By Tom LaTourrette, PhD, Senior Physical Scientist, RAND Corporation, Santa Monica, California

rom 2000 to 2009, an average of 141 police officers in the United States died each year from injuries sustained in the line of duty (excluding job-related illnesses and 72 deaths as a result of the 9/11 attacks).¹ For an average workforce of 913,000 police, detectives, and first-line supervisors over this time period,² this translates to a fatality rate of 15 workers per 100,000 workers. Although the rate has been decreasing over time, it is nonetheless nearly four times greater than for the average American worker.³ Statistics for injuries are less readily available, but estimates suggest that 100,000 police officers experience occupational injuries or illnesses each year.⁴ This similarly represents a rate two to three times the national average.⁵ These statistics suggest that protecting the safety and health of police officers warrants greater attention. This article reviews RAND Corporation research on police officer safety and health and provides some recommendations for improving police officer safety and health protection efforts.

Hazards Faced by Police Officers and the Injuries They Cause

The first step in improving police officer safety and health is to understand the range of safety and health hazards police face in the line of duty. The spectrum of hazards can be estimated from casualty statistics and in-depth discussions with police department representatives.⁶

Some of the most important hazards police face are assaults, vehicle crashes, being struck by vehicles, stress, overexertion, and falls. Police are also concerned about exposure to infectious diseases, exposure to chemicals involved in illegal drug manufacture, and terrorist attacks. In addition to these primary hazards, police are exposed to a wide range of less common hazards by virtue of the wide range of situations they encounter. This is exacerbated by the fact that police are often the first on the scene of an emergency or incident, and therefore have the least amount of advance information about the scene’s potential hazards. For this reason, police have sometimes been referred to as blue canaries, meaning that their injuries can act as a warning to subsequent responders about an unknown hazard.

One can characterize the relative importance of different safety and health concerns in a few different ways. Table 1 distinguishes leading hazards from 1997 to 2006, according to their contribution to fatal injuries, nonfatal injuries, and lost work time, as well as the activities most commonly engaged in when those injuries occurred.⁷ These statistics are gleaned from national survey databases and a sample of California public safety workers.

Table 1. Classification of Safety and Health Priorities
	Fatal Injuries	Nonfatal Injuries	Lost Work Time
Leading Causes and Percentage of Category Attributable to Each Cause	Assaults (38 percent); vehicle crashes (37 percent)	Strains and sprains (64 percent, 42 percent of which are back injuries)	Strains and sprains (63 percent, 33 percent of which are back injuries)
Leading Activities Associated with Each Cause	Driving (37 percent); traffic stops and traffic-related activities (18 percent)	Driving (16 percent); traffic stops and traffic-related activities (11 percent)

In looking at the first row of table 1, the first column shows that vehicle crashes and assaults together account for 75 percent of all police fatalities. Nearly all (94 percent) fatal assaults are shootings, such that shootings account for 35 percent of all police fatalities. The second and third columns show that strains and sprains, particularly those to the back, are the most common types of nonfatal injuries and contribute the most towards lost work time. The causes of these injuries are diverse, but one common cause is trips and falls, particularly during foot pursuits. Officers are at increased risk for falls when pursuing suspects, particularly over uneven surfaces, fences, and other obstacles. Back injuries may be associated with extended driving and with the weight and ergonomic impacts of equipment belts and body armor. The second row in table 1 shows that driving is the most dangerous activity police engage in, with the greatest fraction of both fatal and nonfatal injuries resulting from vehicle crashes. Traffic stops, directing traffic, assisting motorists, and other activities conducted outside the vehicle near traffic are also high-risk activities, primarily because they make officers vulnerable to assaults and to being hit by vehicles.

Protection Efforts

A number of factors influence the design and effectiveness of safety and health protection efforts for police. Some important considerations are the extent to which protection efforts address the greatest risks, the extent to which they are effective at reducing those risks, and constraints on their design and implementation imposed by job performance requirements.

The preferred approach to worker safety is to use passive engineering solutions to reduce the risks in the workplace environment. However, because police work exists primarily outside of controllable environments, opportunities for this approach are limited. Vehicle safety technologies, such as air bags and seat belts, represent one opportunity for engineering controls in the police work environment.

The second-best approach for worker safety is personal protective equipment, the most obvious example in police work being body armor. And, as noted, police officers face a wide range of hazards and often have limited information about protection needs.

