Police officer safety and health

Last updated May 10, 2024

Police officers face various occupational hazards such as poor ergonomics that can cause musculoskeletal problems, exposure to infectious diseases and illicit substances, noise from training on the use of firearms, line of duty deaths and work stress.

Occupational Hazards

Ergonomic Hazards

Law enforcement is a hazardous profession with various inherent sources of risk.^[1] A common occupational risk for police officers is poor ergonomics.^[2] In fact, it is estimated that 67% of police officers experience chronic low back pain due to ergonomic issues such as prolonged sitting in patrol cars and wearing heavy duty belts.^[3] Heavy and cumbersome duty belts can be of special concern to female officers.^[3] Recent innovations have been targeted at decreasing the weight and size of the belt without compromising necessary tools.^[3] In recent years, some law enforcement organizations have introduced physical wellness programs that hope to mitigate ergonomic problems through strength training and general exercise.^[3]

Noise from firearms' training

Law enforcement officers are required to train regularly in the use of firearms, typically at indoor firing ranges. Training schedules vary widely, from eight hours four times a year, every month for special teams, up to 20 times a month for the agency’s firearms instructors. In these training sessions, an officer could accrue hundreds to thousands of rounds of exposure to firearms impulse noise. Such exposures can exceed the occupational health limits of 140 decibels (dB), with sound levels often reaching 160-170 dB peak sound pressure levels . These could lead to hearing disorders such as hearing loss and tinnitus. While hearing protection devices are often provided in the US, officers rarely receive information on hearing loss prevention or hearing protection devices.

Lead

Training conducted in firing ranges can also expose those who train or work at the range to lead, as detected by blood lead levels.^[4]^[5] Lead is considered an occupational hazard for those who work or train target shooting in firing ranges. Lead exposures at work have been associated with neurological effects, gastrointestinal effects, anemia, and kidney disease. In the US the Occupational Safety and Health Administration (OSHA), promulgated a lead standard that regulates many workplace exposures to this metal across manufacturing industries. Similarly, many other occupational health agencies in different countries also regulated lead exposures.^[5] OSHA identified ways to reduce lead exposures in firing ranges such improving ventilation systems, removing dust and debris use of wet mopping or high-efficiency particulate air vacuuming, and using lead-free bullets.

Bloodborne pathogen exposure

According to the National Institute for Occupational Safety and Health (NIOSH) 3.8%-8% of police officers in the United States have reported sustaining a needlestick or sharps injury.^[6] These type of injuries often occur during such activities as performing an arrest, searching property or being involved in a take-down.^[6] Needlestick and sharps injuries are concerning because they carry the risk of transmission of infectious diseases such as Human Immunodeficiency Virus (HIV), Hepatitis B and Hepatitis C.^[7] The incidence of officer needlestick injuries can be reduced through employer prevention training and education.^[6] NIOSH has provided official educational material for employers and police officers that targets prevention as well as steps to follow if a needlestick injury does occur.^[6]^[7]

Unintentional Exposure to Illicit Drugs

Exposure to illicit drugs is a common occupational hazard for police officers and thus proper education and use of personal protective equipment is crucial.^[8] Possible routes of exposure include inhalation, contact with a mucous membrane or non-intact skin, ingestion or via needlestick.^[9] In recent years, occupational exposure to fentanyl powder by law enforcement has been heavily publicized.^[10] NIOSH provided guidance noting that officers should wear nitrile gloves, respiratory protection, and eye protection to avoid unintentional fentanyl exposure.^[9] While use of appropriate personal protective equipment is crucial, efforts have been made to alleviate anxiety around fentanyl overdose by educating officers that an overdose would not occur through the absorption of the drug via intact skin.^[8]

Line of duty deaths

Memorial to a fallen police officer at the Texas Department of Public Safety Houston Webster Office in Houston PoliceofficermemorialHoustonTX.JPG — Memorial to a fallen police officer at the Texas Department of Public Safety Houston Webster Office in Houston

