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The prevalence and incidence of HIV-1 infection and syphilis in a cohort of police officers in Dar es Salaam, Tanzania: a potential population for HIV vaccine trials.

OBJECTIVES: To assess the suitability of a cohort of police officers in Dar es Salaam for HIV vaccine trials by determining the prevalence and incidence of HIV-1 infection, active syphilis and their associated factors. DESIGN AND SETTING: An open cohort study of police officers in Dar es Salaam, Tanzania. METHODS: Recruitment of police officers began in 1994. A standardized questionnaire was completed at enrolment and subsequent visits. HIV antibodies were determined using two consecutive enzyme-linked immunosorbent assays. Samples repeatedly discordant on the two tests were tested by a Western blot assay. Treponema pallidum antibodies were first determined by Venereal Disease Research Laboratory (VDRL) test and reactive sera were confirmed by Treponema pallidum hemagglutination test. RESULTS: At the end of 1996 a total of 2850 police officers had been recruited of whom 2733 (96%) consented to be tested for HIV. The overall HIV-1 seroprevalence at recruitment was 13.8% (378 of 2733). Females had a significantly higher HIV-1 seroprevalence, 18.0% (55 of 306), as compared to males, 13.3% (323 of 2427), P< 0.05. From a total of 2215 married police officers, 585 (26.4%) responded to a question on extramarital sex within the previous 3 months of whom 36.2% (212 of 585) admitted to have had at least one extramarital sexual intercourse. Condoms were not used during these encounters by 178 of 212 (84.0%). As of 31st December 1998, among the 1524 males observed for 2553 person-years (PYAR), 50 had seroconverted and among 200 females observed for 357 PYAR, eight had seroconverted. The overall crude HIV-1 incidence was thus 19.9/1000 PYAR; 19.6 and 22.4/1000 PYAR for males and females, respectively. The overall prevalence and incidence of active syphilis were 3.1% (88 of 2850) and 8.6/1000 PYAR (26 of 3149), respectively. Males had a higher prevalence of active syphilis, 84 of 2525 (3.3%) than females, five of 325 (1.5%), P = 0.09. CONCLUSIONS: There was high risk sexual practice including low condom use in this cohort of police officers. The incidence and prevalence of HIV infection were high. Police officers in Dar es Salaam are therefore a potential population group for HIV vaccine evaluation.

AIDS Vaccines↗

Review of police inquiries to an accident and emergency department.

OBJECTIVE: To assess the workload generated by police inquiries to an accident and emergency (A&E) department and the adherence of medical staff to departmental guidelines relating to these inquiries. DESIGN: Prospective analysis of the number, nature, and timing of police inquiries and the information released by medical staff. SETTING: A&E department of an inner city teaching hospital. OUTCOME MEASURES: Number of personal and telephone requests for information from police; completion of a form of inquiry; record of patient consent for release of information. RESULTS: A daily average of 8.7 police inquiries were made, but in only 10% of cases was a form of inquiry completed. The patient's consent for release of information to the police was recorded in 4% of cases. CONCLUSIONS: Police inquiries generate a significant workload for an A&E department, often at clinically busy times. Medical staff need further education to ensure that patient confidentiality is respected while assisting the police with their investigations.

Confidentiality↗

Investigation of bias after data linkage of hospital admissions data to police road traffic crash reports.