Beyond targeted engineering controls and personal protective equipment, safety and health protection for police has a broad focus, encompassing training, education, physical fitness, wellness, self-defense, and limiting off-duty workloads.

As for targeting the most important safety and health risks, the findings summarized in Table 1 can help guide the design and prioritization of safety and health protection efforts for police. The fatality data indicate a clear need to focus on vehicle safety and assault protection. Consistent with these results, protection efforts place a high priority on these risks.

Vehicle safety is addressed in several ways. Police departments praise the benefits of specialized emergency vehicle operations training programs. Vehicle pursuit policies nationwide have become more restrictive in recent years. The design and placement of equipment mounted inside vehicles is also being improved to enhance safety. However, anecdotal evidence suggests that the greatest improvement in vehicle safety could be achieved with the most basic of methods: the increased use of seat belts. RAND lacks sufficient data on seat belt use or on the association between seat belt use and injuries among police, but police representatives contacted often note that enforcement of seat belt policies is lax and compliance is low. This problem is not limited to police: more than three-quarters of the firefighters killed in vehicle accidents in the last 30 years were known to be not wearing a seat belt.⁸ If compliance among police is similar to that among fire service workers, this represents a major safety and health gap—the leading cause of police fatalities is not being effectively addressed, despite the availability of an effective, low-cost solution.

Police are also acutely aware of the risk of assaults and several lines of protection exist, including verbal de-escalation techniques, self-defense training, less-lethal weapons, and body armor. Given that almost all fatal assaults are shootings, protective body armor remains the primary protection method. Thanks to technical advances leading to increased comfort and wearability, ardent promotional efforts, and federal grant funding, body armor use continues to increase. Still, a quarter of the police in the United States are not required to wear armor under any circumstances. ⁹ RAND’s recent work shows that an officer shot in the torso is 3.4 times more likely to survive when wearing body armor. It also finds that the benefit of extending armor use to all police far exceeds the cost.¹⁰ Given that 35 percent of police officer deaths result from shootings, continuing to increase the use of body armor is an important goal. An important, unanswered question is whether officers without armor are killed primarily because they work in departments that do not require armor, or because they are not wearing armor in departments that require armor use. In other words, should efforts to increase armor use focus on increasing armor deployment or compliance?

When considered from the perspective of the frequency of occurrence or amount of lost work time, strains and sprains are the predominant injuries to police. We know little about the causes of these injuries, making it difficult to design safety and health protection efforts targeting them. Specific causes and possible interventions may be identified through systematic analysis of incident data and sharing of lessons learned. Some departments have implemented intradepartmental information sharing efforts to understand the potential safety and health implications of particular actions or situations and to help identify new hazards. In general, however, strains and sprains arise from a wide variety of causes, making it difficult to design interventions specifically targeting this type of injury. An increasing emphasis in public safety on wellness, particularly on maintaining a healthy body weight and staying physically fit, may have a beneficial effect. Recent studies have shown strong associations between obesity, the probability of sustaining an injury, and the frequency and cost of workers’ compensation claims.¹¹

Protection efforts can also be designed around activities that pose the greatest safety and health risks. The most hazardous types of duty are driving and engaging in activities outside of vehicles in traffic. Driving results in vehicle crashes, as discussed earlier. Working in and around vehicle traffic is another dangerous activity. The Law Enforcement Stops and Safety Subcommittee (LESSS) addresses this risk through conducting surveys, compiling research results, and sharing best practices through roll-call videos and other channels. Efforts focus on improving safety through vehicle design, policies and procedures, and highway and environment design.¹²

Observations for Moving Forward

Much more progress can be made. Analysis of injury and fatality data coupled with in-depth discussions with law enforcement representatives provides some helpful insights regarding police officer safety and health. The principal causes of death for police—vehicle crashes and assaults—are being aggressively addressed, and many important gains have been made. While the returns on continued efforts may be decreasing, the solutions—particularly the increased use of seat belts and body armor—are effective and affordable, and, hence, continued efforts are demonstrably worthwhile.

More information about the proximal and distal causes of less severe injuries, primarily strains and sprains, is needed to design effective interventions for these injuries. Evidence is emerging that weight and fitness, which have traditionally been associated with cardiovascular risks, may be important factors in acute musculoskeletal injuries as well. More data on the association between physical fitness and injuries will help determine the extent to which increased attention to officer wellness might be warranted.

