Police occupational demands, psychological distress and the coping function of alcohol

Prevalence of metabolic syndrome and its risk factors among 10,348 police officers in a large city of China: A cross-sectional study

The aim of this study was to assess the prevalence of metabolic syndrome (MS) and its risk factors among the police officers in a large city of China.A cross-sectional study was conducted in 10,348 police officers in 2017 in Changsha, a provincial capital located in central-south China. All participants underwent a physical examination to measure the compotents of MS and completed a questionnaire to collect data on potential risk factors. According to the current guidelines of China, MS was defined as the presence of any 3 of the following five traits: abdominal obesity, defined as a waist circumference ≥90 cm in men and ≥85 cm in women; fasting serum triglycerides ≥1.70 mmol/L, or drug treatment for elevated triglycerides; fasting serum high-density lipoprotein cholesterol <1.03 mmol/L, or drug treatment for low high-density lipoprotein cholesterol; blood pressure ≥130/85 mmHg, or drug treatment for elevated blood pressure; fasting plasma glucose ≥6.1 mmol/L, or 2-hour plasma glucose ≥7.8 mmol/L after a 75-g oral glucose load, or drug treatment for elevated blood glucose.The prevalence of MS was 23.2% (95% confidence interval [CI]: 22.2%-24.2%). The main risk factors associated with MS were older age (odds ratio [OR] 1.546, 95% CI 1.431-1.670), being male (OR 11.256, 95%CI 7.147-17.726), alcohol consumption (OR 1.250, 95% CI 1.070-1.461), and tobacco use (OR 1.398, 95% CI 1.232-1.586). Exercise was associated with decreased risk of MS (OR 0.865, 95% CI 0.755-0.991).The prevalence of MS was low in the study population. Its risk factors were similar to those identified in the general population of China. Lifestyle intervention is warranted in policemen to reduce the risk of MS and prevent diabetes and cardiovascular disease.

Prevalence of Hypertension and its Determinants among Policemen in a City of Haryana, India

Introduction

Noncommunicable diseases (NCDs) kill 40 million people each year, equivalent to 70% of all deaths globally. Cardiovascular diseases account for most NCD deaths or 17.7 million people annually. Police work has been regarded by some researchers as one of the most stressful occupations in the world, and coronary heart disease has been identified as a major cause of mortality in this population.

Materials and Methods

A cross-sectional study was carried out during July 2016-June 2017 among 450 policemen posted in Rohtak city of Haryana selected randomly. The investigator made two measurements of blood pressure. Data were collected using predesigned, pretested, semi-structured interview schedule, and analyzed using the Statistical Package for the Social Sciences version 20.0.

Results

Of 450 participants, 164 (36.4%) participants were found to be hypertensive. Age of study participants, duration of service, rank, and education are significantly associated with the prevalence of hypertension (HTN) among policemen.

Conclusion

HTN in policemen has emerged as an important public health problem. Knowledge of risk factors for HTN may give tracks for prevention in this population. Therefore, it is the need of hour to devise a sound screening strategy to diagnose HTN among policemen and devise a comprehensive strategy for the management of HTN.

Prevalence and predictors of problematic alcohol use, risky sexual practices and other negative consequences associated with alcohol use among safety and security employees in the Western Cape, South Africa

Introduction

Harmful alcohol use can compromise worker health and productivity. Persons employed in safety-sensitive occupations are particularly vulnerable to hazardous alcohol use and its associated risks. This study describes the patterns of harmful alcohol use, related HIV risks and risk factors for the harmful use of alcohol among a sample of employees in South Africa working in the safety and security sector.

Methods

A cross-sectional study that formed the baseline for a clustered randomized control trial was undertaken in 2011. A random sample of 325 employees employed within a safety and security sector of a local municipality in the Western Cape Province of South Africa participated in the study. Data were collected by means of an 18-page self-administered structured questionnaire and analyzed using SAS/STAT software version 9.2. For all significance testing, the F-statistic and p-values are reported.

Results

Three hundred and twenty-five employees were surveyed. Findings suggest that more than half (76.1%) of the 78.9% of participants who consumed alcohol engaged in binge drinking, with close to a quarter reporting a CAGE score greater than the cut-off of 2, indicating potentially hazardous drinking patterns. The study further found that employees who use alcohol are more likely to engage in risky sexual practices when under the influence. A favorable drinking climate (p < 0.001) and poor levels of group cohesion (p = 0.009) were significantly correlated to binge drinking.

