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Nonfatal Injuries to Law Enforcement Officers: A Rise in Assaults

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Introduction: Limited studies exist that describe nonfatal work-related injuries to law enforcement officers. The aim of this study is to provide national estimates and trends of nonfatal injuries to law enforcement officers from 2003 through 2014. Methods: Nonfatal injuries were obtained from the National Electronic Injury Surveillance System-Occupational Supplement. Data were obtained for injuries treated in U.S. emergency departments from 2003 to 2014. Nonfatal injury rates were calculated using denominators from the Current Population Survey. Negative binomial regression was used to analyze temporal trends. Data were analyzed in 2016-2017. Results: Between 2003 and 2014, an estimated 669,100 law enforcement officers were treated in U.S. emergency departments for nonfatal injuries. The overall rate of 635 per 10,000 full-time equivalents was three times higher than all other U.S. workers rate (213 per 10,000 full-time equivalents). The three leading injury events were assaults and violent acts (35%), bodily reactions and exertion (15%), and transportation incidents (14%). Injury rates were highest for the youngest officers, aged 21-24 years. Male and female law enforcement officers had similar nonfatal injury rates. Rates for most injuries remained stable; however, rates for assault-related injuries grew among law enforcement officers between 2003 and 2011. Conclusions: National Electronic Injury Surveillance System-Occupational Supplement data demonstrate a significant upward trend in assault injuries among U.S. law enforcement officers and this warrants further investigation. Police-citizen interactions are dynamic social encounters and evidence-based policing is vital to the health and safety of both police and civilians. The law enforcement community should energize efforts toward the study of how policing tactics impact both officer and citizen injuries.
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RESEARCH ARTICLE
Nonfatal Injuries to Law Enforcement Ofcers:
A Rise in Assaults
Hope M. Tiesman, PhD,
1
Melody Gwilliam, MPH,
1
Srinivas Konda, MPH,
1
Jeff Rojek, PhD,
2
Suzanne Marsh, MPA
1
Introduction: Limited studies exist that describe nonfatal work-related injuries to law enforcement
ofcers. The aim of this study is to provide national estimates and trends of nonfatal injuries to law
enforcement ofcers from 2003 through 2014.
Methods: Nonfatal injuries were obtained from the National Electronic Injury Surveillance
SystemOccupational Supplement. Data were obtained for injuries treated in U.S. emergency
departments from 2003 to 2014. Nonfatal injury rates were calculated using denominators from the
Current Population Survey. Negative binomial regression was used to analyze temporal trends. Data
were analyzed in 20162017.
Results: Between 2003 and 2014, an estimated 669,100 law enforcement ofcers were treated in
U.S. emergency departments for nonfatal injuries. The overall rate of 635 per 10,000 full-time
equivalents was three times higher than all other U.S. workers rate (213 per 10,000 full-time
equivalents). The three leading injury events were assaults and violent acts (35%), bodily reactions
and exertion (15%), and transportation incidents (14%). Injury rates were highest for the youngest
ofcers, aged 2124 years. Male and female law enforcement ofcers had similar nonfatal injury
rates. Rates for most injuries remained stable; however, rates for assault-related injuries grew among
law enforcement ofcers between 2003 and 2011.
Conclusions: National Electronic Injury Surveillance SystemOccupational Supplement data
demonstrate a signicant upward trend in assault injuries among U.S. law enforcement ofcers and
this warrants further investigation. Policecitizen interactions are dynamic social encounters and
evidence-based policing is vital to the health and safety of both police and civilians. The law
enforcement community should energize efforts toward the study of how policing tactics impact
both ofcer and citizen injuries.
Am J Prev Med 2017;](]):]]]]]]. Published by Elsevier Inc. on behalf of American Journal of Preventive Medicine
INTRODUCTION
Law enforcement ofcers (LEOs) have had histor-
ically high rates of fatal and nonfatal injuries. LEO
fatalities are documented in several well-estab-
lished data systems, including the National Law Enforce-
ment Ofcer Memorial Fund, the Federal Bureau of
Investigations (FBIs) Law Enforcement Ofcers Killed
and Assaulted database, and the Bureau of Labor
Statistics Census of Fatal Occupational Injury.
13
According to 2015 Census of Fatal Occupational Injury
data, police and sheriffsofcers had the 18th highest
fatality rate behind occupations such as loggers, roofers,
and construction laborers.
4
Although these systems
provide a national picture of ofcer fatalities, much less
is known about nonfatal injuries among ofcers and how
these injuries impact ofcers and agencies.
From the
1
Division of Safety Research, National Institute for Occupational
Safety and Health, Morgantown, West Virginia; and
2
Department of
Criminal Justice, University of Texas at El Paso, El Paso, Texas
Address correspondence to: Hope M. Tiesman, PhD, Division of Safety
Research, Analysis and Field Evaluations Branch, National Institute for
Occupational Safety and Health, 1095 Willowdale Road, M/S 1811,
Morgantown WV 26505. E-mail: htiesman@cdc.gov.
