Characterization of Injuries Suffered by Mounted and Non-Mounted Police Officers

[Find the meaning and references behind the names: Dos Santos, Law, Add, Range, Santos, Canetti, Doi, June, Aim, Robin, Work, January, Ben, Basel, Baptista, Unique, Orr, Gear, Cardoso, Vary, Cristina, Charles, Joana, Dawes, Int, Body, Falls, Pain, Vital, Return, Lab, Time, Guedes, Mar, December, Edu, Robina, Pope, Gonz, Ability, Data, Under, Hand, Robert, High, State, Back, Jay, Fullerton, Officer, July, Open, Bond, Rate, Elisa, Non, Hours, Lower, Study, Strong, Tel, Nieves, Schram, Rodney, Common]

Citation: Orr, R.; Canetti, E.F.D.; Pope, R.; Lockie, R.G.; Dawes, J.J.; Schram, B. Characterization of Injuries Suffered by Mounted and Non-Mounted Police Officers Int. J Environ. Res. Public Health 2023 , 20 , 1144. https://doi.org/10.3390/ ijerph 20021144 Academic Editors: Jo ã o dos Santos Baptista, Joana Cristina Cardoso Guedes and Mar í a de las Nieves Gonz á lez Garc í a Received: 10 December 2022 Revised: 4 January 2023 Accepted: 5 January 2023 Published: 9 January 2023 Copyright: © 2023 by the authors Licensee MDPI, Basel, Switzerland This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https:// creativecommons.org/licenses/by/ 4.0/) International Journal of Environmental Research and Public Health Article Characterization of Injuries Suffered by Mounted and Non-Mounted Police Officers Robin Orr 1,2, * , Elisa F. D. Canetti 1,2 , Rodney Pope 1,3 , Robert G. Lockie 4 , J. Jay Dawes 5,6 and Ben Schram 1,2 1 Tactical Research Unit, Bond University, Robina, QLD 4226, Australia 2 Faculty of Health Sciences and Medicine, Bond University, Robina, QLD 4226, Australia 3 School of Allied Health, Exercise and Sports Sciences, Charles Sturt University, Albury, NSW 2640, Australia 4 Department of Kinesiology, California State University, Fullerton, CA 92831, USA 5 School of Kinesiology, Applied Health and Recreation, Oklahoma State University, Stillwater, OK 74078, USA 6 OSU Tactical Fitness and Nutrition Lab, Oklahoma State University, Stillwater, OK 74078, USA * Correspondence: rorr@bond.edu.au; Tel.: +61-468-646-027 Abstract: Mounted police officers are subject to unique occupational tasks which may lead to unique injuries. This study’s aim was to describe policing injuries suffered by mounted police officers contextualized through comparison to non-mounted officers. Injury data from 01 July 2014 to 30 June 2020 were provided from a state policing agency’s incident reporting database. The data reported the numbers and rates of injuries and classified the injuries by gender, cause, mechanism, nature, and hours worked. Of the 35,406 reported injuries, 35,255 (99.6%) injuries were reported by nonmounted police officers. An annual incidence rate of 338–364 and 626–952 injuries per 1000 personnel were reported in non-mounted and mounted police, respectively. For mounted police, the leading causes of injuries were slips, trips, and falls (23.8%), followed by repetitive tasks and movements (9.9%). Physical assault was the leading cause of injury for non-mounted police officers (21.3%), followed by slips, trips, and falls (16.0%). In mounted police, falls from heights (15.9%) and repetitive tasks and movements (10.6%) comprised the most frequently specified mechanisms of injury, as compared to physical assault (21.0%) and physical exercise (5.2%) in non-mounted police. The most common activities being performed at the time of injury for mounted police were animal handling (64.9%) as opposed to arresting an offender (31.2%) for non-mounted police. Sprains and strains and bruises and swelling were the leading natures of injuries among both mounted (44.4% and 29.1%, respectively) and non-mounted (36.6% and 21.2%, respectively) officers. The leading body sites of injury in mounted officers were the lower back (13.9%) and neck and shoulders (7.3% each), and for non-mounted police, the knee (13.9%), lower back (10.0%), and hand (8.2%) were the most common. Mounted police officers sustained injuries through different activities, causes, and mechanisms and to different body sites at 2–3 times higher incidence rates. Mounted police officers warrant specifically tailored injury mitigation and return-to-work strategies Keywords: law enforcement; horses; back pain; occupation; policing; equestrian 1. Introduction Police officers are expected to perform a variety of occupational tasks. These tasks range from checking an individual’s identity to chasing and apprehending a fleeing suspect [ 1 ]. This variety means that a police officer could experience situations that greatly vary in physical demands, ranging from those that are predominantly sedentary (e.g., desk work and communications) to those that are high intensity in nature (e.g., grappling with a suspect) [ 1 ]. To add to the potential physical demand, police officers often have to perform these tasks while carrying extra weight on their persons (up to 10 kg) comprising vital gear and safety equipment [ 2 ]. Additionally, these physically demanding tasks often occur with little to no warning, limiting the ability of an officer to prepare themselves mentally and Int. J. Environ. Res. Public Health 2023 , 20 , 1144. https://doi.org/10.3390/ijerph 20021144 https://www.mdpi.com/journal/ijerph