Line of duty deaths are deaths which occur while an officer is conducting his or her appointed duties. Despite the increased risk of being a victim of a homicide, automobile accidents are the most common cause of officer deaths. Officers are more likely to be involved in traffic accidents because of their large amount of time spent conducting vehicle patrols, or directing traffic, as well as their work outside their vehicles alongside or on the roadway, or in dangerous pursuits. Officers killed by suspects make up a smaller proportion of deaths. In the U.S. in 2005, 156 line of duty deaths were recorded of which 44% were from assaults on officers, 35% vehicle related (only 3% during vehicular pursuits) and the rest from other causes: heart attacks during arrests/foot/vehicular pursuits, falling from heights during foot chases, diseases contracted either from suspects' body fluids or, more rarely, from window period emergency blood transfusions received after motor vehicle accidents, shootings, stabbings, accidental gun discharges or falls that result in blood loss.^[12]

Police officers who die in the line of duty, especially those who die from the actions of suspects or in accidents or heart attacks, are often given elaborate funerals, attended by large numbers of fellow officers. Their families may also be entitled to special pensions. Fallen officers are often remembered in public memorials, such as the National Law Enforcement Officers Memorial in the U.S., the National Police Memorial in the U.K. and the Scottish Police Memorial, at the Scottish Police College.

In the United Kingdom, in the 10 years from April 2000 there were 143 line of duty deaths: 54 in road accidents travelling to or from duty, 46 in road accidents on duty, 23 from natural causes on duty, 15 from criminal acts, and 5 in other accidents.^[13] In Great Britain, police do not normally carry firearms. Officers in Northern Ireland are routinely armed.

The Singapore Police Force registered just over 100 deaths in a century up to the year 2000. There have been 28 New Zealand police officers killed by criminals since 1890.^[14]

Work stress

A video on the Buffalo Cardio-Metabolic Occupational Police Stress study

Indicators

The actual presence of stress in police work is well documented and evidenced by certain statistics. Researchers typically use suicide, divorce and alcoholism rates as three key indexes of stress in a group of people.^[15] These factors paint a compelling picture of police officers demonstrating signs of significant stress, for example:

A study in the United States, by National Surveillance of Police Suicide Study (NSOPS), showed 141 suicides in 2008 and 143 in 2009. This yields a suicide rate of 17/100,000, a figure that holds up under scrutiny and is consistent with CDC/NOMS data.^[16] The overall suicide rate in the United States was 11.3 suicide deaths per 100,000 people.^[17] There is some speculation or controversy that this official rate may understate the actual rate as it is often other police officers that report facts that lead to a cause of death determination, and death benefits, institutional image, and other factors may be incentives to misreport incident facts. It is speculated that some suicides are reported by fellow officers as accidents or as deaths in the line of duty perpetrated by unknown assailants. Also, many jurisdictions simply don't keep suicide statistics. Even though the information is incomplete, the available statistics suggest that police officers are more likely to commit suicide than the general population. However, there is still controversy in the interpretation of these statistics. When comparisons are made within age, gender, and racial cohorts, the differences are much less dramatic.^[18]^[19] Although suicides may be notably more prevalent among police, it is not clear whether police suicides are the result of work stress or the consequence of other variables, such as the influence of a subculture of violence^[20]
Police officers are not more likely to experience interpersonal relationship problems. In a 2009 study, the divorce rates of law enforcement personnel were compared with the rates for other occupations, where data was analyzed from the 2000 U.S. Census. The results of the analysis indicate that the divorce rate for law enforcement personnel is lower than that of the general population, even after controlling for demographic and other job-related variables.^[21] The propensity to domestic violence is also thought to be higher for police officers than the general population, though the statistics are very fuzzy and controversial. Police officers also seem to have relationship problems at work, typically with superiors or with political oversight, though the evidence is largely anecdotal and controversial.
Alcoholism is considered another aberrant statistic for police officers. Although the statistics are fuzzy, clinically treated alcohol addiction rates are usually calculated to be about twice as high for police officers than for the general population in the United States. In contrast, statistics documenting alcohol abuse are less precise. Rates for arrest for driving under the influence of alcohol, or DUI or DWI, are somewhat higher for police officers than for other drivers, but the statistics are not widely trusted outside of the insurance industry since it is other police officers that make DUI arrests. Some departments and even some individual officers tend to hold police officers to a higher behavioral and ethical standard while others will recognize a 'blue line' behind which those within the 'brotherhood' are not held to the same standards as the rest of society. Despite the controversies in the interpretation of the statistics, it is generally considered evident that police officers are more susceptible to alcohol abuse than other occupations. The same conclusions are usually made regarding the police abuse of other substances, though the statistics are even less accurate, and even though the higher rates of substance abuse may be due in part to the more ready access to drugs and the more permissive atmosphere 'behind the blue line' rather than to occupational stresses.

