Table 1 Summary of assessed studies (1987 and 2017) on occupational hazards and related diseases among police officers worldwide

Ellis (1993) [36]

To determine the dangers of domestic conflicts and identify factors increasing the risks of injury to police officers.

Canada

Survey

Accident

Factors that led to injuries were attempting to arrest suspects or answering a domestic disturbance call alone. The police were exposed to verbal or physical abuse, intoxication and physical injury from the suspects.

Larsen et al. (2016) [37]

To investigate the injuries sustained by the Australian specialist police division.

Australia

Cohort study

Accident

Half of the reported injuries occurred during operational policing tasks, while more than 30% of injuries occurred during training activities. Strain or sprain and upper body injuries were almost five times more common than lower-body or torso injuries.

Ferguson et al. (2011) [38]

To examine the prevalence of work-related injuries and occupational violence experienced by police officers from 2000 to 2008.

Australia

Case-control study

Accident

The police officers were among the top three highest claiming occupations for occupational injuries and deaths when compared with security officers. Stress accounted for 87.3% of injuries among police officers.

Thejus et al. (2014) [39]

To identify injuries, associated factors and effects on the health of police officers.

India

Cross-sectional study

Accident

Police officers were susceptible to accident hazards. These hazards led to injuries and accidents. Lacerations were on the increase when compared to fractures.

Brand I (1996) [40]

To compare assault and accident rates, in order to understand accidental injuries and deaths among police.

USA

Case reports and series

Accident

Most injuries were as a result of accidents based on 2073 police injury incident reports. Accidents led to increased number of injuries, medical treatment and days of work lost.

James, S.M. (2015) [41]

To examine the effect of distraction caused by the use of text while police officers are driving.

USA

Controlled laboratory experiments

Accident

Lane deviations resulting from distracted driving increased the risk of collision. Motor vehicle accidents were common among police officers, whose role required them to drive while at work.

Lesage et al. (2009) [42]

To evaluate the association between police employment and noised induced hearing loss (NIHL).

France

Cross-sectional study

Physical

Police officers were 1.4 times at risk of hearing loss compared to other civil servants. There was an observed difference between motorcycle operators and civil servants.

Win et al. (2015) [43]

To estimate the prevalence of NIHL in the police force.

Brunei

Cross-sectional study

Physical

Of the reported NIHL cases, 74.8% were police officers. A strong association between NIHL and male sex, increased age as well as longer duration of service was observed. Overall, mild NIHL was 93%, moderate NIHL was 3.5% and severe NIHL was also 3.5%.

Gu et al. (2011) [44]

To examine the incidence of cancer in white-male police officers.

USA

Cohort study

Chemical

Between 1976 and 2006, the risk of brain cancer was slightly higher among police officers than in the general population. Police officers who worked for more than 33 years had an increased risk of Hodgkin’s lymphoma.

Chen et al. (2015) [34]

To evaluate exposure of particulate matter (PM) concentrations in Sinying police station near a highway.

Taiwan

Case-control study

Chemical

There was a higher carbon dioxide concentration on the selected police station due to emission sources and indoor air pollution than the reference station. Police officers working along the busy roadways were exposed to high concentration of air pollution.

Treudler et al. (1999) [46]

To evaluate the effect of 2-chloracetophenone (CN) on occupational contact dermatitis.

Germany

Case reports and series

Chemical

Localized dermatitis was observed on contact site of three police officers who experienced the accidental escape of CN, from professional tear gas canisters. Patch tests revealed allergic reactions, which led to extensive health problems.

Mittal et al. (2016) [47]

To evaluate prevalence of needle stick injuries (NSIs) among police officers.

Mexico

Survey

Biological

Police officers reported incidence of NSIs. Contributing factors were exposure to syringes with drugs and breaking of used needles. Police officers were predisposed to various blood borne diseases such as the Human Immunodeficiency Virus (HIV).

Lorentz et al. (2000) [48]

To assess the risk of NSIs and determine predictors of injuries and reporting rates among officers.

