale: a third of staff needed to take time off work after suffering physical violence, more than a fifth had moved to a different role in healthcare as a result, and three in five staff (61%) had considered quitting nursing or midwifery altogether due to violence concerns.
The workforce implications are severe. Healthcare systems already under strain are losing experienced nurses not to retirement or career change, but to a violence problem that could, with the right measures, be significantly reduced.
If the problem is this serious and this widespread, why are so many incidents not formally recorded? The answer lies in a complex web of professional culture, institutional barriers, and individual fear, a picture thoroughly examined in a 2023 systematic review published in BMC Nursing.
The review, covering 19 studies from 16 countries, found that underreporting of workplace violence is a pervasive and internationally recognised challenge. Some studies found that as few as 6.5% to 12% of workplace violence events were formally reported, while reporting rates in more recent studies ranged from around 23.5% to 60%, depending on the setting.
The most prominent individual reason nurses do not report is the widespread perception that violence is “part of the job.” This attitude leads staff to minimise incidents particularly if the behaviour was perceived as unintentional, no visible injury resulted, or the patient apologised. The review notes these attitudes normalise violence and promote complacency.
Fear was identified as a significant deterrent in 15 of the 19 studies reviewed. Nurses reported fearing management reprisals, poor performance appraisals, a lack of peer support, or even legal consequences if they filed a report. Fear of being blamed for the incident was also common.
At a management level, the most frequently cited barrier was the absence of visible change after an incident was reported making staff feel that reporting was pointless. A culture of non-support and the lack of consequences for perpetrators compounded this sense of futility.
The UNISON survey findings mirror these patterns directly: despite reporting attacks to their employer, only a third of respondents felt supported. More than half said they felt unsupported, and 69% said their employer failed to take violence against staff sufficiently seriously.
As one nurse quoted in the survey put it:
“Pressures in the system can cause patients and visitors to become angry. However, there’s little trust-wide support when violence or abuse occurs.” – Nursing Times, February 2025
The review puts it plainly: “what goes unreported, goes unfixed.” Without accurate data on the true frequency of bite and other assault incidents, organisations cannot design proportionate interventions, and the problem compounds in silence.
Healthcare employers in the UK carry clear legal obligations to protect their staff from the risk of violence, including biting. The Royal College of Nursing (RCN) notes that all employers have a legal duty to protect the health and safety of workers under the Health and Safety at Work Act 1974 and must assess the risk of harm and take all reasonable steps to reduce it under the Management of Health and Safety at Work Regulations 1999.
The RCN expects all employers to have policies in place to manage violence and aggression, including clear steps to manage unacceptable behaviours encountered by nursing staff and outlining when and how services will be managed because of ongoing risks.
Specifically, employers should be providing training in personal safety, escalation, and dynamic risk assessment; reviewed health and safety risk assessments covering violence and aggression; means of raising the alarm; and clear emergency protocols for lone workers.
Where a physical assault results in more than seven days off work, this should be formally reported to the Health and Safety Executive through the Reporting of Injuries, Diseases and Dangerous Occurrences Regulations (RIDDOR).
The RCN is unambiguous: nursing staff should not be put in dangerous situations, and employers must take all reasonable steps to make workplaces safe, including providing psychological support following an assault and actively supporting staff to report incidents to police where appropriate.
The good news is that the risk of bite injuries, while it can rarely be eliminated entirely, can be substantially reduced. The key is a layered approach that combines organisational culture, training, and physical protection.
Build a culture of reporting. The systematic review in BMC Nursing recommends that management create a non-judgmental environment in which reporting is actively encouraged, visible action is taken after incidents, and the perception that violence is “part of the job” is directly challenged.
Conduct and regularly review risk assessments. Every care environment where biting has occurred or is a realistic risk should have this specifically identified in its risk assessment, with mitigating measures clearly documented.
Invest in training. Staff should receive training in de-escalation, personal safety, and dynamic risk assessment, knowing how to read a situation and respond safely before it escalates.
Provide appropriate protective equipment. For environments where biting is a known risk, protective workwear is not a luxury, it is a legal and ethical obligation. As David Watts, Director of Risk and Safety of Priory Group, has noted: “Whilst we are in the fortunate position to only need to use bite resistant clothing and arm guards in rare circumstances, when it has been used, we have received very favourable feedback. I am absolutely certain that the use of this type of protective clothing has helped us to prevent serious incidents and serious injury.”
Bite resistant arm guards and clothing, such as those in the BitePRO® range, act as the last line of defence when everything else has failed. They do not replace training or risk assessment, but when a patient bites, they can be the difference between an intact arm and a wound that requires stitches, blood tests, and weeks off work.
No one should live in fear of being assaulted at work. When nurses and healthcare workers are just trying to do their job, sometimes under extreme conditions, the least employers can do is provide safety equipment and training to protect there staff from abuse.
The voices of nurses themselves are equally clear. One respondent in the UNISON survey, a nurse leaving after 30 years, said: “I am leaving the service in August after 30 years. I don’t feel safe and dread going to work.”
These are not statistics. They are professionals who trained for years to care for others, now walking away because the people and institutions responsible for their safety have not taken the threat seriously enough.
Patient biting is not inevitable, not acceptable, and not something that should be normalised as part of nursing. It is a manageable risk, but only if it is acknowledged, recorded, and addressed with the seriousness it deserves.
“Employers have a legal duty to protect staff from any risk to their health or safety at work and must do more. A dramatic cultural shift is needed in the NHS, or the service will keep losing experienced people who’ve simply had enough.” – Christina McAnea, UNISON General Secretary
BitePRO® is the world’s first specialised brand of bite resistant protective clothing, designed specifically for healthcare professionals, mental health workers, and others who work with individuals displaying challenging behaviour. Our garments prevent teeth from breaking the skin, significantly reducing the risk of serious injury and infection.
Whether you work in a psychiatric unit, a dementia ward, an A&E department, or you handle vulnerable individuals demonstrating challenging behaviours, our BitePRO® clothing range offers dependable, discreet, and practical protection.
If you are an employer seeking to address a bite risk identified in your workplace risk assessment, our specialist team is available to advise on the right products for your environment.