Other researchers, though, claim that police officers are more psychologically healthy than the general population^{[ citation needed ]}. Police officers are increasingly more educated, more likely to engage in a regular program of exercise and to consume less alcohol and tobacco, and increasingly family-oriented. Healthy behavior patterns typically observed at entry training usually continue throughout the career of an officer. Even though the presence of occupation related stress seems to be well documented, it is highly controversial. Many within the law enforcement industry claim the propagation of incorrect suicide, divorce, and substance abuse statistics comes from people or organizations with political or social agendas, and that the presence of these beliefs within the industry makes it hard for health workers to help police officers in need of treatment to deal with the fear of negative consequences from police work which is necessary to enable police officers to develop a healthy expectancy of success in treatment.^[22]

In August 2014, the U.S. Federal Bureau of Investigation revealed that 8 out of every 10 law enforcement officers are overweight. This sparked some Police Departments to improve their officers' overall fitness. Assistant Chief Jeff Bryan of Garland, Texas stated, "I think it's important for all of us to keep the weight down and stay in shape-especially this job. The stress that we incur at this job... this is a great way to relieve stress and to keep the blood pressure down."^[23] Indonesian policemen are required to participate in an exercise program because. In 2009, Mexican police also "set up a nutrition education program." In 2011, Russia's interior ministry warned its police officers, "lose weight or lose your job." Indian physician Dr Edmond Fernandes, founder and CEO of CHD Group called for protecting police health to prevent social deterioration in the midst of police suicides.^[24]

Sources

Even though the presence of occupational stresses appear to be well documented, though not without controversy, the causes of workplace stress are comparatively unclear or even a matter of conjecture. An explanation often advanced is the idea that police officers will undergo some traumatic experience in their police work that they never recover from, leading to suicide, divorce, etc. However, since the effects of such traumatic stresses is readily recognized, there are usually proactive programs in place to help individual police officers deal with the psychological effects of a traumatic event. Unfortunately, there is some evidence that such programs are actually ineffective, especially group therapies, may re-traumatize the participant, weaken coping mechanisms, and contribute to the development of post traumatic stress disorder (PTSD).^[25]^[26]^[27]

Observations where police officers and other emergency workers, such as firemen, experience the same traumatic event, it is more likely that the police officer will have difficulty dealing with the long term emotional effects of the traumatic event. On this observation, some of the academic literature suggests that along these lines the causes of occupational stress is more complex for police officers. Stress in police work is often present in other occupations, but not in an ongoing capacity. One line of thinking is that the individual stresses of police work produce a condition of chronic stress. Police officers encounter stressors in call after call which sap their emotional strength. Debilitation from this daily stress accumulates making officers more vulnerable to traumatic incidents and normal pressures of life. The weakening process is often too slow to see; neither a person nor his friends are aware of the damage being done. The effects of chronic stresses is two-fold:

First, prolonged stress causes people to regress. Their psychological growth reverses, and they become more immature. They rapidly become more childish and primitive, much like a person being sick for several days becoming more irritable and childish in its demands on other people.
Second, chronic stress numbs people's sensitivity. They can't stand to continually see human misery. They must stop feeling or they won't survive. The mind has this defense mechanism so people can continue working in horrible situations. If they kept their normal sensitivity, they would fall apart. As they become insensitive to their own suffering, they become insensitive to the suffering of others. When treated with indignity, they lose not only a sense of their own dignity but also the dignity of others. The pain of others stops bothering them, and they are no longer bothered when they hurt others.

The daily work of a police officer involves certain paradoxes and conflicts which may be difficult to deal with, the predominant examples are^[15]

Interaction with the public, whether socially or officially, such as in a traffic stop, involves a risk of physical harm. Being on guard for an attack and treating every interpersonal situation with affirmative commands makes the police officer appear brutal and detached, limits his actual effectiveness with the public and engenders chronic stress.