Prevention of work-related illness for police has received little attention. While it is known that police and other workers with high exposures to vehicle exhaust have increased risks of respiratory disease and cancer, little has been done to address these risks. More data are needed to help establish baseline exposures and assess possible exposure reduction strategies. Mental health is another area in which risks among police are known to be elevated, yet for which little progress has been made in developing effective interventions.

Another potentially productive avenue for improving police safety and health is improving national-scale initiatives to increase safety and health awareness and education. The fire service maintains several high-profile national campaigns emphasizing safety and health, which provide guidance, increase awareness, and send a clear message about the priority of firefighter safety and health. Law enforcement, in contrast, has far fewer national programs targeting worker safety and health, contributing to a perception that safety and health are lesser concerns or that they are individual rather than service-wide responsibilities. ?

Notes:

¹“Causes of Law Enforcement Deaths,” National Law Enforcement Officers Memorial Fund, http://www.nleomf.org/facts/officer-fatalities-data/causes.html (accessed February 5, 2011).
²Employment and Earnings (Bureau of Labor Statistics, U.S. Department of Labor, January 2010), 205–211, table 11. Employed Persons by Detailed Occupation, Sex, Race, and Hispanic or Latino Ethnicity, http://www.bls.gov/cps/cpsa2009.pdf (accessed February 7, 2011).
³“Number of Fatal Work Injuries, 1992–2009,” U.S. Bureau of Labor Statistics, U.S. Department of Labor, http://www.bls.gov/iif/oshwc/cfoi/cfch0008.pdf (accessed February 7, 2011).
⁴Ari N. Houser, Brian A. Jackson, James T. Bartis, and D. J. Peterson, Emergency Responder Injuries and Fatalities: An Analysis of Surveillance Data (Santa Monica, Calif.: RAND Corporation, 2008), http://www.rand.org/content/dam/rand/pubs/technical_reports/2005/RAND_TR100.pdf (accessed February 5, 2011).
⁵2009 Survey of Occupational Injuries and Illnesses, Summary Estimates Charts Package (U.S. Bureau of Labor Statistics, U.S. Department of Labor, October 21, 2010) http://www.bls.gov/iif/oshwc/osh/os/osch0042.pdf (accessed February 7, 2011).
⁶Tom LaTourrette, David S. Loughran, and Seth A. Seabury, Occupational Safety and Health for Public Safety Employees: Assessing the Evidence and the Implications for Public Safety (Santa Monica, Calif.: RAND Corporation, 2008), http://www.rand.org/content/dam/rand/pubs/monographs/2008/RAND_MG792.pdf (accessed February 1, 2011); and Tom LaTourrette, D.J. Peterson, James T. Bartis, Brian A. Jackson, and Ari Houser, Protecting Emergency Responders, Volume 2: Community Views of Safety and Health Risks and Personal Protection Needs (Santa Monica, Calif.: RAND Corporation, 2003), http://www.rand.org/content/dam/rand/pubs/monograph_reports/2005/MR1646.pdf (accessed February 1, 2011).
⁷Adapted from Tom LaTourette et al., Occupational Safety and Health for Public Safety Employees.
⁸Rita F. Fahy, Paul R. LeBlanc, and Joseph L. Molis, What’s Changed over the Past 30 Years? (Quincy, Mass.: National Fire Protection Association, June 2007), http://www.nfpa.org/assets/files/PDF/whatschanged.pdf (accessed February 1, 2011).
⁹Matthew J. Hickman and Brian A. Reaves, Local Police Departments, 2003, NCJ 210118 (Washington, D.C.: Bureau of Justice Statistics, May 2006), http://www.bjs.ojp.usdoj.gov/content/pub/pdf/lpd03.pdf (accessed February 1, 2011).
¹⁰Tom LaTourrette, “The Life-Saving Effectiveness of Body Armor for Police Officers,” The Journal of Occupational and Environmental Hygiene 7, no. 10 (October 2010): 557-562.
¹¹See references in Tom LaTourette et al., Occupational Safety and Health for Public Safety Employees, 116–125.
¹²For information on LESSS, visit http://www.theiacp.org, click Membership, then click Committees, and scroll down to Law Enforcement Stops and Safety Subcommittee.

Please cite as:

Tom LaTourrette, "Safety and Health Protection Efforts in the Police Service," The Police Chief 78 (June 2011): 74–78.

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