Conclusion

This study identifies alcohol-related behaviors and associated risks in the context of safety-sensitive occupations at the workplace. It suggests that persons employed within such positions are at high risk for developing alcohol-related disorders and for contracting HIV. This study highlights the need for testing a comprehensive package of services designed to prevent hazardous alcohol use among safety and security employees.

High prevalence of cardiovascular risk factors among policemen in Puducherry, South India

BACKGROUND

Diabetes mellitus and hypertension (HT) are common diseases in adulthood, pre-disposing to many cardiovascular complications, posing a major public health challenge. Few studies have reported increased prevalence of cardiovascular disease risk factors and type 2 diabetes in policemen. Hence, this study aims to assess the prevalence of cardiovascular risk factors such as diabetes, HT, smoking, alcohol intake, and obesity among policemen.

MATERIALS AND METHODS

A cross-sectional study was carried out in 2008-2009 among 256 policemen in Puducherry, South India. Policemen were selected by simple random sampling. Socio-demographic details and some of the risk factors such as alcohol intake and smoking history were obtained using a pre-tested, structured questionnaire. Presence of stress was measured using the professional life stress score questionnaire. Blood pressure, waist circumference, and hip circumference were measured by standard methods. Fasting blood sugar was estimated using a glucometer. Serum cholesterol was also measured. Lipid profile was measured for a randomly chosen subgroup of 50 participants.

RESULTS

Mean age of study participants was 40.9 years (SD ± 10.9). Out of the study subjects, 23% (n = 60) were known diabetic and 16.8% (n = 43) were known hypertensive. Prevalence of diabetes among study participants was 33.6% (CI: 27.8%-39.6%). Prevalence of HT among study participants was 30.5% (CI: 24.9%-36.5%). Seventy percent (n = 178) had at least moderate range of stress in their life related to their profession and 4% (n = 11) had stress as a "problem" in their life.

CONCLUSIONS

Burden of cardiovascular risk factors such as diabetes and HT was high among police personnel of Puducherry.

[Assessment of the risk of ischemic heart disease and its relevant factors among Japanese police officers]

OBJECTIVES

Compared to other public employees, police officers have higher absence rates due to heart diseases, and ischemic heart disease (IHD) is one of the most frequent causes of death in their occupational life. The aim of this study was to investigate the prevalence of the risk factors for IHD among police officers and to examine its association with working conditions and lifestyles.

METHODS

First, 58 male police officers who developed IHD from 1996 to 2011 and 116 age- and rank-matched controls who were free from cerebro- and cardiovascular diseases were compared with respect to the prevalence of traditional risk factors five years before the onset of IHD. Then, the prevalence of IHD risk factors, and the frequency of metabolic syndrome (MetS) by age group, working condition and lifestyle were investigated in a cross-sectional survey of data of 1,539 male police officers and 153 male office workers in a prefectural police force.

RESULTS

In the case control study, the IHD cases had significantly higher prevalences of hypertension (p<0.001), hyper-LDL-cholesterolemia (p<0.05), glucose intolerance (p<0.05), and hyperuricemia (p<0.05) before the onset of IHD. Multiple logistic regression analysis revealed that hypertension (odds ratio [95% confidence interval] : 3.96 [1.82-8.59]), glucose intolerance (3.28 [1.34-8.03]), hypo-HDL-cholesterolemia (2.26 [1.03-4.97]), and hyper-LDL-cholesterolemia (2.18 [1.03-4.61]) were independently associated with the development of IHD (model chi-square, p<0.001; correct classification rate, 77.0%). In the cross sectional analyses, among the police officers, abdominal obesity (waist circumference of ≥ 85 cm) was significantly more frequent (57.3% vs. 35.3%, p<0.001) and the prevalence of dyslipidemia and glucose intolerance increased with age more remarkably than in the general office workers. In the age-group of 45-59 years, the clustering number of risk factors in individuals (1.8 vs. 1.4, p<0.01) and the frequency of MetS (25.0 vs. 15.5, p<0.1) were greater in the police officers than the office workers. Among the police officers, subjects with MetS had significantly higher rates of shift work (33.6% vs. 25.4%, p<0.01), lack of sound sleep (42.5% vs. 33.7%, p<0.01), and heavy drinking (12.8 vs. 6.3%, p<0.01) than those without MetS.