0749-3797/$36.00
https://doi.org/10.1016/j.amepre.2017.12.005
Published by Elsevier Inc. on behalf of American Journal of Preventive Medicine Am J Prev Med 2017;](]):]]]]]] 1
A handful of studies on nonfatal LEO injuries have been
conducted, but were limited by either size or scope. The
FBIs Uniform Crime Reporting program collects monthly
data on nonfatal assaults of duly sworn university and
college, county, state, municipal, and tribal ofcers who
were performing a law enforcement function at the time of
the assault.
5
However, this program does not track unin-
tentional injuries, such as accidental falls or motor vehicle
crashes. Also, this program is voluntary and some agencies
do not participate.
6
These missing data make it difcult to
describe national nonfatal injury trends.
6
Another effort is
that of the International Association of Chiefs of Police
Reducing Ofcer Injuries Final Report, which collected
self-reported injury data from 18 law enforcement agen-
cies.
7
This report documented nearly 1,300 injuries, 6,000
missed work days, and $2 million in estimated overtime
costs in a single year. Although the study was a signicant
undertaking, it used a nonspecicinjurydenition that
may have included deaths, reports of pain, and off-duty
injuries.
7
Also, these data may not be generalizable to the
law enforcement community as a whole.
Recent events involving LEOs have called attention to a
wide range of internal policing issues, including use of force,
discipline of ofcers, and policing culture. Conversely, these
events have also caused law enforcement practitioners,
criminologists, and occupational safety and health profes-
sionals to consider the impact of police work on the health
and safety of ofcers. The purpose of this article is to extend
prior work by enumerating and describing nonfatal injuries
among on-duty LEOs between 2003 and 2014. To the best of
the authorsknowledge, this will be the rst study to examine
nonfatal injuries among LEOs on a national scale.
METHODS
Study Sample
On-duty nonfatal injuries occurring between January 1, 2003 and
December 31, 2014 to U.S. LEOs were obtained from the National
Electronic Injury Surveillance System Occupational Injury Supple-
ment (NEISSWork). The National Institute for Occupational
Safety and Health (NIOSH), in collaboration with the Consumer
Product Safety Commission, collects surveillance data on work-
related nonfatal injuries and illnesses treated in U.S. hospitals with
a 24-hour emergency department (ED).
a
The sample of hospitals
is a national stratied probability sample of 67 U.S. hospitals
divided into strata by hospital size, based on number of annual
ED visits.
8
An injury is considered work-related if it occurred to a
civilian, non-institutionalized worker who was working for pay,
performing farm-related activities, traveling between locations as
part of a job requirement, or volunteering for an organized group.
Injuries are identied from ED medical records by trained coders
at each participating hospital. To calculate national estimates, each
case is assigned a statistical weight based on the inverse probability
of selection of the hospital in the sample, and adjustments are
made for nonresponding hospitals during each calendar year.
Injury event characteristics for 2003 through 2011 were coded
based on the Bureau of Labor Statistics Occupational Injury and
Illness Classication System, version 1.01.
9,10
Data from 2012 to
2014 were coded using Occupational Injury and Illness Classi-
cation System, version 2.01.
10
Thus, 2012 is considered a break in
series for injury event data. NEISSWork does not follow a
standard coding classication system for the occupation and
industry of workers. No review was required by NIOSHs IRB
because the analysis was conducted using existing surveillance
data.
Measures
For this analysis, LEO was dened as a state or local ofcer who
carried a rearm and had full arrest powers. Law enforcement
occupations, such as animal control ofcers, security guards,
correctional/detention ofcers, federal LEOs, parole ofcers,
school safety/resource ofcers, private investigators, crossing
guards, volunteer police, public safety ofcers serving in a re
capacity, and off-duty ofcers were excluded. Inclusion and
exclusion criteria for occupational classication purposes are
important, as the criteria may affect injury rates.
11
Because NEISSWork does not include standardized industry
and occupation codes, a stepwise process was used to identify LEO
cases. The inclusion/exclusion criteria noted here was used to
develop a list of law enforcement keywords. These keywords were
used to search three variables: business type, employer name, and
occupation type. If all three variables included a law enforcement
keyword, cases were included without further review. Remaining
cases were then reviewed manually if: (1) two of the three variables
(business type, employer name, occupation type) included a law
enforcement keyword, (2) occupation type included a law enforce-
ment keyword and the other two variables did not include an
exclusion term listed here, or (3) occupation type was missing and
one of the other two variables included a law enforcement
keyword. For these remaining cases, the injury incident narrative
variable was reviewed to determine if the injury could be attributed
to police work. Cases were kept where the activity was unique to
law enforcement, such as (1) chasing or pursuing a suspect, (2)
arresting or restraining a suspect, (3) ghting an assailant/suspect,
or (4) participating in police-related training. Cases were
excluded when the injury incident narrative was generic, such as
fell at work.