Policies, regulations, and procedures cover every facet of police work. Everything is expected to be done by the book with substantial repercussions, including civil and criminal liability, for varying from the expectations of operating procedures. Often the facts of a situation require a course of action that does not follow procedures. If he follows procedures exactly, he knows he won't fully help the public, and the public will think he is shirking his responsibility. If the officer follows his own judgment, he is taking a risk. The community and department expect officers to use judgment, but when they do, there is a danger they will be disciplined; another unnatural no-win situation engendering chronic stress.^{[ citation needed ]}
Police officers tend to become socially isolated. The reasons given for this isolation are lack of department support, a perceived sense of alienation from the residents of the community where they patrol, the degree of urbanism ("Big City"), and "anti-police" judicial verdicts. When a group of people are isolated they become disoriented and confused. Ironically an isolated class are usually the ones losing real world wisdom and tend to judge from a very limited perspective, leading to more stress.^[28]

A more anecdotal view looks at specific sources of stress in police work.^[29] The sources of stress most often actually cited are:

The fear of killing someone in the line of duty.
Feeling at least partially responsible for getting your partner or somebody else killed in the line of duty.
Lack of support by the department or superiors.
The scheduling of work and irregular work demands resulting in a disruption of family time or family events or activities.

Other more academic studies have produced similar lists, but may include items that the more anecdotal surveys do not reveal, such as 'exposure to neglected, battered, or dead children.'^[30]

Again, the actual fear of occupational death or physical harm is not high on the list of stress sources.

There have been numerous academic studies on the specific sources of police stress, and most conclude organizational culture and workload as the key issues in officer stress.^[31]

Traumatic events are usually concluded to not be of sufficient scope or prevalence to account for prevalence of suicide, divorce, and substance abuse abnormalities.

On August 6, 2019, New Jersey Attorney General Gurbir Grewal announced creation of the first U.S. statewide program to support the mental health of police officers. The goal of the program would be to train officers in emotional resiliency and to help destigmatize mental health issues.^[32]

Related Research Articles

<span class="mw-page-title-main">Firefighter</span> Rescuer trained to extinguish fires and save people

A firefighter is a first responder trained in firefighting, primarily to control and extinguish fires that threaten life and property, as well as to rescue persons from confinement or dangerous situations. Male firefighters are sometimes referred to as firemen.

<span class="mw-page-title-main">Blood-borne disease</span> Medical condition

A blood-borne disease is a disease that can be spread through contamination by blood and other body fluids. Blood can contain pathogens of various types, chief among which are microorganisms, like bacteria and parasites, and non-living infectious agents such as viruses. Three blood-borne pathogens in particular, all viruses, are cited as of primary concern to health workers by the CDC-NIOSH: HIV, hepatitis B (HVB), & hepatitis C (HVC).

An occupational injury is bodily damage resulting from working. The most common organs involved are the spine, hands, the head, lungs, eyes, skeleton, and skin. Occupational injuries can result from exposure to occupational hazards, such as temperature, noise, insect or animal bites, blood-borne pathogens, aerosols, hazardous chemicals, radiation, and occupational burnout.

The National Institute for Occupational Safety and Health is the United States federal agency responsible for conducting research and making recommendations for the prevention of work-related injury and illness. NIOSH is part of the Centers for Disease Control and Prevention (CDC) within the U.S. Department of Health and Human Services. Despite its name, it is not part of either the National Institutes of Health nor OSHA. Its current director is John Howard.

A needlestick injury is the penetration of the skin by a hypodermic needle or other sharp object that has been in contact with blood, tissue or other body fluids before the exposure. Even though the acute physiological effects of a needlestick injury are generally negligible, these injuries can lead to transmission of blood-borne diseases, placing those exposed at increased risk of infection from disease-causing pathogens, such as the hepatitis B virus (HBV), hepatitis C virus (HCV), and human immunodeficiency virus (HIV). Among healthcare workers and laboratory personnel worldwide, more than 25 blood-borne virus infections have been reported to have been caused by needlestick injuries. In addition to needlestick injuries, transmission of these viruses can also occur as a result of contamination of the mucous membranes, such as those of the eyes, with blood or body fluids, but needlestick injuries make up more than 80% of all percutaneous exposure incidents in the United States. Various other occupations are also at increased risk of needlestick injury, including law enforcement, laborers, tattoo artists, food preparers, and agricultural workers.

A health professional, healthcare professional, or healthcare worker is a provider of health care treatment and advice based on formal training and experience. The field includes those who work as a nurse, physician, physician assistant, registered dietitian, veterinarian, veterinary technician, optometrist, pharmacist, pharmacy technician, medical assistant, physical therapist, occupational therapist, dentist, midwife, psychologist, audiologist, or healthcare scientist, or who perform services in allied health professions. Experts in public health and community health are also health professionals.

