Law Enforcement Appreciation Day

January 9th is National Law Enforcement Appreciation Day. Law enforcement officers (LEO) place their lives and their health and safety at risk while protecting the public. While some of the risks may be obvious, there are many hazards officers face in the line of duty including: motor vehicle incidents, needlestick injuries, noise and lead exposure, shift work and associated fatigue, and workplace stress and exposure to traumatic incidents that may impact mental health. This blog highlights resources from the National Institute for Occupational Safety and Health (NIOSH) to help keep law enforcement officers safe and healthy.

Motor Vehicle-related Incidents

Motor vehicle-related incidents are a leading cause of line-of-duty deaths for law enforcement officers in the United States – they are also preventable. [1] In the last 10 years, on average, one officer per week has been killed on our nation’s roads. [1] Most years, motor vehicle-related incidents — including crashes and being struck by moving vehicles while on foot — are the main cause of death for officers. A recent study shows that from 2017-2021 a total of 244 law enforcement officers were killed in traffic crashes (137 in auto crashes, 87 in struck-by crashes, 20 in motorcycle crashes). [2] An impaired driver was involved in 27% of the struck-by crashes.

The 2017-2021 LEO fatality analysis showed that of the 137 crash fatalities, 47% of the officers were not wearing a seat belt. [2] Some other behaviors that put officers at risk of a crash on the job are [2]:

• Unnecessarily speeding, particularly through intersections
• Being distracted while using a mobile data terminal or other in-car electronics
• Experiencing tunnel vision from increased stress
• Experiencing fatigue

The NIOSH Law Enforcement Motor Vehicle Safety website offers resources and prevention strategies for all motor vehicle-related incidents including the Officer Road Code Toolkit.

Struck-by incidents occur when an officer is hit by a motorist while working outside of their patrol vehicle. Of the struck-by fatalities from the 2017-2021 analysis [2], over half were officers at existing crash scenes. Other struck-by fatalities involved officers conducting traffic stops or deploying tire deflation sticks. Almost half involved violations of the “slow down and move over law” by other motorists. By following proper safety procedures, officers can lower their risk of being struck by a vehicle. Some prevention recommendations include maintaining situational awareness, working within the temporary traffic control zone, avoiding the gap between vehicles, and conducting passenger side approaches during traffic stops. Read more recommendations in the infographic and article Struck-by: Officer Safety.

Needlesticks

Common work tasks may expose law enforcement officers to needlesticks and other sharps injuries, putting them at risk for exposure to bloodborne pathogens including, hepatitis B and C (HBV, HCV) and human immunodeficiency virus (HIV). The NIOSH document Reducing Work-Related Needlestick and Other Sharps Injuries Among Law Enforcement Officers  recommends employers implement a comprehensive bloodborne pathogen exposure control program, conduct effective training, provide prompt treatment, and report needlesticks and other sharps injuries on the OSHA 300 log.

To prevent needlestick injuries on the job, law enforcement officers can: complete training pertaining to search techniques; wear puncture-resistant gloves when conducting searches; and follow steps for safe sharps handling, transportation, and disposal.  See more recommendations in the document linked above.

Shiftwork

Working outside the normal daylight hours of 7am – 5pm is known as “shiftwork” and it has become an unavoidable part of our society. Shiftwork has been linked to certain health problems including gastrointestinal disorders, risk factors for cardiovascular disease (CVD), diabetes, cancer, and cognitive impairment. [3] Shiftwork is necessary in several occupations, especially in jobs such as first responders where a 24-hour service is required. Most police officers do not have the option to avoid working on the afternoon or night shifts and in some departments, these officers may also have to rotate shifts.

Scientists with the Buffalo Cardio-Metabolic Occupational Police Stress (BCOPS) study looked at relationships between shiftwork and several health conditions among police officers. Their findings showed that shiftwork (afternoon and/or night) is associated with:

• Poor sleep quality and short sleep duration which can lead to fatigue and poor concentration on the job [4], [5]
• An increase in job-related injuries and more severe injuries [6]
• An increase in sickness absences [7]
• Higher stress levels and feelings of burnout [8]]
• An increase in depressive symptoms; over 4 times higher odds observed compared to day shift [9]
• Higher levels of inflammation which is associated with most chronic diseases [10]
• Worsening of CVD risk factors (e.g., blood pressure) which lead to heart disease [11]

Most of the findings from the published BCOPS papers show how work-related factors are related to health problems. [3-11] NIOSH investigators are also conducting longitudinal studies to identify factors that predict or lead to health and safety problems among these police officers.

