Public Safety

Participating core and specialty programs: Center for Occupational Robotics Research, Center for Workers’ Compensation Studies, Center for Motor Vehicle Safety, Center for Direct Reading and Sensor Technologies, National Center for Productive Aging and Work, and Translation Research

Public safety department management, labor organizations, workers, and consensus standard organizations adopt interventions based on NIOSH research to prevent motor vehicle incidents and resulting injuries among public safety workers.

NOTE: Goals in bold in the table below are priorities for extramural research.

  Health Outcome Research Focus Worker Population Research Type
A Fatal and non-fatal injuries Collision as vehicle occupant (including fatigue as a risk factor) Law enforcement, fire service and emergency medical service (EMS) subsectors InterventionTranslation
B Fatal and non-fatal injuries Struck-by on the side of the road Fire service and EMS subsectors InterventionTranslation
C Fatal and non-fatal injuries Struck-by on the side of the road Law enforcement subsector InterventionTranslation

Activity Goal 6.11.1 (Intervention Research): Conduct studies to develop and assess the effectiveness of interventions to prevent motor vehicle collisions, roadside struck-by incidents, and resulting injuries among law enforcement, fire service, and EMS workers.

Activity Goal 6.11.2 (Translation Research): Conduct translation research to understand barriers and aids to disseminating and implementing effective interventions to prevent motor vehicle collisions, roadside struck-by incidents, and resulting injuries among law enforcement, fire service, and EMS workers.

Burden

Over 3.2 million people are employed in occupations in the public safety sector in the U.S. Public safety employees, particularly those engaged in law enforcement, firefighting, and emergency medical service (EMS), have substantial workplace exposure to road traffic hazards, often in emergency situations. Motor vehicle crashes (MVCs) are the leading cause of fatal occupational injuries in the U.S., accounting for 37% of all fatalities in 2015 [BLS 2016a] and among public safety workers, MVCs account for 44% of all fatalities [BLS 2016b]. Law enforcement officers were involved in the highest number of fatal MVCs (n=48), followed by firefighters (n=8) and EMS workers (n=8) [BLS 2016b]. Most of the incidents were due to collisions with other vehicles while the decedent was a vehicle occupant, but 25% occurred when a public safety worker was struck by another vehicle while working outside their vehicle [BLS 2016b]. Risk factors for MVCs involving public safety workers include non-use of occupant restraints, unsafe driving practices, non-use of high visibility clothing, inappropriate incident management, fatigue, and distractions from in-vehicle technology.

Need

In general, MVC risk factors for public safety employees are well-understood. For this worker population, intervention and translation research are the most critical for reducing crashes, injuries, and fatalities. Intervention research is needed because there is limited research to date that has assessed the effectiveness of road safety interventions within the unique operating environments of public safety organizations. Translational research is also important to ensure that information about effective interventions will be accepted and adopted, given the unique cultures of public safety organizations where workers routinely accept risk to help others. Research on implementation of connected vehicle technology may also lead to reduction of MVCs involving public safety workers. NIOSH research that follows the public health model from surveillance through to implementation of effective interventions complements the efforts of other agencies to prevent MVCs and injuries. In addition, NIOSH has built strong working relationships with professional and labor organizations and academic researchers with interest in public safety, increasing the likelihood that NIOSH research results will be adopted.

Public safety and health department management, labor organizations, and consensus standard organizations will adopt interventions based on NIOSH research to prevent injuries among high-risk populations in public safety workplaces.

NOTE: Goals in bold in the table below are priorities for extramural research.

  Health Outcome Research Focus Worker Population Research Type
A Fatal and non-fatal injuries Assault and violent encounters, civil disturbances Law enforcement subsector InterventionTranslation
B Fatal and non-fatal injuries Patient assault, bystander violence Emergency medical service (EMS) subsector InterventionTranslation
C Fatal and non-fatal injuries Violent encounters and daily interactions, bystander violence Corrections subsector InterventionTranslation

Activity Goal 6.12.1 (Intervention Research): Conduct studies to develop and assess the effectiveness of interventions to prevent violence in public safety worksites.

Activity Goal 6.12.2 (Translation Research): Conduct translation research to understand barriers and aids to implementing effective violence-prevention strategies among public safety workers.

