The Biological Risks of Being a Law Enforcement Officer

Let’s review the most important safety and health issues for law enforcement officers. Some hazards are tracked and analyzed, others are not. According to the U.S. Bureau of Labor Statistics, the leading causes of occupational fatalities among police officers are highway incidents and homicides. Additionally, untracked serious health risks include other occupational injuries, occupational stress and unavoidable physical contact with people who have contagious diseases.

Sure, LEOs have a higher risk of being attacked, wounded or even killed at work than almost all other professions. But you also have a much higher chance of exposure to a debilitating and even life- threatening illness.

While arresting suspects, investigating crimes, conducting searches, or taking samples, police can be exposed to a staggering number of pathogens.

The Transmission of Communicable Diseases

A disease is termed communicable (CD) if it is infectious and can be transmitted from a sick person to a healthy person. Communicable diseases are caused by four main types of organisms: bacteria, viruses, fungi, and parasites. Most infectious diseases are passed from person to person; however, others are transmitted via bites from insects and animals, acquired by ingesting contaminated food or water, and other exposures in the environment. The most common modes of transmission are listed below.

• Bloodborne pathogens are transmitted when contaminated blood or body fluids enter the body of another person. This can occur through a number of ways: an accidental puncture by a sharp object contaminated with the pathogen (needles, scalpels, razor blades, broken glass, pen); cuts or skin abrasions coming in contact with contaminated blood or body fluids; or sexual contact. Examples include HIV and hepatitis viruses.
• Droplet contact (also known as the airborne or respiratory route) occurs when an infected person coughs or sneezes on another person. The microorganisms, suspended in warm, moist droplets, may enter the body through the nose, mouth or eye surfaces. Examples include tuberculosis and influenza.
• Fecal-oral transmission occurs when food or water becomes contaminated and then consumed. Examples include Hepatitis A and polio.
• Sexual transmission occurs during sexual activity with an infected partner. Examples include syphilis and gonorrhea.
• Transmission by direct contact with objects such as sharing towels or clothes. Examples include Athlete’s foot and warts.

The Dreaded Diseases

Universally, the most feared contagious diseases for law enforcement officers are HIV and Hepatitis C as there is currently no vaccinations to prevent these life-threatening infections. However, treatment for both diseases has become increasingly effective.

Human Immunodeficiency Virus (HIV): HIV is a virus contracted from an infected person's blood, semen, vaginal fluid, breast milk, saliva, and body fluids surrounding joints and organs. To contract the disease infected body fluids must come in contact with an uninfected person’s blood. More than one million people in the United States currently are living with HIV/AIDS. Of course the risk of contracting HIV is ever present; the truth is that the perception of the risk far exceeds the probability. The risk of contraction is 0.03%; only about one in 300 of HIV exposure incidents (needle stick or cut) results in transmission of the disease.   There has been no case to date where an individual has been infected with HIV via contact with an environmental surface. HIV is a fragile virus and is easily killed by hot water, soap, bleach and alcohol. The virus can only last outside the body as long as blood or body fluid remains liquid.

Hepatitis C Virus (HCV): Hepatitis C is basically contracted the same way as the HIV virus is. More than four million people in the United States currently are living with HCV. The risk of contraction of Hepatitis C is 1.8% (6 times greater than HIV). The hepatitis C virus, or HCV, can live outside the body for up to 4 days. However, many experts think it usually only survives up to 16 hours at room temperature

Hepatitis B Virus (HVC): Previously officers had an increased risk of contracting Hepatitis B than the general population. However, a person who has received the hepatitis B vaccine and has developed immunity to the virus is at virtually no risk for infection.

According to the National Criminal Justice Reference Service (NCJRS), the diseases that should most concern law enforcement are those that are spread by casual contact between individuals, such as the flu or measles. If there is an outbreak in the community, officers will be exposed repeatedly.

Additionally, there is a staggering list of other communicable diseases to be aware of including: amebiasis, Anthrax, chickenpox, the common cold, croup, diarrhea, diphtheria, E. Coli, Genital warts (at least 75% of sexually active adults have been infected with at least one type of genital HPV at some time in their life) German measles, Giardiasis, group B streptococcal disease, hepatitis (A-G), herpes, influenza, intestinal roundworms, legionellosis, lyme, malaria, measles, meningitis (bacterial and viral), mononucleosis, MRSA, mumps, pertussis, pinworm infection, pneumonia, polio, rabies, ringworm, Rocky Mountain spotted fever, rotavirus infection, rubella, rubeola, salmonellosis, scabies, scarlet fever, tetanus, tuberculosis, typhoid, West Nile fever, whooping cough and yellow fever.

