New reports of violence against paramedics are just the "tip of the iceberg", according to ambulance union.
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The ABC on Wednesday morning reported figures obtained through freedom of information laws, detailing abuse and injuries involving paramedics and firefighters in the ACT.
The figures showed paramedics were subjected to 17 incidents of verbal or physical abuse over the past two financial years, and 57 workplace injuries to ambulance officers and firefighters, which required them to take five or more days off work.
The new figures follow similar reports in the middle of last year , which showed a total of 21 paramedics were subjected to physical assaults in five years.
That included five assaults against paramedics each year in 2009, 2010, and 2011.
Four of those assaults had resulted in time off work and led to workers compensation claims totalling about $440,000.
Last year's media reports prompted warnings that alcohol and the increased use of "cocktails" of drugs were putting paramedics at more risk of violence.
The role of alcohol and drugs in the violence was reiterated by Transport Workers Union official Ben Sweaney following the new reports this morning.
Mr Sweaney described violence against ambulance officers as "unacceptable" and said it should not be tolerated by the community.
"It's unfortunately all too common, officers join the service to help people, not to get spat at and punched by drunk idiots," Mr Sweaney told ABC Radio.
"We should expect more, these people are there to help us and to provide an essential service," he said.
But Mr Sweaney warned there was a reluctance to report violence or abuse, which he attributed to cultural problems within the ACT Ambulance Service.
That was rejected by ACT Ambulance Service acting Deputy Chief Officer Howard Wren who said there was now a culture encouraging to report.
"I don't think anyone would suggest that it's perceived as a sign of weakness to report this... we would strongly encourage all of our staff to report any situation where they feel threatened," he said.
He said there would have been over 70,000 patient contacts over two years in which 17 incidents of verbal and physical abuse occurred.
The ACT Government is currently planning a review into the culture of the ACT Ambulance Service.
The Human Rights Commission and WorkSafe ACT are looking at individual complaints of bullying and harassment, while the TWU says Comcare is assessing claims of a similar nature.
New powers giving ambulance officers the power to detain mentally ill patients are also being considered.