An additional step was taken for remaining cases where the
occupation type variable was trainee. Because trainee could be
interpreted as a cadet (non-sworn ofcer) or as a sworn ofcer
participating in physical training or under the supervision of a eld
training ofcer, the injury incident text was manually reviewed to
exclude non-sworn ofcers from the study. Questionable cases at
any stage in this process were reviewed by two additional co-
authors to arrive at consensus. After removing ofcers aged o21
years, the nal dataset included 12,270 cases that were identied as
LEOs with certainty.
a
NIOSH collects NEISSWork data in collaboration with the Consumer
Product Safety Commission, which operates the base NEISS hospital
system for the collection of data on consumer productrelated injuries.
The Consumer Product Safety Commission product-related injury esti-
mates exclude work-related injuries, whereas NEISSWork estimates
include all work-related injuries regardless of product involvement (i.e.,
NEISS and NEISSWork cases are mutually exclusive).
Tiesman et al / Am J Prev Med 2017;](]):]]]]]]2
www.ajpmonline.org
Statistical Analysis
Data were analyzed in 20162017 using SAS, version 9.3. Nonfatal,
ED-treated injury estimates were obtained by summing the
statistical weights assigned to each case. Nonfatal injury rates were
calculated using denominator data from the Bureau of Labor
StatisticsCurrent Population Survey (CPS). The CPS is a national
household survey, conducted monthly on approximately 60,000
non-institutionalized residents aged 15 years.
12
Respondents
provide information on their occupation, industry, hours of work,
and other work-related characteristics.
12
The CPS provides infor-
mation on the number of full-time equivalent (FTE) workers based
on the 2002 and 2010 Bureau of Census Occupation codes.
13
Federal ofcers and those aged o21 years were removed to match
the numerator data.
Estimated injuries with 95% CIs were calculated using PROC
SURVEYMEANS. Nonfatal injury rates were calculated as the
estimated number of nonfatal injuries divided by the estimated
FTE and expressed as injuries per 10,000 FTEs per year. The 95%
CIs for rates were calculated by pooling the variances for the
NEISSWork injuries and CPS data. Sociodemographics (sex and
age) were compared with rate ratios and 95% CIs. Trends over
time were analyzed using a negative binomial regression model to
correct for overdispersion that occurred when using a Poisson
model.
RESULTS
Between 2003 and 2014, the overall nonfatal, ED-treated
injury rate for LEOs was 635 per 10,000 FTEs (95%
CI¼436, 834). The LEO nonfatal injury rate was three
times higher than the injury rate of 213 per 10,000 FTEs
for all other U.S. workers (excluding LEOs). The annual
LEO nonfatal injury rate increased from 2007 to 2011
and then decreased until 2014. This resulted in a 1.2%
annual increase across the 12-year period (p¼0.18;
Figure 1). The LEO nonfatal injury trend is in contrast
with the trend for all other U.S. workers. Between 2003
and 2014, nonfatal injury rates for all other U.S. workers
signicantly decreased 2.6% annually (po0.0001).
Between 2003 and 2014, an estimated 669,100 (95%
CI¼461,000, 877,200) ofcers were treated in EDs for a
nonfatal injury (Table 1). Although 88% of the injuries
occurred in male LEOs, male and female LEOs had
similar injury rates (male, n¼652; female, n¼535, rate
ratio¼1.2, 95% CI¼0.6, 1.8). As age increased, nonfatal
injury rates decreased. Ofcers aged between 21 and 24
years had the highest injury rate (1,230 per 10,000 FTEs).
Sixty-three percent of nonfatal injuries among LEOs
occurred in municipal ofcers (n¼423,800) and 27%
occurred in county-level ofcers (n¼185,600). Most
injured LEOs were treated and released from the ED
(n¼654,400, 98%).
Table 2 describes the body part injured and diagnosis.
The two most commonly injured body part categories
were hands and ngers (n¼157,600, 24%) and lower
extremities (n¼147,100, 22%). The most common injury
diagnosis was sprains and strains (n¼199,000, 30%). The
leading nonfatal injury events from 2003 to 2011 were
assaults and violent acts (n¼181,100, 35%, 95%
CI¼119,400, 242,800), bodily reactions and exertion
(includes overexertion from running and repetitive
motion injuries; n¼74,000, 15%, 95% CI¼401,000,
107,900), transportation incidents (n¼71,000, 14%,
95% CI¼46,200, 95,800), contact with objects
(n¼66,000, 13%, 95% CI¼46,400, 85,600), and falls
(n¼57,400, 11%, 95% CI¼37,500, 77,300). Nonfatal
injury rates for bodily reaction and transportation
injuries did not signicantly change during the 9-year
time period. Rates for assault-related injuries signi-
cantly increased 9.6% annually from 2003 to 2011
(po0.0001, Figure 2A).