USA

Survey

Biological

Of the respondents, 29.7% had at least one NSI while 27.7% of the group had two or more. Risk factors included pat-down searches, working evening shifts, male gender, patrol duties and less years of experience. Only 39.2% of participants sought medical attention following a NSI.

Merchant et al. (2008) [49]

To estimate incidence of emergency department visits due to blood or body fluid exposures on utilization of HIV post-exposure prophylaxis (PEP) by police officers.

USA

Case-control study

Biological

The average incidence rate of emergency department visits due to blood or body fluid exposures was at 4.41 per 1000 officers. Of the officers, 15% sustained percutaneous injuries or blood-to-mucous membrane exposures.

Averhoff et al. (2002) [50]

To determine the frequency and type of occupational exposures and risk of hepatitis B virus infection experienced by public safety workers.

USA

Survey

Biological

Of the participants, 6.8% reported at least one occupational exposure within six months. Human bites were 3.5%, cuts from a contaminated object were 2.8% and NSIs were 1.0%, while mucous membrane exposures to blood were 0.9%.

Cho et al. (2014) [51]

To examine the status and prevention of musculoskeletal disorders in Korean police officers.

Republic of Korea

Case reports and series

Egornomic

The shoulder disorders were 4.87 times higher in police lieutenants than corporals. For police officers with chronic diseases, the risk was 1.78 times higher than in those without chronic diseases.

Ma et al. (2015) [53]

To examine the association between shift work and police work-related stress.

USA

Survey

Psychological

There was a higher risk of PTSD among police officers. The common factors were increased exposure to life-threatening or traumatic events, negative thoughts about work, lack of social support and shift work.

Maia et al. (2007) [54]

To determine prevalence of post-traumatic stress symptoms and compare morbidity among police officers.

Brazil

Survey

Psychological

The prevalence rates of “full PTSD” and “partial PTSD” were 8.9 and 16%, respectively. Compared with the “no PTSD” group, police officers with “full PTSD” had additional medical consultations during the previous year, reported poor physical health and more lifetime suicidal ideation.

Maia et al. (2008) [71]

To measure the serum lipid composition on police officers with and without PTSD who are regularly exposed to potentially traumatic situations.

Brazil

Cross-sectional study and Medical evaluation

Psychological

Police officers with PTSD presented an increased serum total cholesterol and low-density lipoprotein levels than those without PTSD. Abnormal serum lipid profile and higher body mass index (BMI) suggests that PTSD increases the risk of developing metabolic syndrome.

Houdmont et al. (2012) [11]

To study the association between exposures and perceived work-related stress on police officers.

United Kingdom (UK)

Survey

Psychological

There was evidence of highly stressful work as reported by the police officers. Such stresses were linked to the nature of duties performed by police officers.

Garbarino et al. (2015) [56]

To evaluate the association between occupational stress and metabolic syndrome (MetS) in a rapid response police unit.

Italy

Medical evaluation and Survey

Psychological

Majority of police officers reported high stress levels. There was a higher risk of developing MetS and hypertriglyceridemia among police officers. Work-related stress proved to induce MetS among police officers.

Hartley et al. (2011) [58]

To examine the association between stress and MetS with its individual components among police officers.

USA

Survey

Psychological

The stress with MetS constituents was elevated among female, when compared to male police officers. Perceived stress, administrative or organizational pressure and lack of support was associated with the MetS among female police officers.

Janczura et al. (2015) [59]

To examine whether higher levels of stress might be related to MetS and plaque presence, and whether MetS might affect pulmonary function.

Poland

Medical evaluation

Psychological

Job-specific stress increased with the prevalence of MetS and affected coronary plaque presence among police officers. Leisure-time physical activity proved to reduce the risk of developing MetS, while MetS subjects had worse parameters for pulmonary function.

Malach-Pines (2006) [57]

To map stressors that effect Israeli border police, assess its outcomes and suggest ways to reduce burnout and stress.

Israel

Survey

Psychological

The police officers reported lack of resources, low salary and overload as stressors. Those who reported traumatic experience such as a terrorist attack were 74%, while 52% reported high levels of stress. The burnout level among police officers was 4.15 compared to the national burnout level of 2.8.

