A Profile of Injuries Sustained by Law Enforcement Officers: A Critical Review

The Association Between Fitness Test Scores and Musculoskeletal Injury in Police Officers

A police officer’s career is hazardous and physically demanding. In order to perform occupational tasks effectively and without injury, officers require adequate physical abilities. The aim of this study was to investigate the relationship between scores on several fitness tests and musculoskeletal injury in a group of municipal police officers. This retrospective study used existing data to examine the relationship between risk of injury and fitness test performance. Injured and uninjured police officers scored significantly differently on several fitness measures. A multivariate regression indicated that a combination of age, sex, number of pull ups completed and maximal oxygen consumption (VO_2max) best explained injury risk. Additionally, the findings indicated an interaction between sex and VO_2max, and so the effect of VO_2max on injury risk cannot be understood without accounting for sex.

Factors associated with civilian and police officer injury during 10 years of officer-involved shooting incidents

BACKGROUND

Previous officer-involved shooting (OIS) research has focused primarily on antecedents to fatal shootings, with few studies investigating injury more broadly. Our study examined the factors associated with fatal or non-fatal injury to both civilians and officers during OIS incidents, to better understand how harm might be reduced in the most extreme law enforcement scenarios.

METHODS

Data included 281 officers involved in 177 unique shooting incidents recorded by Dallas Police Department between 2005 and 2015. Bivariate logistic regression and multivariable generalised estimation equation analyses were used to investigate incident characteristics associated with fatal or non-fatal injury to civilians and officers.

RESULTS

Civilian injury occurred in 61% and officer injury in 14% of unique OIS incidents. In adjusted models, multiple shooting officers increased the odds of injury to both civilians (adjusted OR (AOR): 3.22, 95% CI 1.39 to 7.50) and officers (AOR 4.73, 95% CI 1.64 to 13.65). Odds of civilian injury were also significantly higher during the daytime and among non-Hispanic white compared with non-Hispanic black and Hispanic/Latina/o civilians, although a majority of OIS incidents (79%) involved non-Hispanic black or Hispanic/Latino/a civilians. Odds of officer injury were significantly higher for detectives compared with patrol (AOR=9.32, 95% CI 1.85 to 47.03) and during off-duty versus on-duty shootings (AOR=5.23, 95% CI 1.37 to 19.99).

CONCLUSIONS

Both civilians and officers are at risk for injury during OIS incidents, though to different degrees and with unique risk factors. Additional research is needed to understand whether these results are replicated elsewhere and to further understand the mechanisms of injury.

A Profile of Injuries Sustained by Firefighters: A Critical Review

Firefighters, along with other tactical personnel, are at a high risk of work-related physical injury above that of the private sector. The aim of this critical narrative review was to identify, critically appraise and synthesise key findings from recent literature investigating firefighting musculoskeletal injuries to inform injury reduction programs. The methodological approach (search terms, databases, etc.) was registered with PROSPERO and reported following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Study quality was assessed using the Downs and Black checklist with scores graded according to the Kennelly grading system. Levels of evidence were ranked according to the Australian National Health and Medical Research Council. Of the 8231 studies identified, 17 met the criteria for inclusion. The methodological quality of the studies was ‘fair’ with a level of evidence of III-2. Reported injury rates ranged from 9% to 74% with the lower extremities and back the leading aggregated bodily sites of injury. Sprains and strains were the leading nature of musculoskeletal injury, often caused by slips, trips and falls, although muscle bending, lifting and squatting or muscle stressing were also prevalent. This review may inform injury reduction strategies and given that injuries reported in firefighters are similar to those of other tactical populations, safety processes to mitigate injuries may be of benefit across the tactical spectrum.

Relationships Between Motor Proficiency and Academic Performance in Mathematics and Reading in School-Aged Children and Adolescents: A Systematic Review

Positive associations exist between physical activity, cognition, and academic performance in children and adolescents. Further research is required to examine which factors underpin the relationships between physical activity and academic performance. This systematic review aimed to identify, critically appraise, and synthesize findings of studies examining relationships between motor proficiency and academic performance in mathematics and reading in typically developing school-aged children and adolescents. A systematic search of electronic databases was performed to identify relevant studies. Fifty-five eligible articles were critically appraised and key data was extracted and synthesized. Findings support associations between several components of motor proficiency and academic performance in mathematics and reading. There was evidence that fine motor proficiency was significantly and positively associated with academic performance in mathematics and reading, particularly during the early years of school. Significant positive associations were also evident between academic performance and components of gross motor proficiency, specifically speed and agility, upper-limb coordination, and total gross motor scores. Preliminary evidence from a small number of experimental studies suggests motor skill interventions in primary school settings may have a positive impact on academic performance in mathematics and/or reading. Future research should include more robust study designs to explore more extensively the impact of motor skill interventions on academic performance.