Because data from three hospitals in a single metro-
politan area had large increases in assault-related injuries
compared with other hospitals, the assault-related injury
trend was also examined, excluding these hospitals
(Figure 2A). This trend analysis was run with adjusted
weights because of the removal of three hospitals. This
trend also increased signicantly, 2.9% annually from
2003 to 2011 (p¼0.002). Because 2012 represented a
break in series for injury event codes, 20122014 data
were examined separately (Figure 2B). Between 2012 and
2014, the leading nonfatal injury events were violence
and other injuries by people or animals (n¼73,500, 45%,
95% CI¼41,000, 106,000); transportation incidents
(n¼19,600, 12%, 95% CI¼9,900, 29,300); falls, slips,
and trips (n¼18,700, 11%, 95% CI¼11,800, 25,600),
contact with objects and equipment (n¼18,400, 11%,
95% CI¼13,000, 238,000), and overexertion and bodily
reactions (n¼15,800, 10%, 95% CI¼9,900, 21,700).
Figure 1. Nonfatal injury rates per 10,000 FTEs among U.S.
LEOs and all other U.S. workers: NEISSWork, 20032014.
FTE, full-time equivalent; LEO, law enforcement ofcer; NEISS, National
Electronic Injury Surveillance System.
Tiesman et al / Am J Prev Med 2017;](]):]]]]]] 3
]2017
Injury rates for transportation incidents and falls, slips,
and trips decreased signicantly during this time period
(p¼0.04 and po0.0001, respectively). Comparatively,
injury rates because of violence increased 6% annually,
though this increase was not statistically signicant
(p¼0.53).
Table 1. Number and Rate of Nonfatal Injuries Among LEOs by Sex, Age, Disposition, and Agency Type: NEISSWork,
20032014
Characteristic
Weighted injury estimates
a
(95% CI) %
Labor estimate
b
(FTE)
Rate per 10,000 FTE
(95% CI)
RR
(95% CI)
Sex
Male 590,400 (406,700, 774,100) 88 9,060,500 652 (447, 857) 1.2 (0.6, 1.8)
Female 78,800 (51,400, 106,200) 12 1,472,900 535 (324, 746) 1.0
Age group, years
2124 45,300 (27,300, 63,300) 7 367,300 1,230 (530, 1930) 7.1 (2.1, 12.1)
2534 301,300 (203,200, 399,400) 45 2,941,900 1,020 (662, 1378) 5.9 (2.7, 9.1)
3544 233,700 (151,400, 316,000) 35 3,788,800 617 (391, 843) 3.5 (1.6, 5.4)
4554 71,200 (49,800, 92,600) 11 2,426,400 293 (195, 391) 1.7 (0.8, 2.6)
55 17,600 (11,600, 23,600) 3 1,009,100 174 (102, 246) 1.0
Disposition
Treated and
released
654,400 (448,000, 860,800) 98 10,533,400 620 (423, 817)
Treated and
admitted
14,600 (8,800, 20,400) 2 10,533,400 13 (8, 18)
Agency type
Municipal 423,800 (237,500, 610,100) 63 ——
Sheriff
c
185,600 (37,400, 333,800) 27 ——
State 30,300 (18,100, 42,500) 5 ——
Other 29,400 (14,500, 44,300) 4 ——
Total 669,100 (461,000, 877,200) 100 10,533,400 635 (436, 834)
a
Number may not sum to total due to rounding.
b
Labor estimates from the Current Population Survey.
c
Estimate is statistically unreliable with a 40% coefcient of variation.
FTE, full-time equivalent; LEO, law enforcement ofcer; NEISS, National Electronic Injury Surveillance System; RR, rate ratio.
Table 2. Number and Percentage of Nonfatal Injuries Among LEOs by Body Part Injured and Diagnosis: NEISSWork,
20032014
Variable Weighted injury estimates
a
(95% CI) %
a
Body part injured
Hand and ngers 157,600 (108,500, 206,700) 24
Lower extremities 147,100 (103,200, 191,000) 22
Trunk and neck 108,900 (73,200, 144,600) 16
Head and face 90,400 (56,800, 124,000) 14
Upper extremity 82,400 (55,100, 109,700) 12
Shoulder 42,200 (26,600, 57,800) 6
All other 29,100 (17,700, 40,500) 4
Diagnosis
Sprain and strain 199,000 (125,900, 272,100) 30
All other 194,400 (140,100, 248,700) 29
Contusions and abrasions 181,200 (110,500, 251,900) 27
Laceration 50,800 (36,200, 65,400) 8
Fracture and dislocation 43,700 (30,700, 56,700) 7
Total 669,100 (461,000, 877,200) 100
a
Number may not sum to total due to rounding.
LEO, law enforcement ofcer; NEISS, National Electronic Injury Surveillance System.
Tiesman et al / Am J Prev Med 2017;](]):]]]]]]4
www.ajpmonline.org
DISCUSSION
This research provides a national description of nonfatal,
ED-treated injuries occurring to U.S. LEOs between 2003
and 2014. Nonfatal injury rates for LEOs remained high
compared with all other U.S. workers, and these rates
increased from 2007 until 2011. This trend was divergent
from the trend for all other U.S. workers, which
decreased signicantly from 2003 to 2014. The increase
in nonfatal injury rates among LEOs may be driven by
the large and signicant increase in assault-related
injuries that started in 2008 and continued until 2012.