RESEARCH QUESTION: Does a database of hospital admission data linked to police road traffic accident (RTA) reports produce less biased information for the injury prevention policymaker, planner, and practitioner than police RTA reports alone? DESIGN: Data linkage study. STUDY POPULATION: Non-fatal injury victims of road traffic crashes in southern England who were admitted to hospital. DATA SOURCES: Hospital admissions and police RTA reports. MAIN OUTCOME MEASURES: The estimated proportion of road traffic crashes admitted to hospital that were included on the linked database; distributions by age, sex, and road user groups: (A) for all RTA injury admissions and (B) for RTA serious injury admissions defined by length of stay or by nature of injury. RESULTS: An estimated 50% of RTA injury admissions were included on the linked database. When assessing bias, admissions data were regarded as the "gold standard". The distributions of casualties by age, sex, and type of road user showed major differences between the admissions data and the police RTA injury data of comparable severity. The linked data showed smaller differences when compared with admissions data. For RTA serious injury admissions, the distributions by age and sex were approximately the same for the linked data compared with admissions data, and there were small but statistically significant differences between the distributions across road user group for the linked data compared with hospital admissions. CONCLUSION: These results suggest that investigators could be misinformed if they base their analysis solely on police RTA data, and that information derived from the linked database is less biased than that from police RTA data alone. A national linked dataset of road traffic crash data should be produced from hospital admissions and police RTA data for use by policymakers, planners and practitioners.

Accidents, Traffic↗

Exposure to benzene in urban workers: environmental and biological monitoring of traffic police in Rome.

OBJECTIVES: To evaluate the contribution of traffic fumes to exposure to benzene in urban workers, an investigation on personal exposure to benzene in traffic police from the city of Rome was carried out. METHODS: The study was performed from December 1998 to June 1999. Diffusive Radiello personal samplers were used to measure external exposures to benzene and alkyl benzenes during the workshift in 139 policemen who controlled medium to high traffic areas and in 63 office police. Moreover, as biomarkers of internal exposure to benzene, blood benzene, and urinary trans, trans-muconic and S-phenyl mercapturic acids were measured at the beginning and at the end of the workshift in 124 traffic police and 58 office police. RESULTS: Time weighted average (TWA) exposure to benzene was consistently higher among traffic police than among indoor workers (geometric mean 6.8 and 3.5 microg/m(3), respectively). Among the traffic police, the distribution of individual exposures was highly asymmetric, skewed toward higher values. Mean ambient benzene concentrations measured by municipal air monitoring stations during workshifts of traffic police were generally higher (geometric mean 12.6 microg/m(3)) and did not correlat with personal exposure values. In particular, no association was found between highest personal exposure scores and environmental benzene concentrations. Among the exposure biomarkers investigated, only blood benzene correlated slightly with on-shift exposure to benzene, but significant increases in both urinary trans, trans-muconic and S-phenylmercapturic acids were found in active smokers compared with non-smokers, irrespective of their job. CONCLUSION: The exposure to traffic fumes during working activities in medium to high traffic areas in Rome may give a relatively greater contribution to personal exposure to benzene than indoor sources present in confined environments. Smoking significantly contributed to internal exposure to benzene in both indoor and outdoor workers.

Adult↗

Policing and the mentally disordered.

I hope this article has given at least a flavour of the variety and complexity of challenges faced at the immediate operational level by police officers who have very little training in recognising the signs or symptoms of mental disorder and who very often have to deal with violent or irrational people who are quite simply criminal rather than ill. There is no question that in Dumfries Division police officers rely heavily upon the personal imput of on-call police doctors. Whilst at an operational level it is believed that incidents involvidng people with mental disorders are on the increase, it is particularly difficult to quantify exact extent of this perceived increase or indeed the impact which increasing abuse of alcohol and cotrolled drugs is having on the perception of mentally disordered offenders in the community. The vast majority of prisoners who are arrested and held within cells at Dumfries Police Office are suffering from some form of drug dependency and are in need of some form of assistance. Many display a variety of irrational behaviours when suffering the effects of drug withdrawal and increasingly it is difficult to keep any prisoner within the cells at Dumfries unless they have been examined by the on call police surgeon. Many are depressed, confused and increasingly providing at least verbal indicators that they are suicidal. It is more often the case that prisoners who are held within cells at Dumfries are in some form of constant observation whilst in our care. Given the increasing presence of mentally vulnerable people within our communities, it is vital that operational police officers play their part in responding appropriately to the needs of these people and the dangers they may pose to themselves or others. Dealing sensitively with increasing public concerns through appropriate community representative channels will also pose a considerable challenge. A challenge which can only be met through increasing awareness of the real situation and a commitment to enhance relationships across the caring and policing professions. The best chance of success in this area undoubtedly lies in the strength of these local relaitonships as progressed through honest and open inter-agency working.