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Int. J. Environ. Res. Public Health 2023 , 20 , 1144 2 of 12 physically [ 3 ]. This combination of factors is a key reason why police officers are at an increased risk of injury [ 4 ]. A critical review by Lyons et al. [ 4 ] found that police officers suffered injuries at a rate ranging from 240 to 2500 per 1000 personnel per year, a higher injury rate than some other physically demanding occupations, such as mining, which has shown a rate of 164 to 638 injuries per 1000 people per year [ 5 ]. The review found that injuries commonly affected the upper limb and back and were mainly musculoskeletal in nature [ 4 ]. These injuries have multiple downstream effects on both organizations and individuals. At the organizational level, injuries increase healthcare costs (to provide sufficient care for the officers) [ 6 ] and increase workforce strain [ 7 ]. If an officer is unable to work, other officers would need to work more hours, adding to their workload and potentially increasing their risk of injury. Individually, injuries could affect career longevity by increasing the risk of future injury [ 8 ] and impairing performance upon return to full-time duty [ 9 ]. While sports teams may offer some control over the rehabilitation of players, police officers work in a naturally unpredictable environment and perform a wide variety of different tasks [ 1 , 10 ]. Given their role in protecting the public, decreases in officers’ performance could lead to severe injury or even death of themselves, their colleagues, or members of the community they serve [ 11 , 12 ]. Due to the significant impacts injuries have on both organizations and personnel, it is vital that injury mitigation strategies are developed and implemented Injury mitigation strategies should be specifically created for their target population [ 13 ]. Although the review by Lyons et al. [ 4 ] reported a general injury profile for police officers, injuries may vary across roles and responsibilities. For example, specialist police are more likely to experience back injuries [ 6 ], and individual studies of various police forces have found the lower limb to be the most common site of injury [ 14 ]. Given the wide range of roles that exist in a police department, from general police to water police and specialist tactical groups [ 1 , 15 , 16 ], it is unlikely that all facets of a department would experience the same injuries in the same fashion. As such, specific strategies need to be designed to address the specific sources of injury risk within each group. One group that has received little scientific analysis is the mounted police Mounted police are unique in their job demands as, in addition to their general duties, they must also look after and work with horses [ 17 , 18 ]. Apart from the anticipated unique duties like grooming and caring for their mounts, saddlery, and cleaning stables, operational and special duties tasks may see mounted officers patrolling parks and streets on horseback, working as mounted crowd and traffic control, and even working in livestock mustering [ 17 , 18 ]. These officers and their mounts may also conduct ceremonial and public relations activities, like parades, escorts, vaulting exhibitions, and official excursions [ 17 , 18 ]. Due to the uniqueness of this position, it cannot be reasonably assumed that mounted police would experience similar injuries in the same manner as general police. Therefore, the aim of this study was to describe policing injuries suffered by mounted police officers To contextualize this data, a comparison of injuries among non-mounted officers was also conducted using the data from non-mounted police of the same organization. It was hypothesized that mounted police officers would report different injuries to non-mounted officers and, as such, require different injury mitigation strategies 2. Materials and Methods The study was designed as a population-based, longitudinal study using data previously collected prospectively by an Australian state police force. Injury incident data relating to preceding years were provided in a spreadsheet from the police force’s incident reporting database. The provided data set contained records related to the frequencies of injury incidents that occurred in the mounted and non-mounted elements of the police force within each financial year between 01 July 2014 (the financial year of 2014/15) and 30 June 2020 (the financial year of 2019/20). These frequencies were also broken down by gender, reported activity performed at the time of injury, injury cause, injury mechanism, injury nature, affected body site, and hours worked prior to the injury. In relation to this