An occupational hazard is a hazard experienced in the workplace. This encompasses many types of hazards, including chemical hazards, biological hazards (biohazards), psychosocial hazards, and physical hazards. In the United States, the National Institute for Occupational Safety and Health (NIOSH) conduct workplace investigations and research addressing workplace health and safety hazards resulting in guidelines. The Occupational Safety and Health Administration (OSHA) establishes enforceable standards to prevent workplace injuries and illnesses. In the EU, a similar role is taken by EU-OSHA.

Musculoskeletal disorders (MSDs) are injuries or pain in the human musculoskeletal system, including the joints, ligaments, muscles, nerves, tendons, and structures that support limbs, neck and back. MSDs can arise from a sudden exertion, or they can arise from making the same motions repeatedly repetitive strain, or from repeated exposure to force, vibration, or awkward posture. Injuries and pain in the musculoskeletal system caused by acute traumatic events like a car accident or fall are not considered musculoskeletal disorders. MSDs can affect many different parts of the body including upper and lower back, neck, shoulders and extremities. Examples of MSDs include carpal tunnel syndrome, epicondylitis, tendinitis, back pain, tension neck syndrome, and hand-arm vibration syndrome.

Incident stress is a condition caused by acute stress which overwhelms a staff person trained to deal with critical incidents such as within the line of duty for first responders, EMTs, and other similar personnel. If not recognized and treated at onset, incident stress can lead to more serious effects of posttraumatic stress disorder.

Workplace health surveillance or occupational health surveillance (U.S.) is the ongoing systematic collection, analysis, and dissemination of exposure and health data on groups of workers. The Joint ILO/WHO Committee on Occupational Health at its 12th Session in 1995 defined an occupational health surveillance system as "a system which includes a functional capacity for data collection, analysis and dissemination linked to occupational health programmes".

Prevention through design (PtD), also called safety by design usually in Europe, is the concept of applying methods to minimize occupational hazards early in the design process, with an emphasis on optimizing employee health and safety throughout the life cycle of materials and processes. It is a concept and movement that encourages construction or product designers to "design out" health and safety risks during design development. The process also encourages the various stakeholders within a construction project to be collaborative and share the responsibilities of workers' safety evenly. The concept supports the view that along with quality, programme and cost; safety is determined during the design stage. It increases the cost-effectiveness of enhancements to occupational safety and health.

An occupational fatality is a death that occurs while a person is at work or performing work related tasks. Occupational fatalities are also commonly called "occupational deaths" or "work-related deaths/fatalities" and can occur in any industry or occupation.

A physical hazard is an agent, factor or circumstance that can cause harm with contact. They can be classified as type of occupational hazard or environmental hazard. Physical hazards include ergonomic hazards, radiation, heat and cold stress, vibration hazards, and noise hazards. Engineering controls are often used to mitigate physical hazards.

<span class="mw-page-title-main">Line of duty death</span>

A line of duty death (LODD) is a death in the fire service or the police service while on duty.

Occupational safety and health (OSH) or occupational health and safety (OHS) is a multidisciplinary field concerned with the safety, health, and welfare of people at work. OSH is related to the fields of occupational medicine and occupational hygiene and aligns with workplace health promotion initiatives. OSH also protects all the general public who may be affected by the occupational environment.

Occupational heat stress is the net load to which a worker is exposed from the combined contributions of metabolic heat, environmental factors, and clothing worn, which results in an increase in heat storage in the body. Heat stress can result in heat-related illnesses, such as heat stroke, hyperthermia, heat exhaustion, heat cramps, heat rashes, and chronic kidney disease (CKD). Although heat exhaustion is less severe, heat stroke is a medical emergency and requires emergency treatment, which if not provided, can lead to death.

Occupational cardiovascular diseases (CVD) are diseases of the heart or blood vessels caused by working conditions, making them a form of occupational illness. These diseases include coronary heart disease, stroke, cardiomyopathy, arrythmia, and heart valve or heart chamber problems. Cardiovascular disease is the leading cause of death in the United States and worldwide. In the United States, cardiovascular diseases account for one out of four deaths. The 6th International Conference on Work Environment and Cardiovascular Diseases found that within the working age population about 10-20% of cardiovascular disease deaths can be attributed to work. Ten workplace stressors and risk factors were estimated to be associated with 120,000 U.S. deaths each year and account for 5-8% of health care costs.