Both employers and police officers can adopt strategies to lessen the effects of shiftwork. Employers can provide training and ensure access to appropriate health care and counseling services. Officers can take the following steps to stay healthy: 1) exercise regularly; 2) eat a diet that consists of more fresh fruits and vegetables and less processed foods that contain lots of sugar, fats, and preservatives; 3) improve sleep quality by reducing noise and light, getting seven or more hours of sleep, and keeping a regular sleep schedule; 4) adopt proven stress-reducing strategies such as meditation and yoga; and 5) talk to a professional about other useful strategies to stay well while on a shift schedule.

Read more about the study here including strategies for minimizing the effects of shiftwork or view this webinar. 

Suicide

First responders may be at elevated risk for suicide because of the environments in which they work, their culture, and occupational and personal stress. This stress can be acute (associated with a specific incident) or chronic (an accumulation of day-to-day stress). Occupational stress in first responders is associated with increased risk of mental health issues, including hopelessness, anxiety, depression, post-traumatic stress, as well as suicidal behaviors such as suicidal ideation (thinking about or planning suicide) and attempts. [12] Law enforcement officers are more likely to die by suicide than in the line of duty. [13] Death certificate data analysis for over 4 million deaths in 26 reporting states found that law enforcement personnel are 54% more likely to die of suicide than all others with a usual occupation. [14]

More needs to be done to provide culturally competent mental health resources for first responders’ mental health needs. Promising approaches include the use of peer-to-peer counseling and peer teams and the use of formal and informal post event decompression sessions. Read more on the blog Suicides Among First Responders: A Call to Action.

Nonfatal Injuries

NIOSH research [15] found that between 2012 and 2017, an estimated 303,500 officers were treated in U.S. emergency departments for nonfatal injuries. The leading causes of injury were workplace assaults (48%), transportation incidents (11%), and falls (11%). Of the total injuries, more than half occurred when officers were interacting, detaining, or pursuing a suspect. Other workplace violence research [16] showed that in 2019, law enforcement officers had the highest incidence rate of injuries that resulted in time away from work due to workplace violence. The rate of 42.5 per 10,000 full-time workers was over 11 times higher than the overall worker rate of 3.6. While more research is needed, policy and training considerations, as well as exploring ways to improve officers’ overall physical fitness and injury rehabilitation, could help to prevent officer injury risk.

Noise and Lead Exposure at Firing Ranges

More than a million Federal, State, and local law officers are required to train regularly at indoor firing ranges; many others train at outdoor ranges. While using these facilities officers can be exposed to hazardous levels of lead and noise. At indoor firing ranges, lead dust from firearms discharge can be inhaled or contaminate surfaces and then transferred to people’s skin, especially the hands. Lead from the hands can be ingested while handling food, beverages, and other items that contact the mouth. Elevated blood lead levels can lead to lead poisoning.

The discharge of firearms in an indoor firing range produces peak noise levels that exceed the occupational health limits of 140 dB SPL; even outdoors, peak noise levels are hazardous. NIOSH recommends that officers who use a firing range as part of their occupation wear double hearing protection (earplugs and earmuffs) as part of an overall hearing conservation program. See the blog and website for more information including prevention recommendations.

Response During Emergencies

Law enforcement officers are often the first to respond to an emergency or a disaster such as hurricanes, floods, COVID-19, and 9/11.  Exposures at disaster or emergency situations can put officers’ health at risk. The NIOSH Emergency Preparedness and Response Program prepares for and responds to chemical, biological, radiological, and natural incidents and events. The program integrates occupational safety and health into responses to protect response and recovery workers.

Over 25,000 law enforcement officers responded to the 9/11 attacks in New York City. [17]  The World Trade Center Health Program provides no-cost medical monitoring and treatment for certified WTC-related health conditions to those directly affected by the 9/11 attacks. In 2020, COVID-19 deaths accounted for 62% of all duty-related law enforcement officer deaths. [18] View COVID-19 resources and practices for law enforcement.

More Information

We appreciate the sacrifices law enforcement officers make in the interest of public safety. NIOSH is doing our part to ensure the safety and health of those who protect us all. The NIOSH Public Safety Program maintains the mission of reducing or eliminating occupational injuries, illnesses, and fatalities among workers through a focused program of research and prevention. Visit the NIOSH law enforcement website which includes information and resources for officers including more than 50 Health Hazard Evaluations related to law enforcement.

Hope M. Tiesman, PhD, is a Research Epidemiologist in the NIOSH Division of Safety Research.

Melanie Lee Fowler, MS, CSP, is a Lieutenant Commander in the US Public Health Service and an Occupational Safety and Health Specialist in the NIOSH Division of Safety Research.

Luenda Charles, PhD, MPH, is an epidemiologist in the NIOSH Health Effects Laboratory Division.