CONCLUSIONS

In this study, the development of IHD in police officers was significantly associated with traditional risk factors, especially with hypertension, dyslipidemia and glucose intolerance. The increase with age of the prevalence of IHD risk factors and the frequency of MetS were greater in police officers than office workers. Irregular working conditions, such as shift work, long working time, and unfavorable lifestyles, e.g. alcohol drinking and poor sleeping conditions, may influence the higher prevalence of risk factors for IHD in police officers.

Occupational risk factors in the emergency medical services

INTRODUCTION

During a medical emergency, the American public often relies on the expertise of emergency medical technicians (EMTs). These professionals face a number of occupational hazards, and the literature suggests that EMTs are at a greater risk of developing physical and mental stress-related disorders. The purpose of this paper is to systematically examine gaps in the extant literature and to present a theoretically driven conceptual model to serve as a basis for future intervention and research efforts.

METHODS

A systematic review of the literature was conducted utilizing relevant databases (e.g., PsychInfo, Medline). All empirical articles regarding emergency medical responders were reviewed, but given the limited research available, relevant theoretical and conceptual literature on the constructs of interest in other, related populations also were included. Based on this extensive review, a modification of the stress process model is suggested to explain the relationships among occupational stress exposure, post-traumatic stress disorder (PTSD), and high-risk alcohol and other drug use.

RESULTS

Exposure to traumatic events was reported to be between 80% and 100% among EMTs, and rates of PTSD are >20%. High-risk alcohol and drug use rates among other emergency response professionals were reported to be as high as 40%. The proposed model suggests direct linkages between occupationally related stress exposure, including chronic and critical incident stress, PTSD, and high-risk alcohol and other drug use. Social support and personal resources (e.g., coping, locus of control) are proposed to have mediating and moderating influences on the three main constructs, and cohesion is introduced as an important, idiosyncratic influence in this population. The moderating influences of gender, age, ethnicity, marital status, and socioeconomic status, level of training, and years of service are included in the proposed model.

CONCLUSIONS

High-risk alcohol and other drug use and post-traumatic symptomatology pose substantial risks for EMTs, and consequently, for the patients they serve. It is imperative that researchers develop and test a theoretically grounded model of risk and protective factors that will guide intervention development and future study. The model suggested in this paper, based on a comprehensive literature review and development of theory, represents a critical first step in the intervention research process.

Stress and quality of life of senior Brazilian police officers

This study examines levels of occupational stress, quality of life, work-related stressors, and coping strategies among senior police officers in Brazil. A quantitative questionnaire survey conducted among 418 senior members of the São Paulo Police Force reveals that high-ranking Brazilian police officers perceive their profession as being very stressful. A large proportion (43%) of police officers are found to have significant stress symptoms. A greater proportion of females (54%) than males (40%) are found to have stress. The most frequently reported stressor is interaction with other departments within the police force. Quality of life is found to be deficient in the 'professional' and 'health' areas. This study is the first to show a clear association between high levels of emotional stress and poor quality of life in Brazilian police officers. The large number of stress symptoms and poor quality of life identified in the present study indicates that there is a need for preventive actions inside the Brazilian police force to motivate lifestyle changes, improve stress-management skills, and promote a better quality of life among high-ranking police officers.

Alcohol and tobacco consumption among police officers

Police occupy an important position within the community as both enforcers of the law and as role models for appropriate behavior. Despite this interesting juxtaposition, research has shown that they may consume alcohol and tobacco at rates higher than the general population. A significant causal factor is occupational stress, and the fact that police are regularly exposed to stressors beyond the range of normal human experiences. Given this ongoing and unavoidable relationship, the recognition and control of stress is paramount within law enforcement. Because police stressors are usually multi-faceted, health promotion interventions should focus on stress-reduction at both the institutional and individual level. Examples of health promotion strategies may include reducing overtime, carefully organizing shift rosters, streamlining administrative processes and allowing rest breaks for those on the night-shift. Interventions which focus on the individual are also important, because excess alcohol and tobacco consumption levels often relate to individual stress-coping mechanisms. Programs to help recognize and prevent excess alcohol and tobacco consumption may be worthwhile, as too, counseling, interpersonal support and critical incident debriefing. Promoting non-drinking and non-smoking stress-reduction activities where police can socialize and de-brief with their colleagues may be beneficial. Encouraging social events at sports clubs and gymnasiums has also been suggested. In order to achieve these goals however, governments will need to place a greater emphasis on the occupational health of police officers and the law enforcement agencies in which they work.