Commitment of Persons with Psychiatric Disorders↗

Comparison between blood analysis and police assessment of drug and alcohol use by injured drivers.

Official statistics for alcohol/drug use by drivers can influence the introduction of intervention measures against impaired driving. Thus, the validity of official statistics is important. Since official statistics are based on police assessment of inebriation, the present study was aimed at investigating this issue by comparing blood analysis with the rate of police detection of alcohol/drug use by injured drivers. All injured motor vehicle drivers who were hospitalized (HD) (Umeå: n = 104) and all fatally-injured drivers (FD) who were autopsied (Umeå, Northern Sweden: n = 110; Gothenburg, Western Sweden: n = 133) from May 1991 through Dec 1993 were tested for alcohol and both licit and illicit drugs. The findings of the blood analyses were compared with police assessment of inebriation. In the HD, the police suspected inebriation in 13% (n = 13) whilst blood analyses showed drug and or alcohol in 18% (n = 19) of the drivers (sensitivity 69%; specificity 97%). In the FD, the police suspected inebriation in 7% (n = 16) of the drivers whilst blood analyses showed drug and/or alcohol in 23% (n = 57) of the drivers (sensitivity 53%; specificity 100%). The blood alcohol-positive HD who the police suspected to be inebriated had significantly higher mean blood alcohol concentrations than those not suspected. To avoid biased statistics, official statistics on inebriation of injured drivers should be based on blood analysis of drug/alcohol and not on police assessment.

Accidents, Traffic↗

Police discourses of homosexual men in New Zealand.

The present study examined the discourses of homosexuality in the police, using the discourse analytic method developed by Potter and Wetherell (1987). The study asked how police officers constructed gay men using their discourses and why gay men should or should not be employed by the police. Eight police officers were interviewed. Analysis revealed officers drew on three distinct discourses to construct gay men. The effeminate discourse associated homosexuals with effeminate behaviors. The deviant discourse associated homosexuals with behaviors that are morally and legally prescribed, and the discourse of conditional acceptance was used by officers to positively present, while voicing reservations about homosexuals. These discourses formed the linguistic resources officers used to construct types of homosexuals that were subsequently rejected as potential police officers. Several arguments were used to justify the conclusion that homosexuals were unsuited to the police. These related to the internal and external pressures impinging on the department with regard to the employment of homosexuals. The implications of the discourses are discussed with reference to gay men, the police, and the ideologies of heterosexism and gender.

Homosexuality, Male↗

Race and willingness to cooperate with the police: The roles of quality of contact, attitudes towards the behaviour and subjective norms.

Black individuals are usually reluctant to co-operate with the police (Smith, 1983a). We propose that a history of unpleasant interactions with the police generates hostile attitudes towards the institution (Jefferson & Walker, 1993). Using a sample of 56 black and 64 white participants, we examined whether quality of contact predicts black people's attitudes and subjective norms concerning co-operating with the police. Our findings indicated that the Contact Hypothesis (Pettigrew, 1998) and Theory of Planned Behaviour (Ajzen, 1991) jointly provide some insight into the disinclination of black individuals to co-operate with the police. We found that the relationship between race and attitudes or subjective norms concerning co-operation with police investigations was mediated by quality of previous contact with the police. In turn, the relationship between quality of contact and willingness to co-operate with police investigations was mediated by both attitudes and subjective norms. Theoretical and practical implications are discussed.

Attitude↗

Characterizing perceived police violence: implications for public health.