Trauma in first responders refers to the psychological trauma experienced by first responders, such as police officers, firefighters, and paramedics, often as a result of events experienced in their line of work. The nature of a first responder's occupation continuously puts them in harm's way and regularly exposes them to traumatic situations, such as people who have been harmed, injured, or killed.

Hazard controls for COVID-19 in workplaces are the application of occupational safety and health methodologies for hazard controls to the prevention of COVID-19. Vaccination is the most effective way to protect against severe illness or death from COVID-19. Multiple layers of controls are recommended, including measures such as remote work and flextime, increased ventilation, personal protective equipment (PPE) and face coverings, social distancing, and enhanced cleaning programs.

An occupational infectious disease is an infectious disease that is contracted at the workplace. Biological hazards (biohazards) include infectious microorganisms such as viruses, bacteria and toxins produced by those organisms such as anthrax.

References

↑ Violanti, John M.; Fekedulegn, Desta; Shi, Mingming; Andrew, Michael E. (2020-03-27). "Hidden danger: A 22-years analysis of law enforcement deaths associated with duty-related illnesses (1997–2018)". Policing: An International Journal. 43 (2): 330–344. doi:10.1108/PIJPSM-07-2019-0109. ISSN 1363-951X. PMC 10194425 . PMID 37207254.
↑ Range, Jerome; Côté, Charles; Castellucci, Héctor I.; Tremblay, Mathieu; Lavallière, Martin (2023-09-01). "Driving the prevention of low back pain in police officers: A systematic review". Journal of Military, Veteran and Family Health. 9 (4): 39–49. doi:10.3138/jmvfh-2022-0061. ISSN 2368-7924.
1 2 3 4 iupausr (2024-01-16). "Serving and Suffering: Insights into Low Back Pain Among Law Enforcement". The International Union of Police Associations. Retrieved 2024-03-02.
↑ Beaucham, Catherine; Page, Elena; Alarcon, Walter A.; Calvert, Geoffrey M.; Methner, Mark; Schoonover, Todd M.; Centers for Disease Control and Prevention (CDC) (2014-04-25). "Indoor firing ranges and elevated blood lead levels - United States, 2002-2013". MMWR. Morbidity and Mortality Weekly Report. 63 (16): 347–351. ISSN 1545-861X. PMC 4584776 . PMID 24759656.
1 2 Committee on Potential Health Risks from Recurrent Lead Exposure of DOD Firing-Range Personnel; Committee on Toxicology; Board on Environmental Studies and Toxicology; Division on Earth and Life Studies; National Research Council (2012). Potential Health Risks to DOD Firing-Range Personnel from Recurrent Lead Exposure. Washington (DC): National Academies Press (US). ISBN 978-0-309-26736-6. PMID 24901199.
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1 2 "State Departments Issue Guidance Around Fentanyl Exposure". www.tn.gov. Retrieved 2024-03-04.
1 2 "Fentanyl: Emergency Responders at Risk | NIOSH | CDC". www.cdc.gov. 2021-07-14. Retrieved 2024-03-04.
↑ "Recommendations, Video, Seek to Dispel Myths About Fentanyl Exposure | Office of Justice Programs". www.ojp.gov. Retrieved 2024-03-05.
↑ "Houston Dacoma Driver License office to close for expansion Archived 2009-07-05 at the Wayback Machine ." Texas Department of Public Safety. October 29, 2008. Retrieved on June 16, 2009.
↑ "Honoring Officers Killed in the Year 2005". Odmp.org. Retrieved 2010-05-22. See also 2011 figures
↑ "UK Police Line of Duty Fatalities by Cause of Death, April 2000 to March 2010". Policememorial.org.uk. Retrieved 2010-05-22.
↑ "Policeman 28th killed in line of duty". New Zealand Herald. 11 September 2008. Retrieved 2009-01-15.
1 2 "Not So Obvious Police Stress". Tearsofacop.com. Retrieved 2010-05-22.
↑ O'Hara, A. F.; Violanti, J. M. (Winter 2009). "Police suicide- A web surveillance of national data". Journal of Emergency Mental Health. 11 (1): 17–23. PMID 19637497.
↑ "Suicide in the U.S.: Statistics and Prevention". NIMH. Retrieved 26 June 2011.
↑ Aamodt MG, Stalnaker NA. Police officer suicide: frequency and officer profiles. In Sheehan D, Warren J, eds. Suicide and Law Enforcement. Washington, D.C.: U.S. Government Printing Office;2002:383-98
↑ Sheehan D, Warren J, eds. Suicide and Law Enforcement. Washington, D.C.: U.S. Government Printing Office, 2002
↑ W C Terry, Police Stress – The Empirical Evidence, Journal of Police Science and Administration Volume:9 Issue:1 Dated:(March 1981) Pages:61–75.
↑ McCoy, S. P.; Aamodt, M. G. (Spring 2010). "A comparison of law enforcement divorce rates with those of other occupations". Journal of Police & Criminal Psychology. 25: 1–16. doi:10.1007/s11896-009-9057-8. S2CID 145363628.
↑ Archived April 15, 2009, at the Wayback Machine
↑ "FBI: 80 Percent Of Police Officers Are Overweight". CBS. August 14, 2014. Retrieved 16 August 2014.
↑ Fernandes, Dr Edmond. "Protect police health to prevent social deterioration". The Times of India. ISSN 0971-8257 . Retrieved 2024-05-09.
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↑ Kaplan Z, Iancu I, Bo E. A review of psychological debriefing after extreme stress. Psychiatr Serv 2001;52:824-7.
↑ Raphael B, Wilson JP, eds. Psychological Debriefing: Theory, Practice and Evidence. Cambridge University Press;2000:357
↑ Ankony, Robert C., "Community Alienation and Its Impact on Police," The Police Chief, Oct. 1999, 150–53.
↑ "Effects of Stress on police officers". Heavybadge.com. Archived from the original on 2013-01-25. Retrieved 2010-05-22.
↑ Spielberger, C. D.; Westberry, L.G.; Grier, K. S.; Greenfield, G. "Police Stress Survey – Sources of Stress in Law Enforcement". University of South Florida Human Resources Institute.
↑ Collins, P. A.; Gibbs, A. C. C. (June 2003). "Stress in police officers: a study of the origins, prevalence and severity of stress-related symptoms within a county police force". Occupational Medicine. 53 (4): 256–264. doi: 10.1093/occmed/kqg061 . PMID 12815123.
↑ Joe Atmonavage (August 6, 2019). "37 N.J. officers have killed themselves since 2016. AG hopes new plan will prevent suicides". NJ Advance Media for NJ.com. Retrieved August 6, 2019. 'We cannot fully comprehend the emotional and mental stress that our law enforcement officers suffer on a daily basis,' said Grewal during a press conference at the Newark Police Department to announce the New Jersey Resiliency Program for Law Enforcement. 'We owe it to them to not only combat the stigma associated with seeking help, but also give to them the tools they need to deal with the stress and trauma they endure.' The program is the first of its kind in the country, according to the Attorney General's office.