Unfortunately, because of the break in injury event
coding in 2012, data on the cause of injuries cannot be
compared between 2011 and 2012.
This is the rst study to demonstrate an upward
national trend in assault-related injuries among LEOs.
The primary database used to track assaults among LEOs
is the FBIs Law Enforcement Ofcers Killed and
Assaulted, which is part of the Uniform Crime Report
data and has substantial limitations.
14
Per a former FBI
director, Because reporting is voluntary, our data is
incomplete and therefore, in aggregate, unreliable .
15
Yet, studies have used the Law Enforcement Ofcers
Killed and Assaulted data to describe national trends and
may be reaching erroneous conclusions. For example,
Chang et al.
16
reported the number of police assaulted in
the line of duty decreased signicantly from 2003 to
2011. Using data systems that rely on voluntary reporting
could provide misleading results compromising the
interpretations concerning police and civilian interac-
tions. The NEISSWork data may reect more valid
national nonfatal injury rates for LEOs. Although the
current study improves upon nonreporting and incom-
plete data biases, it is crucial to consider all possible
reasons for increases among assault-related injuries. One
potential theory is that the increase reects changing
policies across the law enforcement community to better
document civilianofcer interactions. For example, one
such policy may require ofcers to visit EDs to document
a civilian encounter, regardless of the presence or severity
of the ofcers injury. A second hypothesis is that the
landscape of civilianofcer dynamics is changing.
It is no surprise that assaults are a leading injury for
LEOs. Ofcers can encounter highly unpredictable and
dangerous situations, making it difcult to fully plan
prevention strategies and tactics in advance.
17
Of the ten
risk factors for workplace violence, seven are applicable
to the law enforcement profession.
18
There is also
growing evidence that interactions between police and
the public may be changing. The FBIs Assailant Study
interviewed ofcers and command staff in agencies
where an ofcer had been killed in the line of duty.
19
During these interviews, ofcers expressed concerns over
increasing interactions with people in drug-induced
states, an overall justication of violence against police,
and a perceived general public distrust in the police.
19
Also, a recent Pew Research Center national survey of
police ofcers showed that ofcers believe policecivilian
interactions have become more tense and 93% of police
ofcers are concerned about their safety on the job.
20
Although the understanding and prevention of fatal
shootings of LEOs is imperative, these ndings on
nonfatal assaults among LEOs identify issues that are
equally deserving of inquiry. Policecitizen interactions
are dynamic social encounters where force can occur
when an ofcer seeks to maintain control during
resistance.
21,22
This resistance can range from passive
efforts, such as pulling away, to direct physical assaults
on ofcers.
20,21
The likelihood of injury to ofcers and
citizens depends partially on the level of resistance by the
citizen, as well as the force applied by the ofcer.
23
The
increase in assault-related injuries reported here may be
reective of an increasing willingness of citizens to resist
ofcers. Conversely, it is possible that ofcers have
Figure 2. (A) Assault-related injury rates per 10,000 FTEs
among U.S. LEOs: NEISSWork, 20032011. (B) Nonfatal
injury rates per 10,000 FTEs among U.S. LEOs for three
leading injury events: NEISSWork, 20122014.
Note: Data points for each year are slightly adjusted to the right of the
corresponding year to aid visualization. Assault-related injury trend
examined with three hospitals from a single metropolitan area removed.
FTE, full-time equivalent; LEO, law enforcement ofcer; NEISS, National
Electronic Injury Surveillance System.
Tiesman et al / Am J Prev Med 2017;](]):]]]]]] 5
]2017
become more inclined to use greater force in their
encounters with citizens. A complete understanding of
the dynamics of police encounters that result in force is
critical to effectively reduce assault-related injuries to
LEOs, as well as associated injuries to citizens. If violence
against LEOs is increasing, many questions remain,
including how violence impacts the profession of polic-
ing in general.
Recent data support the theory that the law enforce-
ment community has begun to engage in de-policing,
or a reduction in policing duties.
24
Seventy-two percent
of ofcers in the Pew study reported they were less
willing to stop and question suspicious people, and 76%
were reluctant to use force even when it was appropriate
to do so.
20
Another study of more than 100 agencies in a
single state found that ofcers were making signicantly
fewer vehicle stops and searches in 2015 compared with
2014.
24
Although available studies have not shown a
connection between de-policing strategies and overall
crime rates, it is yet to be determined whether de-policing
strategies and the severity and frequency of ofcer
injuries may be associated.
24,25
Also, there has been
increased scholarly interest in ofcer injuries following
high-prole use-of-force events, such as what occurred in
Ferguson, Missouri in 2014.
26
More specically, in recent
years, is there an increased willingness among citizens to
resist or assault ofcers?
26
It is important to note that the
time frame under examination in the current study does
not overlap with these use-of-force events.