Despite growing recognition of violence's health consequences and the World Health Organization's recent classification of police officers' excessive use of force as a form of violence, public health investigators have produced scant research characterizing police-perpetrated abuse. Using qualitative data from a study of a police drug crackdown in 2000 in 1 New York City police precinct, we explored 40 injection drug using and 25 non-drug using precinct residents' perceptions of and experiences with police-perpetrated abuse. Participants, particularly injection drug users and non-drug using men, reported police physical, psychological, and sexual violence and neglect; they often associated this abuse with crackdown-related tactics and perceived officer prejudice. We recommend that public health research address the prevalence, nature, and public health implications of police violence.

Adult↗

Police service in Victorian and Edwardian London: a somwhat atypical case of a hazardous occupation.

British society in the nineteenth century showed a growing concern with public-health issues and with occupational hazards. Police service, which is at the centre of this paper, was not viewed by many as a hazardous occupation. Using the London Metropolitan Police as a case study, the paper suggests that working conditions in the Victorian and Edwardian police had detrimental effects on the health of officers. It is true that medical statistics of the time showed that police officers in London had a lower death rate than the average working man, but this comparison should not obscure the fact that policemen entered the force much healthier than when they retired and that this gap was not merely age-related. The paper sets out to answer the following questions: What were the prevalent injuries and illnesses in the Metropolitan Police? What was the work experience of the police officer and what impact did it have on his state of health? In addition to accounting for the deteriorating health of police officers, the paper provides the views of contemporary observers on the subject.

Crime↗

Police involvement in domestic violence: the interactive effects of victim injury, offender's history of violence, and race.

While there is a proliferation of research devoted to ascertaining the efficacy of arrest and other formal sanctions in deterring domestic violence, little research has focused on factors related to the pivotal point at which this formal sanctioning process begins, namely, in a victim's decision to report her victimization to police. This paper is an attempt to rectify this omission by examining those factors most important in predicting the police-reporting behavior of 1535 female victims of intimate-perpetrated violence (e.g., by husbands and boyfriends) taken from the National Crime Victimization Survey during 1987-1992. In addition to predicting the reporting decision of these victims, models predicting various police responses to a victim's report were also examined, including police response times, police actions at the scene, and the probability of an arrest being made. A combination of contextual and demographic characteristics affected the probability that incidents would be placed into the realm of formal sanctioning. Black victims, victims who sustained injury as the result of their victimization, and victims who reported that the offender had not victimized them before were more likely to report their victimization to police. These same factors were also significant predictors of arrest. Police were more likely to make an arrest in incidents in which victims had sustained injuries, when the offender did not have a history of violence, and in incidents which involved Black offenders victimizing Black victims. Implications for the "Battered Women Syndrome" and suggestions for future research are discussed.

Black or African American↗

32P-postlabeling detection of aromatic adducts in the white blood cell DNA of nonsmoking police officers.

Atmosphere in urban areas may be polluted by a number of combustion sources, including industries, vehicle traffic, and residential heating. Traffic police constitute a group of workers that is highly exposed to urban pollutants, especially those from motor vehicle exhaust. We conducted a biomonitoring study to simultaneously measure in 34 nonsmoking police officers and in 36 nonsmoking office workers, as referents, the individual benzo(a)pyrene [B(a)P] exposure using personal samplers and the formation of DNA adducts in peripheral WBCs using 32P-postlabeling techniques. Our results show that the police officers were exposed to significantly higher levels of B(a)P than were referents (P < 0.0001). No seasonal variation of the atmospheric levels of B(a)P was found throughout the year. The median relative adduct labeling x 10(-8) values of the controls and exposed police officers were 0.94 (range, 0.1-3.7) and 1.3 (range, 0.1-5.5), respectively, using the nuclease P1 technique. Although the DNA adduct levels of police officers were globally higher than those of referents (P < 0.05), the difference was entirely due to the summer difference [median values 0.80 (range, 0.1-1.8) and 2.8 (range, 0.7-5.5), respectively (P < 0.001)]. In winter, the DNA adduct levels were substantially identical, and in midseason, there was only a very small increase in police officers, with respect to controls (statistically not significant). Moreover, a more significant seasonal variation of bulky aromatic DNA adduct levels was observed in WBC DNA samples of police officers (P < 0.05) compared to those of referents. The seasonal variation of bulky aromatic adduct levels could be correlated with the reported seasonal variation of aryl hydrocarbon hydroxylase inducibility in human lymphocytes.