Team awareness for workplace substance abuse prevention: the empirical and conceptual development of a training program

This paper describes the empirical and theoretical development of a workplace training program to help reduce/prevent employee alcohol and drug abuse and enhance aspects of the work group environment that support ongoing prevention. The paper (1) examines the changing social context of the workplace (e.g., teamwork, privacy issues) as relevant for prevention, (2) reviews studies that assess risks and protective factors in employee substance abuse (work environment, group processes, and employee attitudes), (3) provides a conceptual model that focuses on work group processes (enabling, neutralization of deviance) as the locus of prevention efforts, (4) describes an enhanced team-oriented training that was derived from previous research and the conceptual model, and (5) describes potential applications of the program. It is suggested that the research and conceptual model may help prevention scientists to assess the organizational context of any workplace prevention strategy. The need for this team-oriented approach may be greater among employees who experience psychosocial risks such as workplace drinking climates, social alienation, and policies that emphasize deterrence (drug testing) over educative prevention. Limitations of the model are also discussed.

Work stressors, drinking with colleagues after work, and job satisfaction among white-collar workers in Japan

Although previous studies have examined the buffering effects of social support and coping style on the relationship between stress and alcohol consumption, they have typically relied on analysis of variance (ANOVA) or regression analysis. In addition, few studies have examined the potential stress-buffering effects of drinking with coworkers after work on the relationship between job stress and job dissatisfaction. In the present study, using a signal detection analysis, we evaluated the interactions of drinking with coworkers after work and work-stressor variables among Japanese white-collar workers (n = 397) in 1997. The analysis was performed for two groups of subjects divided based on their status in the company. This was necessary because in Japan the obligations to drink socially increase with one's rising status in the company. In both the "staff members and lower-level managers" and "middle-level and higher-level managers' groups, an interaction between work-stressor variables and drinking variables was observed. The findings imply that drinking with coworkers after work ameliorated the sense of job dissatisfaction, but only among those subjects who already had lower levels of work stressors. For subjects with high levels of work stressors, attitudes toward drinking with coworkers were unrelated to job satisfaction levels.

Migração, trabalho na indústria petroquímica e consumo de bebidas alcoólicas

Objetivou-se testar testar a hipótese de uma associação entre migração recente, trabalho na indústria petroquímica e o consumo excessivo de bebidas alcoólicas, avaliando o papel de variáveis socioeconômicas e demográficas como confundidores ou modificadores de efeito. Foi empregada uma amostra aleatória de 452 chefes de família entre 18 e 60 anos de idade, proveniente de um inquérito de saúde conduzido com famílias que residiam em uma área industrial da Região Metropolitana de Salvador, Bahia, Brasil. Apenas os trabalhadores do setor industrial foram incluídos na análise (n = 299). Consumidores de bebidas alcoólicas foram identificados com o Questionário de Morbidade Psiquiátrica de Adultos, QMPA, aplicado por entrevistadores treinados a informantes chave de cada família selecionada. Migrantes recentes foram definidos como aqueles que tinham até dois anos de residência no local. A prevalência de consumo exagerado de álcool foi maior entre trabalhadores da indústria petroquímica e entre migrantes recentes, em comparação aos trabalhadores de outras indústrias e não migrantes recentes, respectivamente. Petroquímicos migrantes recentes apresentaram uma prevalência de consumo de bebidas alcoólicas 3,4 vezes superior ao grupo de referência. Migração recente e trabalho na indústria petroquímica são fatores de risco potenciais para o consumo de bebidas alcoólicas, por um efeito sinérgico entre essas duas variáveis. Os resultados sugerem a escolaridade como fator de proteção para o consumo de álcool, apenas entre não migrantes recentes nessa população de estudo.

