Nursing home workers who suffer violent attacks from patients and visitors are significantly more likely to develop musculoskeletal pain, according to new research.

The study from the Finnish Institute of Occupational Health surveyed 920 employees with a variety of jobs at 12 nursing homes in Maine and Maryland. The average length of time each employee had spent at his or her position was 12 years; temporary workers were not surveyed. Nearly half of the participants reported having been attacked in the three months prior to the survey. Roughly one-quarter reported multiple attacks. Younger, newer staff members were more likely to be attacked, according to the report.

About 70% of those who had been attacked prior to the survey reported experiencing lower back pain, compared with 40% of those who had not been attacked. In fact, widespread pain across the back, shoulders, knees and hands was three times more common among attack victims than those who hadn’t been attacked, the survey found.

Musculoskeletal disorders are a leading cause of temporary work leave and disability leave, especially in the healthcare profession, according to researchers. The study appears in the Sept. 28 online edition of the journal Occupational & Environmental Medicine.