Adult↗

Police and mental health professionals. Collaborative responses to the impact of violence on children and families.

Coordinating responses through the Child Development-Community Policing Program has led to multiple changes in the delivery of clinical and police services. Mental health clinicians and police officers have developed a common language for assessing and responding to the needs of children and families who have been exposed to or involved in violence. Learning from each other, these unlikely partners have established close working relationships that improve and expand the range of interventions they are able to provide while preserving the areas of expertise and responsibilities of each professional group. The immediate access to witnesses, victims, and perpetrators of violent crimes through the consultation service provides a unique opportunity to expand the understanding of clinical phenomena from the acute traumatic moment to longer-term adaptation, symptom formation, and recovery. In turn, the initiative introduces the systematic study of basic psychological and neurobiologic functions involved in traumatization as well as the investigation of psychotherapeutic and pharmacologic therapies. Similarly, program involvement with juvenile offenders has led to a coordinated response from the police, mental health, and juvenile justice systems. This project provides an opportunity to develop detailed psychological profiles and typologies of children engaged in different levels of antisocial behavior as well as to determine the characteristics that might predict with whom community-based interventions might be most successful. A recent survey of New Haven public school students has yielded promising evidence that community policing and the program are having a positive impact on the quality of life. In a survey of sixth-, eighth-, and tenth-grade students there were substantial improvements in students' sense of safety and experience of violence between 1992 and 1996. When asked if they felt safe in their neighborhood, there was an increase in the percentage of positive responses from 57% to 62% for sixth-grade students, 48% to 66% for eighth-grade students, and 53% to 73% for tenth-grade students, and when asked if they had seen someone shot or stabbed there was a decrease in positive responses from 43% to 28% for sixth-grade students, 46% to 31% for eighth-grade students, and 34% to 28% for tenth-grade students. Today, we are all too familiar with the developmental trajectory that leads children into violent crime. Newspaper articles and clinical case reports have taken on a dreary repetitiveness. These young criminals are often poor, minority, inner-city children who are known to many agencies to be at risk because of family disorganization, neglect, and abuse. They are failing in school or are already on the streets. One day they are victims and the very next they are assailants. We are all familiar with the inadequacies in the social response to these children, from their preschool years through the point at which they become assailants themselves. What is shocking is that the age at which children make the transition from being abused to being abusive seems to be getting earlier, and the number appears to be increasing. On the positive side, there is an increased awareness of the need and the ability of the various sectors of society to respond in concert. The institutions that function in the inner city--schools, police, mental health and child welfare agencies, churches--are all concerned about the same children and families. By working together, with a shared orientation to the best interests of the children, they can intervene earlier and more effectively: first, to disrupt the trajectory leading to violence; and, second, to help those children who are already caught in the web of exposure to violent crime and inner-city trauma. The experience with community-based policing and mental health in New Haven, now being replicated throughout the United States, can thus stand as a model of an active social response to an overwhel

Adolescent↗

Exploring new territory: police organizational responses to child sexual abuse.

Police response to the escalating numbers of child sexual abuse cases has led to the development of a wide range of organizational models within both police departments and the interagency context. This paper compares the results of different models of police intervention in New South Wales, Australia. The data suggest that specialist police units in which police manage the full investigation provide a more comprehensive service than those where the police response is fragmented between units within the police force.

Child↗

Detecting intoxicated drivers in Germany -- estimating the effectiveness of police tests.