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[:5-1] Violanti, John M.; Fekedulegn, Desta; Shi, Mingming; Andrew, Michael E. (2020-03-27). "Hidden danger: A 22-years analysis of law enforcement deaths associated with duty-related illnesses (1997–2018)". Policing: An International Journal. 43 (2): 330–344. doi:10.1108/PIJPSM-07-2019-0109. ISSN 1363-951X. PMC 10194425 . PMID 37207254.

[2] Range, Jerome; Côté, Charles; Castellucci, Héctor I.; Tremblay, Mathieu; Lavallière, Martin (2023-09-01). "Driving the prevention of low back pain in police officers: A systematic review". Journal of Military, Veteran and Family Health. 9 (4): 39–49. doi:10.3138/jmvfh-2022-0061. ISSN 2368-7924.

[:0-3] 1 2 3 4 iupausr (2024-01-16). "Serving and Suffering: Insights into Low Back Pain Among Law Enforcement". The International Union of Police Associations. Retrieved 2024-03-02.

[4] Beaucham, Catherine; Page, Elena; Alarcon, Walter A.; Calvert, Geoffrey M.; Methner, Mark; Schoonover, Todd M.; Centers for Disease Control and Prevention (CDC) (2014-04-25). "Indoor firing ranges and elevated blood lead levels - United States, 2002-2013". MMWR. Morbidity and Mortality Weekly Report. 63 (16): 347–351. ISSN 1545-861X. PMC 4584776 . PMID 24759656.