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Int. J. Environ. Res. Public Health 2023 , 20 , 1144 3 of 12 study, the “activity” was the task being undertaken at the time of injury, the “cause” was considered the action that best described the circumstances that resulted in the injury, while the “mechanism” described how the “cause” was delivered. As an example, for an officer bitten by a horse when leading it from the stables, the activity would be listed as “animal handling”, the cause would be listed as “animal bite”, and the mechanism was “horse”. For an officer who tripped walking up the steps to their office, the activity could be “general duties”, while the cause would be “slips, trips, and falls”, and the mechanism would be “steps/staircase”. The nature of an injury describes the type of injury that occurred (e.g., a ligament sprain or muscle strain), while the body location describes where on the body the type of injury occurred. In addition, the data indicating the annual injury incidence rates in both the mounted and non-mounted elements of the police force were provided as part of the data set. Ethics approval for the study was provided by the Bond University Human Research Ethics Committee (BS 02126) The participants from whom the data had been derived were current active officers within an Australian state police force during the timeframe in which the data were prospectively recorded by the New South Wales police force in the database from which they were extracted. Given the retrospective nature of the data, information regarding the height, weight, or age of the injured officers was not provided, and data regarding the proportions of the underlying mounted and non-mounted police populations that were of each gender or associated with other demographic characteristics were also unavailable This lack of demographic information is common in tactical populations, often due to security concerns [ 19 , 20 ]. The data were analyzed descriptively to derive, for each of the mounted and nonmounted elements of the police force, the annual injury incidence rates reported per 1000 personnel and the proportions of injuries that were associated with each gender and with specific reported activities performed at the time of injury, injury causes, injury mechanisms, injury nature, affected body sites, and hours worked prior to the injury. The calculation of the annual injury incidence rates per 1000 personnel as the denominator allowed for a ready comparison to the research conducted in other law enforcement populations [ 4 ]. Calculations of confidence intervals around the rates, proportions, and significance testing of the differences between the mounted and non-mounted elements of the police force were not performed because this was not appropriate; specifically, the data used in the study were drawn from the entire population of mounted and non-mounted police officers within the state’s police force in the time periods of interest rather than being drawn from samples derived from these populations, and so there was no uncertainty in the population estimates of the rates, proportions, and differences derived from the analysis (which there would have been if the data were drawn from samples derived from the two police populations). This meant that neither calculation of the precision of the population estimates nor the inferential statistics (to derive inferences from a sample for the underlying population) were appropriate or required 3. Results A total of 35,406 injuries were reported. Of these, 151 (0.4%) were reported by mounted police officers, who comprised a single unit within the state’s police force, and 35,255 (99.6%) injuries were reported by non-mounted police officers. The annual injury incidence rates for the mounted officers ranged from 626 to 952 injuries per 1000 personnel, and these rates were substantially higher than the annual injury incidence rates for the non-mounted officers, which ranged from 338 to 364 injuries per 1000 personnel (Table 1 ). Male officers sustained 76% of non-mounted officer injuries, while 82% of the mounted police unit injuries were to female officers. However, information regarding the proportions of the underlying population comprising each element by each gender was not available Thus, it was not possible to ascertain the injury incidence rates for each gender within each of the mounted and non-mounted elements or determine whether and to what extent these differed.

