BUFFALO, N.Y. -- The daily psychological stresses that police
officers experience in their work put them at significantly higher
risk than the general population for a host of long-term physical
and mental health effects. That's the overall finding of a major
scientific study of the Buffalo Police Department called Buffalo
Cardio-Metabolic Occupational Police Stress (BCOPS) conducted over
five years by a University at Buffalo researcher.
"This is one of the first police population-based studies to
test the association between the stress of being a police officer
and psychological and health outcomes," says John Violanti, PhD,
professor of social and preventive medicine in the UB School of
Public Health and Health Professions, and principal investigator on
the study, funded by the National Institute for Occupational Safety
The research, which is in press this month in a special issue of
the International Journal of Emergency Mental Health, reveals
connections between the daily stressors of police work and obesity,
suicide, sleeplessness and cancer, as well as general health
disparities between police officers and the general population.
The study was prompted by the assumption that the danger, high
demands and exposure to human misery and death that police officers
experience on the job contribute to an increased risk of
cardiovascular disease and other chronic health outcomes.
"We wanted to know, in addition to stress, what are other
contributing factors that lead to cardiovascular disease in
police?," says Violanti, a former New York State trooper.
"In an earlier pilot study of 100 police officers, we found, for
example, that shift work is a contributing factor to an increase in
metabolic syndrome, which is a cluster of symptoms that includes
abdominal obesity, hypertension, high triglycerides, low HDL
cholesterol and glucose intolerance. Having metabolic syndrome
increases the risk for developing cardiovascular disease and type 2
The current findings, from a larger, cross-sectional study of
four-hundred-sixty-four police officers, include:
-- more than 25 percent of the officers had metabolic syndrome
versus 18.7 percent of the general employed population
-- female and male officers experiencing the highest level of
self-reported stress were four- and six-times more likely to have
poor sleep quality, respectively
-- organizational stress and lack of support was associated with
the metabolic syndrome in female but not male police officers
-- overall, an elevated risk of Hodgkin's lymphoma was observed
relative to the general population. The risk of brain cancer,
although only slightly elevated relative to the general population,
was significantly increased with 30 years or more of police
Suicide rates were more than eight times higher in working
officers than they were in officers who had retired or left the
"This finding challenges the common assumption that separated or
retired officers are at increased risk for suicide," says Violanti,
noting, however, that the need for suicide prevention efforts
remains important for both active and retired officers.
The BCOPS study findings demonstrate that police work by itself
can put officers at risk for adverse health outcomes.
"Usually, health disparities are defined by socioeconomic and
ethnic factors, but here you have a health disparity caused by an
occupation," says Violanti, "highlighting the need to expand the
definition of health disparity to include occupation as well."
Violanti adds that while police officers do have health
insurance, the culture of police work often goes against the goal
of improving health.
"The police culture doesn't look favorably on people who have
problems," he says. "Not only are you supposed to be superhuman if
you're an officer, but you fear asking for help." Police officers
who reveal that they suffer from a chronic disease or health
problem may lose financial status, professional reputation or both,
The answer, Violanti says, is to change the training of officers
in police academy so they understand signs of stress and how to get
"Police recruits need to receive inoculation training against
stress," says Violanti. "If I tell you that the first time you see
a dead body or an abused child that it is normal to have feelings
of stress, you will be better able to deal with them; exposure to
this type of training inoculates you so that when it does happen,
you will be better prepared. At the same time, middle and upper
management in police departments need to be trained in how to
accept officers who ask for help and how to make sure that officers
are not afraid to ask for that help," he says.
The BCOPS study is based on extensive and rigorous medical
testing and integrates a broad range of psychological,
physiological and subclinical measures of stress, allowing for
correlations between on-the-job stress and stress biomarkers that
reveal the potential for adverse mental and physical health
Violanti and his co-authors note: "This study would not have
been possible without the cooperation of the Buffalo Police
Department administration, the Police Benevolent Association and
the exceptional men and women of the Buffalo Police Department. Our
sincere thanks to them, as we look forward to our follow-up
Co-authors with Violanti were: Michael E. Andrew, Cecil M.
Burchfiel, Luenda E. Charles, Desta Fekedulegn, Ja Kook Gu, Tara
Hartley, Clauda Ma, Anna Mnatsakanova, all from the National
Institute for Occupational Safety and Health of the Centers for
Disease Control and Prevention, as well as Lindsay M. Smith of West
Virginia University, James E. Slaven of Indiana University and
Bryan J. Vila of Washington State University.
In addition to Violanti, co-investigators on BCOPS are Jean
Wactawski-Wende, PhD, professor of social and preventive medicine
and vice provost for strategic initiatives at UB and Joan Dorn,
PhD, professor emeritus of exercise and nutrition sciences, both in
the UB School of Public Health and Health Professions, John Vena of
the University of Georgia, Athens and Bryan Vila. Diane B. Miller
was a NIOSH co-investigator.