[:6-5] 1 2 Committee on Potential Health Risks from Recurrent Lead Exposure of DOD Firing-Range Personnel; Committee on Toxicology; Board on Environmental Studies and Toxicology; Division on Earth and Life Studies; National Research Council (2012). Potential Health Risks to DOD Firing-Range Personnel from Recurrent Lead Exposure. Washington (DC): National Academies Press (US). ISBN 978-0-309-26736-6. PMID 24901199.

[:1-6] 1 2 3 4 "Protecting Law Enforcement Officers from Sharps Injuries | NIOSH | CDC". www.cdc.gov. 2022-09-06. Retrieved 2024-03-03.

[:2-7] 1 2 Reducing work-related needlestick and other sharps injuries among law enforcement officers (Report). U.S. Department of Health and Human Services, Public Health Service, Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health. 2022-07-01. doi:10.26616/nioshpub2022154.

[:4-8] 1 2 "State Departments Issue Guidance Around Fentanyl Exposure". www.tn.gov. Retrieved 2024-03-04.

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[12] "Honoring Officers Killed in the Year 2005". Odmp.org. Retrieved 2010-05-22. See also 2011 figures

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[17] "Suicide in the U.S.: Statistics and Prevention". NIMH. Retrieved 26 June 2011.

[18] Aamodt MG, Stalnaker NA. Police officer suicide: frequency and officer profiles. In Sheehan D, Warren J, eds. Suicide and Law Enforcement. Washington, D.C.: U.S. Government Printing Office;2002:383-98

[19] Sheehan D, Warren J, eds. Suicide and Law Enforcement. Washington, D.C.: U.S. Government Printing Office, 2002

[20] W C Terry, Police Stress – The Empirical Evidence, Journal of Police Science and Administration Volume:9 Issue:1 Dated:(March 1981) Pages:61–75.

[21] McCoy, S. P.; Aamodt, M. G. (Spring 2010). "A comparison of law enforcement divorce rates with those of other occupations". Journal of Police & Criminal Psychology. 25: 1–16. doi:10.1007/s11896-009-9057-8. S2CID 145363628.

[22] Archived April 15, 2009, at the Wayback Machine

[CBS-overweight-23] "FBI: 80 Percent Of Police Officers Are Overweight". CBS. August 14, 2014. Retrieved 16 August 2014.

[24] Fernandes, Dr Edmond. "Protect police health to prevent social deterioration". The Times of India. ISSN 0971-8257 . Retrieved 2024-05-09.

[25] Rose S, Bisson J, Wessely S. Psychological debriefing for preventing post traumatic stress disorder (PTSD) (Cochrane Review). In The Cochrane Library, Issue 3. Oxford: Update Software, 2001.

[26] Kaplan Z, Iancu I, Bo E. A review of psychological debriefing after extreme stress. Psychiatr Serv 2001;52:824-7.

[27] Raphael B, Wilson JP, eds. Psychological Debriefing: Theory, Practice and Evidence. Cambridge University Press;2000:357

[28] Ankony, Robert C., "Community Alienation and Its Impact on Police," The Police Chief, Oct. 1999, 150–53.

[29] "Effects of Stress on police officers". Heavybadge.com. Archived from the original on 2013-01-25. Retrieved 2010-05-22.

[30] Spielberger, C. D.; Westberry, L.G.; Grier, K. S.; Greenfield, G. "Police Stress Survey – Sources of Stress in Law Enforcement". University of South Florida Human Resources Institute.

[31] Collins, P. A.; Gibbs, A. C. C. (June 2003). "Stress in police officers: a study of the origins, prevalence and severity of stress-related symptoms within a county police force". Occupational Medicine. 53 (4): 256–264. doi: 10.1093/occmed/kqg061 . PMID 12815123.

[32] Joe Atmonavage (August 6, 2019). "37 N.J. officers have killed themselves since 2016. AG hopes new plan will prevent suicides". NJ Advance Media for NJ.com. Retrieved August 6, 2019. 'We cannot fully comprehend the emotional and mental stress that our law enforcement officers suffer on a daily basis,' said Grewal during a press conference at the Newark Police Department to announce the New Jersey Resiliency Program for Law Enforcement. 'We owe it to them to not only combat the stigma associated with seeking help, but also give to them the tools they need to deal with the stress and trauma they endure.' The program is the first of its kind in the country, according to the Attorney General's office.

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