Burden

Violence is a leading cause of injury and death for public safety sector workers. Among correctional officers, assaults account for 40% of fatal injuries and 38% of non-fatal injuries occurring in the workplace from 1999-2008 [Srinivas et al. 2013]. Correctional officers are in close contact with inmates, often work alone and late at night and may experience institutional and organizational factors that may contribute to increased risk for correctional officer violence such as inmate overcrowding, inadequate officer training, and staffing shortages all of which may increase corrections officers’ risk of workplace violence [Konda et al. 2012]. While just 8% of emergency medical service (EMS) provider fatalities have been attributed to assaults and violent acts [Maguire and Smith 2013], 67% of nationally registered EMS providers reported experiencing verbal violence and 44% reported experiencing physical violence within a one-year period [Gormley et al. 2016]. Recent research has indicated that many EMS workers are required to respond to calls that involve patients under the influence of alcohol or drugs (such as opioids), violent patients, or patients with weapons [Oliver and Levine 2015; Taylor et al. 2015]. Among law enforcement officers, assaults accounted for 40% of duty-related fatalities in the last decade according to the National Law Enforcement Officers Memorial Fund [2017]. Regarding non-fatal injuries, 27% of law enforcement officers sought treatment at an emergency department for on-duty injuries due an assault or violent encounter [Division of Safety Research 2017]. Multiple factors impact the risk of assaults for LEOS, including region of the country, type of force used on the suspect, type of call, number of officers on scene, and time of day.

Need

The public safety and emergency response community recognizes that violence related injuries and fatalities are an important and preventable cause of injury. Risk factors for workplace violence in the public safety sector, however, vary widely based on occupation. Accordingly, preventive strategies are also occupation dependent. Research is limited on effective and realistic strategies to reduce the risk of workplace violence in corrections facilities that take into account the unique work organization factors in this setting. For EMS, research is needed to better understand how to protect these workers as they are required to respond to emergency situations. The inherent nature of police work puts law enforcement officers at an elevated risk for physical assault, and evidence-based interventions are needed to reduce risk factors.

Training, protocols and protective gear all may impact the risk for workplace violence, however, studies on evidence-based strategies to decrease workplace violence incidents in public safety sector employees are rare. Effective safety management systems can play a part in this from the perspective of encouraging workers to report incidents of violence, monitoring those reports, and implementing interventions as appropriate.

BLS [2016a]. TABLE A-2. Fatal occupational injuries resulting from transportation incidents and homicides, all United States, 2015. Washington, DC: U.S. Department of Labor, Bureau of Labor Statistics, https://www.bls.gov/iif/oshcfoi1.htmExternal

BLS [2016b]. Table A-6. Fatal occupational injuries resulting from transportation incidents and homicides by occupation, all United States, 2015. Washington, DC: U.S. Department of Labor, Bureau of Labor Statistics, https://www.bls.gov/iif/oshwc/cfoi/cftb0300.xlsxCdc-excelExternal

Division of Safety Research [2017]. Law Enforcement officer nonfatal injuries analyses: National Electronic Injury Surveillance System – Work supplement research file (provided to NIOSH by the Consumer Product Safety Commission). Morgantown, WV: Division of Safety Research. Unpublished.

Gormley MA, Crowe RP, Bentley MA, Levine R [2016]. A national description of violence experienced by emergency medical services personnel. Prehosp Emerg Care 20(4):439–47.

Konda S, Reichard AA, Tiesman HM [2012]. Occupational injuries among U.S. correctional officers. J Safety Res 43(3): 181-86.

Maguire BJ, Smith S [2013]. Injuries and fatalities among emergency medical technicians and paramedics in the United States. Prehosp Disaster Med 28(4):376–82.

National Law Enforcement Officers Memorial Fund [2017]. Facts and figures: deaths, assaults and injuries over the last decade (2007-2016). Washington, DC: National Law Enforcement Officers Memorial Fund, http://www.nleomf.org/facts/officer-fatalities-data/daifacts.htmlExternal

Oliver A and Levine R [2015]. Workplace violence: A survey of nationally registered emergency medical services professionals. Epidemiol Res Int, 28: https://www.hindawi.com/journals/eri/2015/137246/External

Srinivas Konda, Konda S, Tieseman H, Reichard A, Hartley D. [2013]. Correctional officers killed or injured on the job. Correct Today 75(5): 122–123.

Taylor JA, Davis AL, Barnes B, Lacovara AV, and Patel R [2015]. Injury risks of EMS responders: evidence from the National Fire Fighter Near-Miss Reporting System. BMJ Open 5(6). http://bmjopen.bmj.com/content/5/6/e007562External

Page last reviewed: April 24, 2018