PTSD:OSHA seeks comments on Police and Stress

NIOSH Study Seeks Comments on Police and Stress
CCH - USA

SAFETY / OSHA - 7/23/08
NIOSH Study Seeks Comments on Police and Stress
There are approximately 861,000 police officers in the United States (http://www.bls.gov/oco/ocos160.htm)

By the nature of their jobs, many police officers face tremendous stress on a daily basis. Research has shown that police officers are at increased risk for cardiovascular events and may face an increased risk for suicide. Yet, police officers are in general an understudied occupational group. The National Institute for Occupational Safety and Health (NIOSH), together with colleagues at the University at Buffalo (UB), is studying the effects of policing and stress on adverse metabolic and early stage (subclinical) cardiovascular outcomes with the ultimate goal of preventing these and other stress-related disorders.

Researchers are using a physiologic measure of stress, salivary cortisol (often called the "stress hormone"), to assess whether stress is associated with adverse metabolic outcomes (e.g., glucose intolerance and metabolic syndrome a clustering of metabolic abnormalities including elevated waist circumference, triglycerides, blood pressure, fasting glucose, and reduced HDL cholesterol) and subclinical cardiovascular outcomes (e.g., decreased brachial artery response, increased carotid artery wall thickness, decreased heart rate variability) that are detectable before they manifest as disease such as diabetes and myocardial infarction.

To date, over 400 police officers have participated in the Buffalo Cardio-Metabolic Occupational Police Stress (BCOPS) study. The clinical examination includes a series of questionnaires, which measure demographic, lifestyle, and psychological factors (e.g., depression, post-traumatic stress), DEXA measurements to record bone density and body composition, ultrasounds of the brachial and carotid arteries, 18 salivary cortisol samples throughout the day and in response to a series of challenges, and blood samples. Upon completion of the clinical exam, officers are given an actigraph, a small electronic device that resembles a wrist watch, to wear over the next 15 days that measures the quantity and quality of sleep throughout their typical police shift cycle.

Another feature of our research has been the success of two previous cross-sectional pilot studies involving a smaller number of Buffalo police officers. Findings include the following:

Female officers had higher mean Impact of Events (a measure of post-traumatic stress symptoms) and CES-D (a measure of depressive symptoms) scores than male officers.

Officers with higher post-traumatic stress disorder (PTSD) symptoms had a nearly two-fold reduction in brachial artery flow-mediated dilation, indicating greater impairment of endothelial function (physiologic dysfunction of the normal biochemical processes carried out by the cells which line the inner surface of blood vessels) than officers with fewer PTSD symptoms.

Officers with moderate or severe PTSD symptoms had higher mean awakening cortisol values compared with those who had less severe PTSD symptoms.

Officers with severe PTSD had a three-fold higher prevalence of metabolic syndrome than those reporting the fewest PTSD symptoms. This association was attenuated slightly by covariate adjustment for age and education.

Additional findings include associations of negative life events with depressive symptoms (Hartley et al.), night shift work with short sleep duration and snoring (Charles et al.), and a series of statistical applications for optimizing the measurement and analysis of study exposures or outcomes (Andrew et al., Fekedulegn et al., Slaven et al.).

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