Berg et al. (2006) [35]

To explore physical and mental health among Norwegian police and associations to job stress.

Norway

Survey

Psychological

Frequent job pressure and lack of support was linked to physical and mental health problems. Anxiety symptoms in females were 4.2 and 3.7 among males. Depressive symptoms were 3.1 among males and 2.4 among females.

Ramakrishnan et al. (2013) [69]

To assess the prevalence of cardiovascular risk factors including stress among police officers.

India

Cross-sectional study and Medical evaluation

Psychological

There was an increase in cardiovascular risk factors such as stress, diabetes and hypertension among police officers. Moderate stress related to work and life problems was 70 and 4%, respectively. The prevalence from the 23% of known diabetic patients, was 33.6%, while from the 16.8% unknown hypertensive patients, it was 30.5%.

Ramey et al. (2011) [67]

To explore risk factors for cardiovascular disease such as stress among Midwestern police officers.

USA

Survey

Psychological

There was a significant relationship between stress and cardiovascular disease and vital exhaustion. A change in unit increased the odds of cardiovascular diseases by 20% on perceived stress and 31% on vital exhaustion among police officers.

Walvekar et al. (2015) [60]

To examine the association between perceived stress, Serum Cortisol and explore stress leading to metabolic syndrome.

India

Survey and Medical evaluation

Psychological

There was a positive link between Serum Cortisol and perceived stress scale, blood glucose and heamoglobin A1c. Among police constables, the biochemical parameters were elevated than the general population. Of the police officers, 38% had cardio metabolic syndrome.

Ganesh et al. (2014) [70]

To assess the prevalence and risk factors of hypertension such as stress among male police personnel.

India

Cross-sectional study

Psychological

Perceived stress was 51%, obesity 54.4%, smoking 21.6%, alcohol use 50.3% and diabetes 10.1%. Higher perceived stress, alcohol use and diabetes were significantly linked to hypertension.

Chen et al. (2015) [74]

To study links between psychological distress and dyslipidemia among police officers.

China

Survey and Symptom checklist

Psychological

In the two and half years of the study, 60.5% of participants developed dyslipidemia. These findings confirmed the relationship between psychological distress and dyslipidemia

Queirós et al. (2013) [75]

To investigate relationship between burnout and aggressivity among police officers.

Portugal

Cross-sectional study

Psychological

There was a relationship between burnout and aggressivity. Feelings of low personal achievement and high depersonalization contributed to anger. While emotional exhaustion was associated with verbal aggression.

Gu et al. (2012) [63]

To investigate the relationship between long work hours and adiposity measures in police officers.

USA

Case reports and series

Organizational

There was an association between long work hours, increased waist circumference and body mass index. The common factors were working midnight shifts, poor eating habits and increased work stress, which could lead to coronary heart diseases.

Kuehl et al. (2016) [68]

To determine changes in blood pressure and associations with the overall sleep quality and fatigue among police officers.

Australia

Cross-sectional study

Organizational

From the participants, 69% reported poor sleep quality and 51% reported severe fatigue. There was an increase of systolic blood pressure across the shifts among female participants, while there were no changes in blood pressure among the male participants.

Tuckey et al. (2010) [65]

To examine mental and cardiovascular health problems related to negative workplace environment exposure.

Australia

Survey

Organizational

Evidence of negative workplace behaviour and cases of bullying affected the cardiovascular outcomes and psychological wellbeing of employees. The negative behaviour led to physical disease and psychological illness.

Yu et al. (2016) [66]

To explore links between occupational stressors and type 2 diabetes mellitus among police officers.

China

Cohort study

Organizational

Stressors increased with the number of years in police work and resulted in new onset diabetes (NOD) among participants. There was a relationship between occupational stressors and abnormal glucose metabolism. In 2008, 2009, 2010 and 2011 the incidence rate of NOD were 0.58, 0.98, 0.52 and 1.01%, respectively.