A Comparison of Aerobic Fitness Testing on a Swim Bench and Treadmill in a Recreational Surfing Cohort: A Pilot Study

The intermittent manner of surfing accentuates the importance of both the aerobic and anaerobic energy systems. Currently, the optimal method of assessing surfing-specific aerobic fitness is using a swim bench (SWB) ergometer; however, their limited availability presents a barrier to surfers wanting to know their maximal aerobic power (VO_2peak). As a result, the aims of this pilot study were to determine the VO_2peak of recreational surfers using a new commercial SWB ergometer and to propose and examine the feasibility of a regression model to predict SWB ergometer VO_2peak values. A total of nine recreational surfers were assessed where body measurements were conducted followed by maximal aerobic capacity testing (swim bench and treadmill) to profile the cohort. Findings demonstrated that VO_2peak values were significantly greater (p < 0.001) on the treadmill compared to the SWB ergometer (M = 66.01 ± 8.23 vs. 37.41 ± 8.73 mL/kg/min). Peak heart rate was also significantly greater on the treadmill compared to the SWB ergometer. Multiple regression analysis was used to produce a model which predicted SWB VO_2peak values with an R² value of 0.863 and an adjusted R² value of 0.726. The physiological profiling of the recreational cohort coupled with a surfer’s predicted SWB VO_2peak value will allow for identification of surfing-specific aerobic fitness levels and evidence-based training recommendations.

Nonfatal Injuries to Law Enforcement Officers: A Rise in Assaults

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.

Anxiety-related psychopathology and chronic pain comorbidity among public safety personnel

Canadian Public Safety Personnel (PSP; e.g., correctional service officers, dispatchers, firefighters, paramedics, police officers) regularly experience potentially traumatic, painful, and injurious events. Such exposures increase risk for developing mental disorders and chronic pain, which both involve substantial personal and social costs. The interrelationship between mental disorders and chronic pain is well-established, and both can be mutually maintaining; accordingly, understanding the relationship between mental health and chronic pain among PSP is important for improving health care. Unfortunately, the available research on such comorbidity for PSP is sparse. The current study was designed to provide initial estimates of comorbidities between mental disorders and chronic pain across diverse PSP. Participants included 5093 PSP (32% women) in six categories (i.e., Call Center Operators/Dispatchers, Correctional Workers, Firefighters, Municipal/Provincial Police, Paramedics, Royal Canadian Mounted Police) who participated in a large PSP mental health survey. The survey included established self-report measures for mental disorders and chronic pain. In the total sample, 23.1% of respondents self-reported clinically significant comorbid concerns with both mental disorders and chronic pain. The results indicated PSP who reported chronic pain were significantly more likely to screen positive for posttraumatic stress disorder (PTSD), major depressive disorder, generalized anxiety disorder, social anxiety disorder, and alcohol use disorder. There were differences between PSP categories; but, the most consistent indications of comorbidity were for chronic pain, PTSD, and major depressive disorder. Comorbidity between chronic pain and mental disorders among PSP is prevalent. Health care providers should regularly assess PSP for both symptom domains.

A Comparison of Military and Law Enforcement Body Armour

Law-enforcement officers increasingly wear body armour for protection; wearing body armour is common practice in military populations. Law-enforcement and military occupational demands are vastly different and military-styled body armour may not be suitable for law-enforcement. This study investigated differences between selected military body armour (MBA: 6.4 kg) and law-enforcement body armour (LEBA: 2.1 kg) in impacts on postural sway, vertical jump, agility, a functional movement screen (FMS), task simulations (vehicle exit; victim recovery), and subjective measures. Ten volunteer police officers (six females, four males) were randomly allocated to one of the designs on each of two days. Body armour type did not significantly affect postural sway, vertical jump, vehicle exit and 5 m sprint times, or victim recovery times. Both armour types increased sway velocity and sway-path length in the final five seconds compared to the first 5 s of a balance task. The MBA was associated with significantly slower times to complete the agility task, poorer FMS total scores, and poorer subjective ratings of performance and comfort. The LEBA was perceived as more comfortable and received more positive performance ratings during the agility test and task simulations. The impacts of MBA and LEBA differed significantly and they should not be considered interchangeable.

