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Journal Article

Citation

Eastman AL, Cripps MW, AbdelFattah KR, Inaba K, Weiser TG, Spain DA, Staudenmayer KL. J. Trauma Acute Care Surg. 2017; 83(2): 237-240.

Affiliation

1 The University of Texas Southwestern Medical Center and The Rees-Jones Trauma Center at Parkland, Dallas, Texas 2 The University of Southern California Keck School of Medicine & the LAC+USC Trauma Center, Los Angeles, California 3 Stanford University, Department of Surgery, Section Trauma and Acute Care Surgery, Stanford, CA.

Copyright

(Copyright © 2017, Lippincott Williams and Wilkins)

DOI

10.1097/TA.0000000000001528

PMID

28422921

Abstract

OBJECTIVE: Trauma-related deaths remain an important public health problem. One group susceptible to death due to traumatic mechanisms is U.S. Law Enforcement (LE). We hypothesized that LE officers experienced a higher chance of violent death compared to the general U.S. population and that risks have increased over time.

METHODS: The National Institute on Occupational Safety and Health (NIOSH) National Occupational Mortality Surveillance (NOMS) is a population-based survey of occupational deaths. It includes data for workers who died during 1985-1998 in one of 30 U.S states (EARLY period). Additional deaths were added from 23 U.S. states in 1999, 2003-2004, 2007-2010 (LATE period). Mortality rates are estimated by calculating proportionate mortality ratios (PMR). A PMR above 100 is considered to exceed the average background risk for all occupations. All adults >18 years of age whose primary occupation was listed as "Law Enforcement Worker" were included in the analysis.

RESULTS: Law enforcement personnel were more likely to die from an injury compared to the general population (Figure 1). The overall PMR for injury in EARLY was 111 (95% Confidence Interval [CI] 108-114, p<0.01), and for LATE was 118 (95% CI 110-127, p<0.01). Four mechanisms of death reached statistical significance: motor vehicle traffic (MVT)-driver, MVT-other, intentional self-harm, and assault/homicide. The highest PMR in EARLY was associated with firearms (PMR 272, 95% CI 207-350, p<0.01). The highest PMR in LATE was associated with death due to being a driver in an MVT (PMR 194, 95% CI 169-222, p<0.01). There were differences in risk of death by race and gender. White females had the highest PMR due to Assault and Homicide (PMR 317, 95% CI 164-554, p<0.01). All groups had similar risks of death due to Intentional Self-Harm (PMR 130-171).

CONCLUSIONS: The risk of death for US LEOs is high and increasing over time, suggesting an at-risk population that requires further interventions. Targeted efforts based on risk factors, such as gender and race, may assist with the development of prevention programs for this population.


Language: en

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