Limitations
There are limitations to these data. First, NEISSWork
does not use a standardized coding system for occupation
or industry; therefore, a systematic case-nding method-
ology was used to identify LEOs. Because this approach
erred on specicity over sensitivity, it is possible that
some LEOs were missed. Also, the injury incident
variable was used to dene cases when other employment
variables were missing. This may have inated the
number of assault-related cases because cases were
included if they involved suspect-related activities. Sec-
ond, LEOs may visit EDs for minor injuries to fully
document use of force incidents. If so, these results may
be overestimates of nonfatal injury rates. On the other
hand, because NEISSWork only collects ED data, it
excludes injuries seen in other medical venues; therefore,
these results could also underestimate the true rates.
Finally, NEISSWork does not collect standardized
information on confounding factors, such as rank,
work conditions, lifestyle factors, physical or mental
comorbidities, and the use of certain tactics and
equipment.
CONCLUSIONS
Although ofcer fatalities are fairly well documented,
nonfatal injuries are harder to dene, capture, and study
from a national perspective. The few efforts to do so have
been limited. This study demonstrated that nonfatal
injury rates for LEOs remain quite high compared with
all other U.S. workers, in spite of a decline in overall
worker rates. Additionally, nonfatal injury trends for
LEOs increased from 2007 to 2011, and this increase
appears to have been driven primarily by assaults.
However, it cannot be determined if this signicant
increase indicates a more dangerous risk environment
for ofcers or other potential reasons, such as simply
policy changes that required LEOs to visit EDs to
document policecivilian encounters. A more thorough
analysis is underway to answer these questions. Although
it may be premature to recommend the implementation
of approaches to mitigate assaults occurring to LEOs, it is
important to note that studies of how policing tactics
impact both ofcer and civilian injuries are virtually
nonexistent. Both citizens and LEOs are impacted by
violence, and evidence-based policing is vital to the
health and safety of both.
27
A more complete under-
standing of policing procedures and tactics that are truly
evidence-based is needed.
ACKNOWLEDGMENTS
The ndings and conclusions in this report are those of the
authors and do not necessarily represent the views of the
National Institute for Occupational Safety and Health (NIOSH).
Mention of any company or product does not constitute
endorsement by NIOSH. In addition, citations to websites
external to NIOSH do not constitute endorsement of the
sponsoring organizations or their programs or products. Fur-
thermore, NIOSH is not responsible for the content of these
websites. All web addresses referenced in this document were
accessible as of the publication date.
The authors of this manuscript do not have any conicts of
interest or nancial disclosures.
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]2017
... Additionally, the review included a select timeframe to capture the nature of contemporary assaults on police. However, this timeframe restriction may have excluded relevant studies that may provide valuable context and insights into the evolution of research in this field-in particular, longitudinal studies (e.g., see Bierie et al., 2016;Bierie, 2017;Crifasi et al., 2016;Hine & Carey, 2021;Hipple et al., 2019;Tiesman et al., 2018). Ultimately, focusing on contemporary studies allowed us to provide a clear, accurate, and timely assessment of the current state of knowledge. ...
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When considering police within violence and victims research, the emphasis typically falls on the police as responders to victims; however, little research has explored the perspective of police officers as victims of violence themselves. Through a systematic literature review of contemporary assaults toward police, 11 empirical articles were identified and analyzed with 4 main themes emerging: the retaliatory nature of police–citizen dynamics, specific predictors of police assaults, environmental features of assaults, and the impact of assaults. These findings provide evidence-based insights, identify research gaps, and help guide future research agendas, ultimately providing a foundational resource for policymakers, law enforcement agencies, and researchers in developing targeted interventions and policies to enhance officers’ safety, foster positive police–community relations, and promote a safer and more resilient society.
... Machines 2024, 12, 502 2 of 25 injuries for LEO was 33.25 per 100,000 full-time equivalent workers, compared to 5.3 for all occupations [3]. Additionally, the nonfatal injury rate for LEOs was three times higher than the rate for other U.S. workers, with transportation incidents being the third leading cause of nonfatal injury events in the law enforcement community [4]. ...
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Mission-based routes for various occupations play a crucial role in occupational driver safety, with accident causes varying according to specific mission requirements. This study focuses on the development of a system to address driver distraction among law enforcement officers by optimizing the Driver–Vehicle Interface (DVI). Poorly designed DVIs in law enforcement vehicles, often fitted with aftermarket police equipment, can lead to perceptual-motor problems such as obstructed vision, difficulty reaching controls, and operational errors, resulting in driver distraction. To mitigate these issues, we developed a driving simulation platform specifically for law enforcement vehicles. The development process involved the selection and placement of sensors to monitor driver behavior and interaction with equipment. Key criteria for sensor selection included accuracy, reliability, and the ability to integrate seamlessly with existing vehicle systems. Sensor positions were strategically located based on previous ergonomic studies and digital human modeling to ensure comprehensive monitoring without obstructing the driver’s field of view or access to controls. Our system incorporates sensors positioned on the dashboard, steering wheel, and critical control interfaces, providing real-time data on driver interactions with the vehicle equipment. A supervised machine learning-based prediction model was devised to evaluate the driver’s level of distraction. The configured placement and integration of sensors should be further studied to ensure the updated DVI reduces driver distraction and supports safer mission-based driving operations.