High-intensity interval training versus moderate-intensity continuous training within cardiac rehabilitation: a systematic review and meta-analysis

BACKGROUND

Aerobic capacity has been shown to be inversely proportionate to cardiovascular mortality and morbidity and there is growing evidence that high-intensity interval training (HIIT) appears to be more effective than moderate-intensity continuous training (MICT) in improving cardiorespiratory fitness within the cardiac population. Previously published systematic reviews in cardiovascular disease have neither investigated the effect that the number of weeks of intervention has on cardiorespiratory fitness changes, nor have adverse events been collated.

OBJECTIVE

We aimed to undertake a systematic review and meta-analysis of randomized controlled trials (RCTs) within the cardiac population that investigated cardiorespiratory fitness changes resulting from HIIT versus MICT and to collate adverse events.

METHODS

A critical narrative synthesis and meta-analysis was conducted after systematically searching relevant databases up to July 2017. We searched for RCTs that compared cardiorespiratory fitness changes resulting from HIIT versus MICT interventions within the cardiac population.

RESULTS

Seventeen studies, involving 953 participants (465 for HIIT and 488 for MICT) were included in the analysis. HIIT was significantly superior to MICT in improving cardiorespiratory fitness overall (SMD 0.34 mL/kg/min; 95% confidence interval [CI; 0.2-0.48]; p<0.00001; I2=28%). There were no deaths or cardiac events requiring hospitalization reported in any study during training. Overall, there were more adverse events reported as a result of the MICT (n=14) intervention than the HIIT intervention (n=9). However, some adverse events (n=5) were not classified by intervention group.

CONCLUSION

HIIT is superior to MICT in improving cardiorespiratory fitness in participants of cardiac rehabilitation (CR). Improvements in cardiorespiratory fitness are significant for CR programs of >6-week duration. Programs of 7-12 weeks' duration resulted in the largest improvements in cardiorespiratory fitness for patients with coronary artery disease. HIIT appears to be as safe as MICT for CR participants.

The Impact of Load Carriage on Measures of Power and Agility in Tactical Occupations: A Critical Review

The current literature suggests that load carriage can impact on a tactical officer’s mobility, and that survival in the field may rely on the officer’s mobility. The ability for humans to generate power and agility is critical for performance of the high-intensity movements required in the field of duty. The aims of this review were to critically examine the literature investigating the impacts of load carriage on measures of power and agility and to synthesize the findings. The authors completed a search of the literature using key search terms in four databases. After relevant studies were located using strict inclusion and exclusion criteria, the studies were critically appraised using the Downs and Black Checklist and relevant data were extracted and tabled. Fourteen studies were deemed relevant for this review, ranging in percentage quality scores from 42.85% to 71.43%. Outcome measures used in these studies to indicate levels of power and agility included short-distance sprints, vertical jumps, and agility runs, among others. Performance of both power and agility was shown to decrease when tactical load was added to the participants. This suggests that the increase in weight carried by tactical officers may put this population at risk of injury or fatality in the line of duty.

Mental Health of the Prison Medical Workers (PMWs) and Influencing Factors in Jiangxi, China

Prison medical workers (PMWs) are critically important, but they are also vulnerable to psychological problems. Currently, there is no study on examining PMWs' mental health conditions and possible influencing factors in China. Hence, we conducted this cross-sectional survey, aiming to understand the mental health status of the PMWs and related impact factors in Jiangxi province of China. We employed the Chinese version of the Symptom Checklist-90-R (SCL-90-R) to assess the mental disorders and psychological health conditions of PMWs in Jiangxi. The t tests were used to compare the differences for the average score of SCL-90-R between the Chinese general population and targeted PMWs of this study. Multivariable logistic regression analyses were conducted to identify the main factors associated with overall detection rate of PMWs' psychological health conditions. The scores of four dimensions (somatization, obsessive-compulsive symptoms, anxiety, and paranoid ideation) were significantly higher than the Chinese national norm, and the total positive rate was 49.09% among the PMWs. Gender, marital status, age, and length of employment are identified to be the most significant predictors to affect PMWs' mental health. Positive correlations between each of the nine dimensions of the SCL-90-R have been verified. This study demonstrated for the first time that PMWs are facing mental health risk and suffering serious psychological problems with psychopathology symptoms, which has become a growing concern in China. Our current findings suggest a need for more in-depth studies on this subject going forward to validate our conclusions and also to identify more impact factors, since such studies and knowledge of PMWs' mental health and influencing factors are very limited in China.