An Exploration of Musculoskeletal Injuries Occurring in a Canadian Police Agency: Can Fitness Test Results Predict Injury Risk?

Abstract

Background Police officers have a greater risk of injury compared to those in most other occupations. A police officer who suffers an injury may not be able to act in their full capacity while they recover resulting in sick time, decreased productivity, limited physical ability, or the development of chronic or comorbid injury. If a police organization has members who are unable to work or perform their regular duties, members of the community may be affected by decreased service, increased response time to emergencies, and increased cost of maintaining services. Purpose There is little information in the literature regarding police officer injury occurrence. Even less research exists exploring the relationship between physical fitness and musculoskeletal injury in this occupational group. This thesis aims to: 1) review existing literature examining occupational injury in first responders, 2) Systematically review existing literature examining the relationship between fitness and injury in first responders, 3) to analyze injury data from a municipal police service in Western Canada in order to quantify injury prevalence and identify the most common MSI experienced by police officers and 4) to investigate the risk of injury and fitness test performance to identify whether different components of fitness have differing relationships to injury. Methods Using existing administrative medical and fitness data, this thesis investigates reported musculoskeletal injuries (MSI) that occurred between January 1, 2013 and June 2, 2016 in a cohort of municipal police officers, in a single police service in Western Canada. The injuries could have occurred at or away from work. Results Over 41 months, the cumulative incidence was 106 injuries per 1,000 personnel, per year. Most injuries were diagnosed as sprains/strains (89.2%) and fractures (8.3%). The back, shoulder, and leg (or lower extremity) were most frequently injured. A multivariate model was constructed using conditional logistic regression to identify what fitness test scores may be used to estimate injury risk. A multivariate conditional logistic regression indicated that a combination of decreased age, female sex, decreased number of pullups, and increased VO2max best explained increased injury risk. Additionally, the findings indicated an interaction between sex and VO2max so the effect of VO2max on injury risk cannot be understood without accounting for sex. Conclusions Police officers frequently suffer MSI with sprains and strains the most dominate injury type. The lower extremity, back, and/or shoulder are most commonly injured in this population. Females an older police officers may be at increased risk of injury in this population. Further research should examine sex specific relationships between fitness test scores and injury risk in this population.