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The purpose of this paper is to provide a state-of-the-art review on the topic of police stressors and associated health outcomes. Recent empirical research is reviewed in the areas of workplace stress, shift work, traumatic stress, and health. The authors provide a comprehensive table outlining occupational exposures and related health effects in police officers.

A review of recent empirical research on police stress and untoward psychological and physiological health outcomes in police officers.

The results offer a conceptual idea of the empirical associations between stressful workplace exposures and their impact on the mental and physical well-being of officers.

A key limitation observed in prior research is the cross-sectional study design; however, this serves as a motivator for researchers to explore these associations utilizing a longitudinal study design that will help determine causality.

This review provides empirical evidence of both mental and physical outcomes associated with police stress and the processes involved in both. Research findings presented in this paper are based on sound psychological and medical evidence among police officers

The purpose of the present study is to examine associations between post‐traumatic stress disorder (PTSD) symptoms and salivary cortisol parameters.

PTSD symptoms and cortisol responses were measured in a random sample of 100 police officers. The impact of event scale (IES) categorized into subclinical, mild, moderate and severe levels was employed to measure PTSD symptoms. Cortisol was analyzed from saliva samples over a period of three days and included an awakening response, high protein lunch challenge, whole day (diurnal), and a dexamethasone suppression test (DST).

Officers in moderate and severe PTSD symptom categories had higher mean awakening cortisol values. A significant sample‐time by PTSD interaction (p=0.008) was found for awakening cortisol responses. Officers in the severe PTSD symptom category showed a blunted response to the cortisol protein meal challenge compared to those in lower PTSD categories. Diurnal cortisol levels suggested an increasing trend across subclinical to severe PTSD categories respectively (p=0.15 test for trend). DST ratios were lower in moderate and severe PTSD symptom categories (6.86 and 8.03 respectively) than in the subclinical and mild categories (9.32 and 10.43 respectively).

The sample was not representative of all police in the USA. These results suggest that associations between psychological trauma symptoms and dysregulation of cortisol patterns may exist and could possibly affect future health outcomes in police officers.

Exposure to trauma and disaster events emphasizes the need to further investigate the health impact of PTSD on police personnel as well as other first responder groups.

This article will not only be of interest to those in the police service but to the general public. The present study may serve to provide a guide for larger police population investigations on PTSD and physiological impact.

Working on the night shift is a potential source of occupational stress and has been associated with sleep disorders. The purpose of this paper is to investigate the association between shift work and sleep problems among police officers from Buffalo, New York.

Randomly selected officers (n=111) responded to questions on sleep quality and quantity. Shift work data were obtained from daily payroll records from 1994 to the exam date (1999‐2000). Prevalence ratios (PR) were obtained using Poisson regression models that examined associations of shift work with sleep quality and quantity.

Among police officers, night shift work was significantly and independently associated with snoring and decreased sleep duration.

Although the sleep questions were similar to those used in validated sleep questionnaires, a major strength of this study was the availability of daily work history data on all officers for up to five years prior to the current examination.

This study aims to look at the prevalence of obesity and its association with sleep problems among police officers.

The authors conducted a cross‐sectional study of the relationship between obesity and sleep disorders among 110 randomly selected police officers from the Buffalo, New York, Police Department in 1999. Participants, who ranged in age from 26 to 61 years (mean±SD=39.5±7.5), responded to sleep related questions and had anthropometric measurements taken.

Results show that several measures of obesity were significantly associated with sleep‐disordered breathing in police officers, but not with other sleep problems.

A major strength of the study was that it was conducted in a cooperative and motivated study population. It was possible to assess a wide range of anthropometric measurements, including many that are important but are rarely used to measure obesity in epidemiologic studies such as abdominal height, neck circumference, and neck‐to‐height ratio. In addition, the assessment of the anthropometric indices was performed by trained clinic staff using standardized procedures.