... Numerous countries report police force injury rates three times higher than other occupations [5][6][7][8]. This is primarily attributable to the demanding nature and structure of their work [7][8][9][10]. Police officers are expected to maintain a level of physical fitness that exceeds the average citizen in order to effectively carry out their duties and protect the community [11]. ...
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Physical fitness is mandatory for public safety officers. Police officers experience elevated levels of cardiovascular disease and associated risks making fitness a peak concern. Officers often have more marked fitness level decreases with aging compared to the general population. This cross-sectional study investigated the cardiovascular health, muscular strength/endurance, and mobility of officers in a medium-sized police department (N = 83); (4 females, 79 males), age (36.82 ± 10 years), height (179.02 ± 7.7 cm), body mass (95.1 ± 16.29 kg) compared to American College of Sports Medicine (ACSM) guidelines. The findings revealed that police officers begin their careers with above average strength but demonstrate greater declines with age than the general population. Officers also demonstrated cardiovascular fitness below ACSM standards and significant decreases with aging compared to the general population. Body fat percentages (p = 0.003) and BMI (p = 0.028) surpassed recommendations, with higher than normal increases with age. Maximum vertical jump decreased as officers age (p = 0.004). These findings support the implementation of a targeted physical fitness regimen and the resources for a program designed to improve current health and fitness, reduce the greater than expected decreases with aging, and aim to optimize occupational performance and the safeguarding of the lifelong health and well-being of officers.
... Finally, to the authors' knowledge, this is the first study to use inferential time-series techniques to quantify trends in national, all-industry monthly occupational injury data in the US for the period assessed. Specifically, ARIMA modeling, which allows for the analysis of monthly occupational injury data, is an improvement over previous methods used to measure trends in national ED-treated injury data, such as negative binomial regression (Tiesman et al. 2018), which generally cannot account for seasonality. However, other studies have used extensions of ARIMA modeling, such as interrupted time-series (ITS) analysis, to assess the impact of occupational safety and health, such as US Mine Safety and Health Administration regulations (Monforton and Windsor 2010), drugfree workplace interventions (Wickizer et al. 2004), and the influence of a crash prevention program in a large law enforcement agency (Tiesman et al. 2019); ITS analysis may allow future studies to assess the impact of interventions with potential to influence national ED-treated occupational injury rates (e.g., implementation of occupational health and safety policies, changes in workers' access to health insurance, etc.) were one to be identified. ...
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Background: Occupational injuries are common among law enforcement officers (LEOs) and can impact an agency's ability to serve communities. Workers' compensation (WC) data are an underutilized source for occupational injury surveillance in the law enforcement field. Methods: LEOs WC claims from the Ohio Bureau of Workers' Compensation (OHBWC) from 2001 to 2019 were identified based on manual review of the occupation title and injury description. Worker, employer, incident, and injury characteristics were described by claim type—medical‐only (MO) and lost‐time (8 or more days away from work). Data are presented using injury claim counts. Results: From 2001 to 2019, 50,793 WC claims were identified among Ohio LEOs. Of these, 68% were MO claims (n = 34,622). WC claims significantly decreased over the 19‐year period (p < 0.001). Seventy‐five percent of WC claims were from a LEO with more than one claim and of these, 34% were from a LEO with five or more claims during the study period. Male officers and those aged 25−54 years incurred the highest proportion of total claims (87.8% & 91.8%, respectively). Violence (n = 17,247; 34%), falls/slips/trips (n = 9079; 17.9%), and transportation events (n = 7977; 15.7%) were the leading events. Among the 50,793 claims, there were 79,637 unique clinical diagnosis groups. The most common injury diagnoses were sprains (n = 32,796; 41.2%) followed by contusions (n = 13,529; 17%). Conclusions: Results can guide the development or improvement of workplace injury prevention strategies for LEOs. Efforts should be focused on better understanding and preventing violent injury events and sprains among LEOs, as well as preventing multiple injury events.
