title: Assaults against U.S. law enforcement officers in the line-of-duty: situational context and predictors of lethality.
abstract: BACKGROUND
  Research on occupational safety of law enforcement officers (LEOs) has primarily focused on fatal assaults. Nonfatal assaults, however, have received little attention. The goal of this study was to describe the situational contexts in which LEOs are assaulted, and compare these contexts and risks between fatal and nonfatal assaults in the U.S. Analyzing both types of assaults provides a more complete understanding of occupational safety and opportunities for intervention.
  
  
  METHODS
  This study includes a descriptive epidemiology of fatal and nonfatal assaults of LEOs in the U.S. and a pooled cross-sectional analysis of risk factors contributing to the odds of lethal assault. Data were collected from the Law Enforcement Officers Killed and Assaulted database. Descriptive statistics were used to characterize fatal and nonfatal assaults. Odds ratios were generated to understand the odds that an assault would result in a fatality.
  
  
  RESULTS
  Between 1998 and 2013, there were 791 fatal assaults and 2,022 nonfatal assaults of LEOs. Nearly 60% of primary wounds in fatal assaults were received to the head, neck, or throat while nearly 50% of primary wounds in nonfatal assaults were received to the arms/hands or below the waist. The odds that an assault resulted in a fatality decreased by 57% (OR 0.43, 95% CI 0.32 to 0.58) when a LEO was wearing body armor. LEOs experiencing an ambush or unprovoked attack had significantly increased odds of an assault resulting in a fatality (OR 3.27, 95% CI 1.83 to 5.85 and OR 2.24, 95% CI 1.44 to 3.47 respectively). LEOs that were disarmed during an encounter with a suspect had more than 2-fold increased odds of an assault resulting in a fatality (OR 2.24, 95% CI 1.48 to 3.38).
  
  
  CONCLUSIONS
  There are specific situational and encounter characteristics that influence the lethality of an assault, which suggest strategies for prevention. Mandatory wear policies for the use of body armor could significantly reduce mortality among assaulted LEOs.
authors.affiliation: Department of Health Policy and Management, Johns Hopkins Center for Gun Policy and Research, Johns Hopkins Bloomberg School of Public Health, 624 N. Broadway, Baltimore, MD, 21205, USA. crifasi@jhu.edu.|Johns Hopkins Education and Research Center for Occupational Safety and Health, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe St, Baltimore, MD, 21205, USA. crifasi@jhu.edu.|Department of Health Policy and Management, Johns Hopkins Center for Injury Research and Policy, Johns Hopkins Bloomberg School of Public Health, 624 N. Broadway, Baltimore, MD, 21205, USA. crifasi@jhu.edu.
authors.forename: Cassandra K
authors.initials: CK
authors.lastname: Crifasi
authors.affiliation: Johns Hopkins Education and Research Center for Occupational Safety and Health, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe St, Baltimore, MD, 21205, USA.|Department of Health Policy and Management, Johns Hopkins Center for Injury Research and Policy, Johns Hopkins Bloomberg School of Public Health, 624 N. Broadway, Baltimore, MD, 21205, USA.
authors.forename: Keshia M
authors.initials: KM
authors.lastname: Pollack
authors.affiliation: Department of Health Policy and Management, Johns Hopkins Center for Gun Policy and Research, Johns Hopkins Bloomberg School of Public Health, 624 N. Broadway, Baltimore, MD, 21205, USA.
authors.forename: Daniel W
authors.initials: DW
authors.lastname: Webster
keywords: Epidemiology; Law enforcement; Violence; Workplace