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

Psychological stress and its consequences may interact with other factors in police work. Shift work is one example. Since the early 1900’s, Buffalo police officers have engaged in a practice called "doubling back", in which officers work 16 hour shifts within a 24 hour period. Many officers then engage in extra jobs during their off-duty time. Such a rapid disruption of the Circadian cycle may add to the risk of arteriosclerotic heart disease risk in younger officers. In addition, there is significant inter-individual variation in the ability to adapt and deterioration with increasing age. Previous work has shown a relationship between shift work and heart disease. Shift work may also affect officer’s dietary and exercise habits. The general nutrition of police officers in poor, lacking many of the nutrients found in fruits and vegetables. Officers have a tendency to consume high-fat "fast food" meals, and generally eat them unscheduled, sometimes between high stress police calls. During shifts, officers may not eat at all or eat at takeout restaurants. The lack of meaningful exercise is evident among police officers , and they have been found to have a high prevalence of arteriosclerotic heart disease risk due to poor physical fitness. In one study, 76% of officers had elevated cholesterol, 26% had elevated triglycerides, and 60% had elevated body fat. Other studies have shown that only police officers who exercised regularly had a lower 10-year risk of heart disease and were absent less from work. The present findings of significantly elevated colon cancer risk may also be the result of a complex interaction of stress, shift work, lack of exercise and poor dietary habits.

Our present findings of increased risk of lymphatic and hematopoietic cancers , especially Hodgkin’s disease and leukemia, suggest additional risk factors in police work. Psychological stress has been suggested as a risk factor in hematopoietic cancer , as well as exposure to chemical substances in the workplace. A study of Hodgkin’s disease in the U.S. Navy consisting of 2.3 million person-years reported that probable exposure to solvents and ionizing radiation may increase risk. Leukemia mortality risk has also been associated with occupational exposures to diesel fuels, benzene, and lead. Police officers are exposed on a daily basis to carbon monoxide from motor vehicles and chemicals on the highway and gun cleaning solvents which may contribute to arteriosclerotic heart and renal diseases. Exposure to lead has been implicated in cerebrovascular and other diseases, and high levels of lead in the blood have been found in police officers exposed to firearms, ammunition, and fingerprint powder. Cancer of the kidney also showed a significantly high risk in our present study. A study of urban policemen in Rome found a high risk of kidney cancer among motorcycle officers, and additional studies have found associations between occupational chemical exposure and kidney cancer.

Increased risk of hematopoietic and brain cancers found in the present study may be in part be a result of electromagnetic field exposure in police work. It is probable, however, that EMF exposure and several environmental carcinogens working together may lead to promotion of these cancers. Most police agencies engage in the widespread use of radio transmissions and radar. Police speed enforcement radar devices generate a continuous wave (CW) reference frequency in either X-band (10.525 Ghz) or in K-band (24.150 Ghz) and transmit nonionizing electromagnetic frequency. Davis and Mostifi found a significant increased risk for testicular cancer among police officers who reported use of hand-held radar units inside of the police vehicle. Violanti (unpublished study) found a 68% increased probability of cancer with increased exposure time to police radar . Officers were, on average, exposed to radar 74% of the time that they were enforcing speeding laws. Hand-held radar units (used inside the police vehicle) had significant associations with self-reported testicle, breast, and prostrate cancer.

There are limitations of the present study. Although the police occupation has been characterized by others as a high stress occupation, we had no measures of psychological stress among officers in our cohort. The retrospective design of this study allowed for evaluation of important factors of calendar year of employment, length of police service, year of initial employment, and age starting working. Our findings suggest that possible correlations to mortality exist among these factors, but they are difficult to disentangle. In addition, retrospective design limits data on confounding factors related to lifestyle such as alcohol use, smoking, social class, work conditions, and exposure to disease producing sources. Future studies of police mortality should include prospective identification of potential confounders which may affect the causal relationship between disease and occupation.

Although it is not possible to change the dangers inherent in police work, it is possible to change aspects which affect the long term health of officers. The present findings suggest that police officers are at significantly elevated risks for a number of diseases and appropriate interventions should be instituted. Elevated mortality risk of colon cancer and other digestive cancers , for example, indicates a need for earlier detection with stool tests or frequent medical examinations. Such medical examinations are lacking as part of work benefits in most police agencies. Elevated risk for cirrhosis, arteriosclerotic heart disease, and all malignant neoplasms combined are also diseases of concern. Prevention should emphasize management programs which include health education, physical exercise , smoking abatement, and dangers of alcohol use. The elevated risk of suicide among police officers in present study indicates the effect of a high stress work environment and perhaps the officer’s inability to adequately cope with stress. In addition to stress management and suicide awareness education, police officers should have confidential psychological services available to help them deal with such difficulties. Only one of five police agencies presently have such programs. Shift work is another possible factor related to long term health problems. Departments should consider arranging work shifts to optimally benefit officers in terms of proper sleep. Shifts, for example, should not be changed for at least 4-6 weeks at a time, as rapid shift changes exacerbate strain on the body.

Lastly, there is need for police departments to consider alternatives to police organizational structure which can produce much of the stress experienced by police officers. Officers report that approximately 90% of stress in their work is a result of a highly structured, unresponsive, uncaring administration. Changes should include allowing officers the opportunity to participate in decisions affecting their work, and a greater organizational awareness of problems at the street level.

No simple answers exist for prevention of disease in police work. The present study may help to understand correlates of the long term health effects of this occupation and provide a basis for future work. Return to Articles

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