Surviving law enforcement

Not all danger is on the street


     On any shift, police officers may be expected to shoot someone, be shot at, see a partner killed, use force to resist a physical attack, rescue a battered child, participate in a high-speed chase, and inform a parent that his or her child has been killed in a traffic accident. It's a small wonder that police officers are twice as likely to die by their own hand than by that of an assailant.

     Suicide is not the only adverse outcome to result from police work. The pressures of law enforcement also put officers' physical and mental health at risk. The University of Buffalo (UB) conducted a long-term study that followed more than 400 police officers. Results showed that officers over the age of 40 have a higher 10-year risk of a coronary event than the national average. It went on to illustrate 72 percent of female officers and 43 percent of male officers have higher than recommended cholesterol levels, and police as a group have higher than average pulse rates and diastolic blood pressure.

     "Policing is psychologically stressful work, filled with danger, high demands, human misery and exposure to death," says John Violanti, a professor in the UB department of social and preventative medicine. Violanti is himself a 23-year veteran of the New York State Police.

     Violanti hopes his work, called the Buffalo Cardio-Metabolic Occupational Police Stress (or BCOPS) study, may lead to police department-centered interventions to reduce the risk of stress-related disease among police. Violanti used measures of cortisol, also called the "stress hormone," to determine how stress is associated with physiological risk factors that can lead to serious health problems such as diabetes and cardiovascular disease.

     Other studies have shown that when cortisol becomes dysregulated due to chronic stress, a person is more likely to become ill. The body becomes physiologically unbalanced, organs are attacked, and the immune system is compromised. "That's what stress does to us," notes Violanti.

     BCOPS' two most recent segments report on the effect of shift work on stress and suicide risk in police, and on male/female differences in stress and signs of cardiovascular disease.

High plains shifter

     Results of the shift work study, involving 115 randomly selected officers, showed that suicidal thoughts were higher in women working the day shift, and in men working swing and graveyard shifts. Data showed that nearly twice as many male officers (23 percent) and female officers (25 percent) reported suicidal thoughts than the general population (13 percent).

     Violanti says the results that women working day shifts were more likely to experience depression and suicide ideation, while the finding in men working the afternoon and night shift were related to PTSD and depression, were surprising. The assumption was that both men and women officers would be negatively affected by midnight shifts.

     "It's possible women may feel more uneasy and stressed in a daytime shift, where there can be more opportunity for conflict and a negative environment," he says.

     On the other hand, higher suicide ideation reported by males on the midnight shift may be accounted for in part by a stronger need to be part of the social cohesiveness associated with peers in the department.

     "Working alone at night without support of immediate backup can be stressful," notes Violanti. There is also the issue of physiological disruption of circadian rhythms. Being awake at night when one should be sleeping can affect judgment and decision-making. The Chernobyl, Three Mile Island, Bhopal, Exxon Valdez and Space Shuttle Challenger disasters all occurred during the night shift.

Change of heart

     The stress and blood vessel reactivity research also found that females had higher cortisol levels upon awakening, and that levels remained high throughout the day. Normally, cortisol is highest in the morning and decreases to its lowest in the evening.

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