Occupational medicine for policing

A wide variety of medical conditions may be associated with police work. Unlike other occupations where a specific link can be traced between an exposure or an action and a specific pathology, the link between police work and disease is more problematic. The medical conditions which seem to be associated with police work are all conditions for which numerous other risk factors are identifiable. These risk factors include physical inactivity, poor nutritional practices, cigarette smoking and alcohol overuse. While it is undoubtedly desirable to minimise these risk factors in any patient population it is imperative, given the increased risks among police personnel, that aggressive attempts he undertaken to reduce cumulative risks. The physician plays an important part in this process by screening for specific conditions associated with police work, by educating the police officer about increased risks and by encouraging lifestyle choices that will reduce risk. It is also important that the physician encourages the use of personal protective equipment where appropriate. Periodic health assessment of police officers by a physician knowledgeable about police work should include education about the risks associated with the occupation and about methods to reduce risk. The physician should also enquire about exposures to violent or dangerous occurrences and should include assessment for possible emotional sequelae of such exposure. Operational procedures designed to reduce risk of violence and to improve police officer safety and survival are appropriate but are not in the normal realm of the physician. The question of whether a medical condition may be attributable to the occupation of policing is liable to produce strong emotions. When a police officer becomes ill there is an understandable desire on the part of other officers and, often, on the part of the public, to attempt to demonstrate a connection between the occupation and the illness. In line with this tendency several US states have policies in place to unquestioningly accept atherosclerotic heart disease among police officers as 'occupationally induced' for pension purposes. This leads to situations where the scientific evidence may be at odds with the political agenda of individuals and groups participating in the determination. This review will examine the evidence for a number of medical conditions. Specific occupational exposures, such as lead exposure among ballistics specialists, or chemical exposure among forensic laboratory workers are addressed elsewhere. Biohazard risks will be addressed in a later review.

The prevalence and sociodemographic correlates of high-risk and problem drinking at an industrial worksite

The study of 833 employees aimed to determine the prevalence and sociodemographic correlates of high-risk and problem drinking in an industrial population. Variables measured included stressful life events, neuroticism, job satisfaction, years of service, job classification and type of shift. As measured by a 7-day retrospective diary, 12.5% of the sample were abstainers, 78.7% were light drinkers and 8.8% were high-risk drinkers. As measured by the Mortimer-Filkins test of problem drinking, 79.2% were non-problem drinkers, 15.2% were presumptive problem drinkers and 5.7% were problem drinkers. Variables that best predicted high-risk drinking were marital status, type of shift and education. Variables that best predicted problem drinking were stressful life events, marital status, education and neuroticism. The results indicate the need for a work-based intervention and provide information to identify at-risk employees and assist in the design of appropriate treatment programmes, including assistance with social and other problems.

Work-stress burnout among paramedics

A survey-based study was conducted among 213 advanced emergency medical technicians (paramedics) to determine if work-related stress and its attendant burnout syndrome could influence the high job dissatisfaction reported by this group. Using Jones' Staff Burnout Scale for Health Professionals, the highest mean burnout score yet reported for any group of health professionals was obtained. of 23 possible correlates of the measure, 18 were associated with burnout. A multiple regression procedure produced a model containing eight independent predictors of burnout. On the whole, the study indicates alarmingly high work-stress burnout among paramedics, which is associated with a rather complex set of correlates. Implications of the study, including job requirement changes for paramedics, are also discussed.

Mortality of a municipal worker cohort: III. Police officers

Very little is known about the long-term health risks associated with the high stress police officer occupation. We report here on a retrospective cohort of 2,376 ever-employed white male police officers employed between January 1950 and October 1979. Vital status was obtained for 96%, the officers accumulating a total of 39,462 person-years. Six-hundred sixty-one deaths were observed. Total mortality from all causes was comparable to that of the overall U.S. white male population (standardized mortality ratio [SMR] = 106). Significantly increased mortality was seen for all malignant neoplasms combined (SMR = 127), cancer of the esophagus (SMR = 286), and cancer of the colon (SMR = 180). Significantly lower than expected mortality was seen for infectious diseases (SMR = 26), respiratory diseases (SMR = 64), and accidents (SMR = 60). Internal cohort comparisons revealed that policeman exhibited significantly higher mortality from suicide compared to all other municipal employees (rate ratio = 2.9). Analysis of mortality by length of service as a police officer showed that those employed 10-19 years were at significantly increased risk of digestive cancers and cancers of the colon and lymphatic and hematopoietic tissues and decreased risk for all diseases of the circulatory system. Policeman employed more than 40 years had significantly elevated SMRs for all causes, all malignant neoplasms combined, digestive cancers, cancers of the bladder and lymphatic and hematopoietic tissues, and arteriosclerotic heart disease. Risk of mortality from arteriosclerotic heart disease tended to increase with increasing years employed. These findings are discussed in light of the police stress literature. The hypotheses generated in this study must be tested through study of the role of important confounders including reactions to stress on the job.