Dying from the Job: The Mortality Risk for Police Officers
by John M. Violanti, PhD

There are an estimated 623,000 sworn police officers employed in the United States, yet few studies of long term health risks have been conducted. It has been argued that police officers are at increased risk for mortality as a result of their occupation. The average age of death for police officer in our 40-year study was 66 years of age.

Our findings provide some insight on associations between police work and long term disease outcome. The police profession is portrayed as a job replete with psychological stress, danger, rotating shifts, family disruption, and exposure to noxious materials. Studies have suggested that the high psychological stress of police work may be one factor which plays a role in the etiology of disease. Some of our findings may hold true within the context of the stress-disease hypothesis. For example, younger officers under conditions of high stress and other risk factors may be at higher risk for arteriosclerotic heart disease.

Psychological stress may also be a catalyst for malignancy at selected sites. Stress is believed to be mediated immunologically and may lead to the onset of cancer. Our findings indicated a significantly elevated mortality risk for all malignant neoplasms in police officers. Specifically, we found a significantly increased risk of all digestive and hematopoietic cancers among officers employed 10-19 years. These findings are consistent with other studies of police mortality and with the hypotheses of a stress-cancer relationship. Interestingly, our previous research found that police officers between 10-19 years of service reported the highest stress scores.

Stress in police work may also lead to maladaptive behaviors which, it turn, may precipitate disease. Alcohol and tobacco use are examples. Twenty-five percent of police officers have been found to be dependent on alcohol, and a significantly strong positive relationship was found between stress and alcohol use among police. Alcohol is an important problem in police work, and may lead to other work problems such as high absenteeism, intoxication on duty, complaints by supervisors and citizens of misconduct on duty, traffic accidents, and an overall decrease in work performance. Alcohol use among police may be underestimated. Many officers, fearing departmental discipline, are unwilling to officially report their dependence. Other departments may "hide" problem drinkers in positions where they will not adversely affect police operations. In addition, approximately 40% of police officers smoke cigarettes. Our present findings indicated that officers have a significantly high mortality risk for esophageal cancer, which has been related to alcohol use and smoking. Also evident in our cohort was the significantly elevated risk of cirrhosis of the liver among officers, a disease which has been related to alcohol use. With the exception of 1-9 years of police service, cirrhosis of the liver was elevated across all years of service categories and had a 3.3-fold mortality risk for officers with over 30 years service.

Suicide is a disturbing maladaptive behavior which may be related to stress. The significantly high suicide risk among police officers in our study denotes the possibility that chronic job stress may lead to emotional numbing in officers and make death easier to accept as a coping solution. Other epidemiological studies which include police also point to a higher risk of suicide for officers. Several population studies have reported police suicide rates to be higher than other occupations. Another reason for the high suicide rate may be the availability and knowledge of firearms. Approximately 95% of all police suicide involve the use of a firearm. The police have a higher rate of firearm suicide than other groups who work with firearms. The military is one example. Although the most common method of suicide in the military is by firearm, approximately 59% of military personnel suicides compared to 95% of police officer suicides used a firearm. The police also have a higher rate of suicide by firearms than persons who possess guns in their home, where approximately 58% of all suicides were committed with a firearm. 92 Alcohol use has also been found to be a factor in suicide, and police use of alcohol may be precipitated by stress. A Chicago police department study documented alcohol abuse in 60% of police officer suicides.

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