John M. Violanti, PhD, is a Research Professor in the Department of Epidemiology & Environmental Health, School of Public Health and Health Professions at the University at Buffalo, Buffalo, NY. 

Desta Fekedulegn PhD, MPH, is a mathematical statistician in the NIOSH Health Effects Laboratory Division.

Christa L. Themann, MA, CCC-A, is a Research Audiologist in the NIOSH Division of Field Studies and Engineering.

Sarah Hughes, MPH, is a Lieutenant in the US Public Health Service and a Research Health Scientist in the NIOSH Division of Science Integration.

References

[1] National Law Enforcement Officers Memorial Fund [2021]. Causes of law enforcement deaths

[2]National Law Enforcement Officer Memorial Fund  Work Plan Presentation Law Enforcement Traffic Fatality Data & A Look at Texas Traffic Safety (nleomf.org)

[3] Boivin DB, Boudreau P, Kosmadopoulos A. Disturbance of the circadian system in shift work and its health impact. J Biol Rhythms 2022:37(1);3-28.

[4] Violanti JM, Owens SL, Fekedulegn D, et al. An Exploration of Shift Work, Fatigue, and Gender Among Police Officers: The BCOPS Study.  Workplace Health Saf. 2018 Nov;66(11):530-537.

[5] Fekedulegn D, Burchfiel CM, Charles LE, et al. Shift Work and Sleep Quality Among Urban Police Officers: The BCOPS Study. J Occup Environ Med. 2016 Mar;58(3):e66-71.

[6] Violanti JM, Fekedulegn D, Andrew ME, et al. Shift work and long-term injury among police officers. 

Scand J Work Environ Health. 2013 Jul;39(4):361-8.

[7] Fekedulegn D, Burchfiel CM, Hartley TA, et al. Shiftwork and sickness absence among police officers: the BCOPS study. Chronobiol Int. 2013 Aug;30(7):930-41.

[8] Ma CC, Andrew ME, Fekedulegn D, el al. Shift work and occupational stress in police officers. Saf Health Work. 2015 Mar;6(1):25-9.

[9] Holst MM, Wirth MD, Allison P, et al.  An analysis of shiftwork and self-reported depressive symptoms in a police cohort from Buffalo, New York.  Chronobiol Int. 2021 Jun;38(6):830-838. https://doi.org/10.1080/07420528.2021.1895197

[10] Wirth MD, Andrew ME, Burchfiel CM, el. Association of shiftwork and immune cells among police officers from the Buffalo Cardio-Metabolic Occupational Police Stress study.  Chronobiol Int. 2017;34(6):721-731.

[11] Charles LE, Zhao S, Fekedulegn D, et al. Shiftwork and decline in endothelial function among police officers. Am J Ind Med. 2016 Nov;59(11):1001-1008.

[12] SAMHSA. May 2018. Disaster Technical Assistance Center Supplemental Research Bulletin First Responders: Behavioral Health Concerns, Emergency Response, and Trauma.)

[13] Heyman M, Dill J, Douglas R, [2018] Ruderman White Paper on Mental Health and Suicide of First Responders. Ruderman Family Foundation.  https://rudermanfoundation.org/white_papers/police-officers-and-firefighters-are-more-likely-to-die-by-suicide-than-in-line-of-duty/.

[14] Violanti JM; Steege A. [2021] Law enforcement worker suicide: an updated national assessment. Policing Jan; 44(1):18-31. NIOSHTIC-2 Search Results.

[15] Tiesman H, Konda S, Grieco, J, Gwilliam M, Rojek J, Montgomery B. [2020] Resistance-Related Injuries Among Law Enforcement Officers: Addressing the Empirical Gap. Am J Prev Med Dec;59(6):e231-e238. doi: 10.1016/j.amepre.2020.05.015. Epub 2020 Nov 18.

[16] Harrell, E., Langton, L., Petosa, J., Pegula, S., Zak, M., Derk, S., Hartley, D., and Reichard, A. [2022]. Indicators of Workplace Violence, 2019 (NCJ 250748; NIOSH 2022-124). Bureau of Justice Statistics, Office of Justice Programs, U.S. Department of Justice; Bureau of Labor Statistics, Office of Safety, Health, and Working Conditions, U.S. Department of Labor; and National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, U.S. Department of Health and Human Services. Washington, DC.

[17] WTC Health Program General Responder Data Center, 12/20/22

[18] Violanti, J.M., Fekedulegn, D., McCanlies, E. & Andrew, M.E. [2022]. Proportionate mortality and national rate of death from COVID-19 among U.S. law enforcement officers: 2020. Policing: An International Journal. 45,5, 881-891.