The most important prerequisite for deterring people from driving while intoxicated is to persuade them of the likelihood of being detected by the police. Detection requires the police (1) to stop intoxicated drivers and (2) to detect the intoxication. The latter is not a simple task in Germany as the police is only allowed to obtain a breath sample when indications of an intoxication are present. The paper estimates the effectiveness of police tests in detecting intoxicated driving by comparing data from the German Roadside Survey and the Unterfranken Accident Study to a study of usual police routine and to official accident statistics. Both the German Roadside Survey and the Unterfranken Accident study were conducted in such a way that breath alcohol testing was carried out for nearly every driver, thus giving an estimate of the number of intoxicated trips and accidents in Germany. Comparing these numbers to the intoxicated trips and accidents detected by the police allows a detailed analysis of different components of detection. From those, suggestions are given for increasing the effectiveness of police work.

Accidents, Traffic↗

Coronary heart disease in police officers participating in the Normative Aging Study.

There is evidence suggesting that male police officers are at a higher risk of developing coronary heart disease than males in the general population. Thus, 1648 men (including 220 police officers and 1428 non-police officers) were followed for 10 years to determine the incidence of coronary heart disease. Subjects were participants of the Normative Aging Study, a longitudinal study of aging initiated in 1963 at the Veterans Administration Outpatient Clinic in Boston, Massachusetts. Comparison of police officers and non-police officers showed no statistically significant differences in the crude incidence rates of coronary heart disease (myocardial infarction, angina pectoris, or death from coronary heart disease) and myocardial infarction alone. When baseline age, serum cholesterol, blood pressure, cigarette smoking, and body mass index were taken into consideration in multiple logistic regression analyses, the lack of significant differences between groups persisted. Police officers relative to non-police officers had an adjusted risk ratio (odds ratio) of 1.4 (95% confidence interval = 0.7-2.4) for coronary heart disease and 1.0 (95% confidence interval = 0.4-2.4) for myocardial infarction. Differences between occupational groups were not statistically significant.

Adult↗

Contagious suicide in prisons and police cells.

STUDY OBJECTIVE: The aim was to determine whether clustering of suicide occurred in prisoners and detainees in police cells and to describe the characteristics of any clusters identified. DESIGN: Mortality from suicide was examined for evidence of clusters. SETTING: Prisons (1971-1988) and police cells (1980-September 1991) in New Zealand. SUBJECTS: 82 male suicides. MAIN RESULTS: There were 38 male suicides in prisons and 44 in police cells over the time periods. Due to the increasing trend in prison suicides, the 1971-1982 and 1983-1988 time periods were examined for evidence of clusters separately. For suicides in police cells the time periods studied were 1980-1982, 1983-1988, and 1989-1991. The event of suicide was treated as a Poisson process with all suicides in a time period used to calculate the mean. Four suicide clusters occurred between 1985 and 1988 in prisons. These did not explain the increased suicide rate over this period. Three clusters of suicide in police cells occurred between 1980 and 1991, which had different characteristics from suicide in prisons in that these three clusters were of longer duration. CONCLUSIONS: The different characteristics of prison and police cell clusters of suicide indicated separate transmission of the contagious component of suicide between these groups. Distinct strategies to reduce clusters of male suicide in custody are required for prisoners and those held in police cells.

Adult↗

Police involvement and influence in involuntary civil commitment.

Although observers agree that the police play an important role in involuntary civil commitment of mentally ill individuals, there are scant empirical data to document the importance of the police in swaying the commitment decision. The authors studied 3,570 randomly selected case records of individuals referred to two county offices of civil commitment in Washington State to determine the types of referrals police become involved in , the extent to which referral sources request police assistance, and the percentage of referrals resulting in commitment with and without police involvement. The authors conclude that police most often are asked to assist in cases involving violent behavior, but that under almost all circumstances police involvement is the primary factor in determining whether referral will result in commitment.

Commitment of Persons with Psychiatric Disorders↗