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Background Research on occupational safety of law enforcement officers (LEOs) has primarily focused on fatal assaults. Nonfatal assaults, however, have received little attention. The goal of this study was to describe the situational contexts in which LEOs are assaulted, and compare these contexts and risks between fatal and nonfatal assaults in the U.S. Analyzing both types of assaults provides a more complete understanding of occupational safety and opportunities for intervention. Methods This study includes a descriptive epidemiology of fatal and nonfatal assaults of LEOs in the U.S. and a pooled cross-sectional analysis of risk factors contributing to the odds of lethal assault. Data were collected from the Law Enforcement Officers Killed and Assaulted database. Descriptive statistics were used to characterize fatal and nonfatal assaults. Odds ratios were generated to understand the odds that an assault would result in a fatality. ResultsBetween 1998 and 2013, there were 791 fatal assaults and 2,022 nonfatal assaults of LEOs. Nearly 60% of primary wounds in fatal assaults were received to the head, neck, or throat while nearly 50% of primary wounds in nonfatal assaults were received to the arms/hands or below the waist. The odds that an assault resulted in a fatality decreased by 57% (OR 0.43, 95% CI 0.32 to 0.58) when a LEO was wearing body armor. LEOs experiencing an ambush or unprovoked attack had significantly increased odds of an assault resulting in a fatality (OR 3.27, 95% CI 1.83 to 5.85 and OR 2.24, 95% CI 1.44 to 3.47 respectively). LEOs that were disarmed during an encounter with a suspect had more than 2-fold increased odds of an assault resulting in a fatality (OR 2.24, 95% CI 1.48 to 3.38). Conclusions There are specific situational and encounter characteristics that influence the lethality of an assault, which suggest strategies for prevention. Mandatory wear policies for the use of body armor could significantly reduce mortality among assaulted LEOs.
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Background: The pattern of law-enforcement related injuries of police and civilians in the US is unknown. Methods: Data were aggregated from the Federal Bureau of Investigations (FBI), the Bureau of Justice (BOJ) Statistics, the Centers for Disease Control (CDC) Web-based Injury Statistics Query and Reporting System (WISQARS), and the Nationwide Inpatient Sample (NIS) from 2003-2011. Law-enforcement related injuries in the CDC WISQARS and the NIS were identified using E codes 970-976, which are meant to identify "injuries inflicted by the police or other law-enforcing agents, including military on duty, in the course of arresting or attempting to arrest lawbreakers, suppressing disturbances, maintaining order, and other legal action". Results: The CDC reported a total of 715,118 non-fatal injuries and 3,156 fatal injuries from 2003 to 2011. In contrast, for the same time period, the NIS identified a total of 3,958 patients, ranging from 348 to 572 per year. Among the injured, 1,548 (48.0%) were whites, 866 were blacks (26.8%), and 605 were Hispanics (18.8%); and 1,011 patients (25.5%) were injured by firearms, while 2,304 (58.2%) suffered from blows or manhandling. Firearm-injured hospitalized patients are more likely to be males, blacks or Hispanics, and in the 18-39 age group. Conclusions: The majority of law-enforcement related injuries are among white or black young men. Hispanic patients are more likely to be injured by a firearm than struck. When categorized by firearm, white and black patients are more likely to die than Hispanic patients. Unfortunately, data about these injuries are scattered across multiple data systems. A uniform national system to aggregate these data sources is needed to better understand the scope of the problem, for both law enforcement personnel and civilians.
Article
Purpose: This study explored whether police departments have engaged in " de-policing " —withdrawal from active police work—in response to unprecedented levels of negative attention, as well as the correlates of changes in police behavior. Methods: Using data from 118 of the 121 police departments serving jurisdictions over 5000 residents in Missouri, we examined changes in both the quantity (rates of vehicle/traffic stops, searches, and arrests) and quality (" hit rates " from searches) of policing from 2014 to 2015 and whether de-policing corresponded with year-over-year changes in crime rates. Results: The findings revealed a − 0.11 standardized change in stops (around 67,000 fewer stops in 2015 than 2014) and a 0.17 standardized change in hit rates (nearly 2 percentage points). Multivariate models indicated that departments serving larger African-American populations conducted fewer stops (β = − 0.44), searches (β = −0.37), and arrests (β = −0.27) in 2015 compared to 2014, although race was unrelated to changes in hit rates. Changes in police behavior had no appreciable effect on total, violent, or property crime rates. Conclusions: The negative attention and increased scrutiny of law enforcement appears to have had an impact on traffic stops and hit rates in Missouri. Given the racialized findings, training and community-outreach programs should aim to increase mutual trust among the police and African-American communities. Also, increasing organizational justice within departments might be one way to improve officer morale and increase motivation in the current policing climate.
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Police agencies in the U.S. are currently facing a major legitimacy crisis resulting from a spate of high-profile use of force incidents, many involving minority citizens. Recent headlines emphasize that there is now a “war on cops” and that police officers are facing increasing levels of hostility and violence fueled by a growing anti-police sentiment. In the aftermath of events in Ferguson, Missouri in August 2014, some commentators claim that the number of police officers feloniously assaulted and killed in the line of duty has increased sharply. Using time series analysis of data from the Officer Down Memorial Page, we test whether events in Ferguson were associated with an increase in the number of police officers murdered in the line of duty. Our results provide no evidence for a “Ferguson Effect” on the number of U.S. police officers murdered in the line of duty as of March 2016.
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Although most police activities do not involve the use of force, those that do reflect important patterns of interaction between officer and citizen. After a brief survey of prior research, this study presents new data and findings to examine these patterns. The force factor applied and the sequential order of incidents of force is included in the analysis. The authors also examine police use of force from the suspect’s perspective, and create a new conceptual framework, the Authority Maintenance Theory, for examining and assessing police use of force.