Prevention of Contagious Diseases

If there is a vaccination for a contagious life threatening disease, like Hepatitis B, get it. There are also many other vaccinations available for officers living in areas which have the potential for outbreaks of certain contagious diseases (tetanus, diphtheria, whooping cough, Hepatitis A, etc). Be alert for announcements from the CDC and local public health departments.

Remember your training related to searches:

• Be aware of any open cuts or abrasions on your skin
• Never put your hands where your eyes can’t see
• Ask an arrestee if there are sharp objects on his/her person. If feasible ask them to empty their pockets and turn them inside out to expose the lining
• Use extreme caution when searching an arrestee’s clothing or possessions
• Wear protective gloves if exposure to blood or body fluids is likely

Personal protective equipment (PPE)

PPE should be planned for and acquired well before a pandemic or other outbreak occurs.

The three main classes of PPE that should be made available to law enforcement are:

1. hand sanitation (hand washing, alcohol gels, antibacterial wipes)
2. protection against blood and body fluids (antimicrobial gloves, gowns, masks, goggles)
3. respiratory protection (including respirators that have been fit tested)

Body Fluid Exposure: What to do

If blood or a body fluid has splashed onto skin, into the eyes, nose, or mouth; wash the skin with soap and water or rinse the eyes/mouth/nose with tap water for 15 minutes.

If you have a needle stick or laceration, the first thing to do is to clean the wound with soap and water. Then apply direct pressure to stop the bleeding if needed.

According to the CDC, if you experienced a needle stick or other sharp object injury, or were exposed to the blood or other body fluid of a patient during the course of your work, immediately follow these steps:

• Wash needle sticks and cuts with soap and water.
• Flush splashes to the nose, mouth, or skin with water
• Irrigate eyes with clean water, saline, or sterile irrigants
• Report the incident to your supervisor
• Immediately seek medical treatment

The Realities of Influenza (the Flu)

It is not too late to get vaccinated, and almost everyone reading this article should do so. Although October through December are the recommended months for vaccination, since that's when viruses begin to circulate, a flu shot later in the winter can still help protect you, your loved ones, partners and unsuspecting civilians from the flu. Each year's seasonal flu vaccine contains protection from the three influenza viruses that are expected to be the most common during that year's flu season. The vaccine is typically available as an injection or as a nasal spray.

The U.S. Centers for Disease Control and Prevention (CDC) estimates that 35-50 million Americans come down with the flu during each flu season; more than 100,000 people are hospitalized and about 36,000 people die from the flu and its complications every year.

Flu Facts

• A person can spread the flu a day before he or she feels sick
• Adults can continue to pass the flu virus to others for another three to seven days after symptoms start
• Children can pass the virus for longer than seven days
• Symptoms start one to four days after the virus enters the body. Some people can be infected and show no symptoms, yet still spread the virus to others.

Do you have a cold or the flu? Because flu symptoms are quite similar to cold symptoms, it's often hard to tell the difference. There is one clue that can help you determine that you have the flu. When you have the flu, you will feel symptoms sooner than you would with a cold, and these symptoms come on with much greater intensity. Both the flu and the common cold are viral versus bacterial infections; antibiotics will not work to treat either disease. However, there are many antiviral medications that can be used to treat the flu.

Either way, you are probably contagious and should stay home and take care of yourself.

There are all kinds of bad guys out there. Some are pretty obvious, like the criminal firing off rounds or the one swinging a machete. Others come in the form of pathogens that you can’t see with a naked eye. Take the steps you need to in order to protect yourself from the countless little guys who surround you every day and everywhere.

Web Links:

• Centers for Disease Control and Prevention (CDC)
• National Institute of Allergy and Infectious Diseases (NIAID)
• The Role of Law Enforcement in Public Health Emergencies (Requires Acrobat Reader)

About The Author:

Pamela Kulbarsh, RN, BSW has been a psychiatric nurse for over 25 years. She has worked with law enforcement in crisis intervention for the past ten years. She has worked in patrol with officers and deputies as a member of San Diego's Psychiatric Emergency Response Team (PERT) and at the Pima County Detention Center in Tucson. Pam has been a frequent guest speaker related to psychiatric emergencies and has published articles in both law enforcement and nursing magazines.