Population-based estimate of trauma-related deaths for law enforcement personnel: Risks for death are higher and increasing over time

Alexander Eastman, Michael W Cripps, Kareem R AbdelFattah, Kenji Inaba, Thomas G. Weiser, David A. Spain, Kristan L. Staudenmayer

Research output: Contribution to journalArticle

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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.

Original languageEnglish (US)
JournalJournal of Trauma and Acute Care Surgery
DOIs
StateAccepted/In press - Apr 18 2017

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Law Enforcement
Mortality
Wounds and Injuries
Population
Confidence Intervals
Motor Vehicles
Homicide
Occupations
National Institute for Occupational Safety and Health (U.S.)
Program Development
Firearms
Police
Public Health

ASJC Scopus subject areas

  • Surgery
  • Critical Care and Intensive Care Medicine

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Population-based estimate of trauma-related deaths for law enforcement personnel : Risks for death are higher and increasing over time. / Eastman, Alexander; Cripps, Michael W; AbdelFattah, Kareem R; Inaba, Kenji; Weiser, Thomas G.; Spain, David A.; Staudenmayer, Kristan L.

In: Journal of Trauma and Acute Care Surgery, 18.04.2017.

Research output: Contribution to journalArticle

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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.",
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AU - Eastman, Alexander

AU - Cripps, Michael W

AU - AbdelFattah, Kareem R

AU - Inaba, Kenji

AU - Weiser, Thomas G.

AU - Spain, David A.

AU - Staudenmayer, Kristan L.

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N2 - 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.

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