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. 2014 Nov 18:349:g6534.
doi: 10.1136/bmj.g6534.

Law enforcement duties and sudden cardiac death among police officers in United States: case distribution study

Vasileia Varvarigou  1 , Andrea Farioli  2 , Maria Korre  3 , Sho Sato  4 , Issa J Dahabreh  5 , Stefanos N Kales  6
Affiliations

Law enforcement duties and sudden cardiac death among police officers in United States: case distribution study

Vasileia Varvarigou et al. BMJ. .

Abstract

Objective: To assess the association between risk of sudden cardiac death and stressful law enforcement duties compared with routine/non-emergency duties.

Design: Case distribution study (case series with survey information on referent exposures).

Setting: United States law enforcement.

Participants: Summaries of deaths of over 4500 US police officers provided by the National Law Enforcement Officers Memorial Fund and the Officer Down Memorial Page from 1984 to 2010.

Main outcome measures: Observed and expected sudden cardiac death counts and relative risks for sudden cardiac death events during specific strenuous duties versus routine/non-emergency activities. Independent estimates of the proportion of time that police officers spend across various law enforcement duties obtained from surveys of police chiefs and front line officers. Impact of varying exposure assessments, covariates, and missing cases in sensitivity and stability analyses.

Results: 441 sudden cardiac deaths were observed during the study period. Sudden cardiac death was associated with restraints/altercations (25%, n=108), physical training (20%, n=88), pursuits of suspects (12%, n=53), medical/rescue operations (8%, n=34), routine duties (23%, n=101), and other activities (11%, n=57). Compared with routine/non-emergency activities, the risk of sudden cardiac death was 34-69 times higher during restraints/altercations, 32-51 times higher during pursuits, 20-23 times higher during physical training, and 6-9 times higher during medical/rescue operations. Results were robust to all sensitivity and stability analyses.

Conclusions: Stressful law enforcement duties are associated with a risk of sudden cardiac death that is markedly higher than the risk during routine/non-emergency duties. Restraints/altercations and pursuits are associated with the greatest risk. Our findings have public health implications and suggest that primary and secondary cardiovascular prevention efforts are needed among law enforcement officers.

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Conflict of interest statement

Competing interests: All authors have completed the ICMJE uniform disclosure form and declare that SNK served as paid expert witness, independent medical examiner, or both, in workers’ compensation and disability cases, including cases involving law enforcement.

Figures

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Fig 1 Review of police fatality databases and selection of cases of sudden cardiac death leading to final study population
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Fig 2 Incidence rates of sudden cardiac death among male law enforcement officers (1989-2010), by age and type of duty
See this image and copyright information in PMC

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References

    1. U.S Department of Labor BLS. The Editor’s Desk, How risky is police work? 2012. www.bls.gov/opub/ted/1999/jun/wk5/art05.htm.
    1. Tiesman HM, Swedler DI, Konda S, Pollack KM. Fatal occupational injuries among U.S. law enforcement officers: a comparison of national surveillance systems. Am J Ind Med 2013;56:693-700. - PubMed
    1. Zimmerman FH. Cardiovascular disease and risk factors in law enforcement personnel: a comprehensive review. Cardiol Rev 2012;20:159-66. - PubMed
    1. Johnson K. Fatal heart attacks among law enforcement officers have been mounting, many striking victims younger than 50 years old, prompting plans for wellness initiatives. USA TODAY 29 July 2013.
    1. National Occuparional Research Agenda. CDC, 2014. www.cdc.gov/niosh/nora/.

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