[Find the meaning and references behind the names: Running, Journey, Foot, Mean, Station, Manual, Boat, Mental]

Int. J. Environ. Res. Public Health 2023 , 20 , 1144 4 of 12 Table 1. Annual injury incidence rates by police force element and financial year Financial Year Mounted Officers Non-Mounted Officers Number of Incidents Incidence Rate (per 1000 Personnel) Number of Incidents Incidence Rate (per 1000 Personnel) 2014–15 30 952 5705 344 2015–16 26 761 5622 338 2016–17 27 770 5931 356 2017–18 22 626 5821 348 2018–19 24 701 6151 364 2019–20 22 638 6025 351 Mean 2014–20 25.17 ± 3.13 741.33 ± 119.33 5875.83 ± 198.81 350.17 ± 9.13 The most commonly specified activities performed at the time of injury for the mounted officers were animal handling (64.9%) and police training (6.0%). For nonmounted officers, the most commonly specified activities were arresting an offender (31.2%) and general duties (9.9%) (Table 2 ). Table 2. Injuries by reported activity at the time of the incident Mounted Officers Non-Mounted Officers Injuries Percentage Activity at the Time of the Incident Injuries Percentage Activity at the Time of the Incident 98 64.9% Animal handling 10,988 31.2% Arresting an offender 19 12.6% Other or unspecified 3505 9.9% Other or unspecified 9 6.0% Police training 3492 9.9% General duties 6 4.0% Manual handling 2306 6.5% Restraining an offender 5 3.3% Walking, running 1715 4.9% Walking, running 4 2.7% Arresting an offender 1645 4.7% Pursuit on foot 3 2.0% Journey to or from work 1266 3.6% Station office duties 2 1.3% Crowd control 1044 3.0% Police training 2 1.3% Station office duties 1047 3.0% Journey to or from work 1 0.7% General duties 1016 2.9% Mental health intervention 1 0.7% Non-work-related incident 969 2.8% Manual handling 1 0.7% Weapons training 818 2.3% Weapons training 646 1.8% Search persons/possess 613 1.7% Patrol in vehicle 386 1.1% Animal handling 463 1.3% Patrol on foot 442 1.3% Journey on duty 302 0.9% OSG training 275 0.8% Attending MVA 250 0.7% Crowd control 221 0.6% Special operations (OSG) 207 0.6% Search premises/vehicle 204 0.6% Search and rescue 177 0.5% Traffic control 175 0.5% Diving 174 0.6% Patrol on bicycle 171 0.5% Patrol on motorcycle 145 0.4% Pursuit in vehicle 115 0.3% Evacuation 114 0.3% Drug or alcohol-related 114 0.3% Technical support 106 0.3% Boat handling 81 0.2% Non-work-related incident 26 0.1% Putting on PPE 19 0.1% Working at heights

[Find the meaning and references behind the names: Step, Transport, Gas, Cont, Motor, Shock, Gun, Noise, Stick, Spray, Struck]

Int. J. Environ. Res. Public Health 2023 , 20 , 1144 5 of 12 Table 2. Cont Mounted Officers Non-Mounted Officers Injuries Percentage Activity at the Time of the Incident Injuries Percentage Activity at the Time of the Incident 5 0.01% Pursuit by motorcycle 4 0.01% Bicycle urgent duty 4 0.01% Handling biochemical waste 3 0.01% Office duties (not station) 2 0.01% Parking patrol 151 100% 35,255 100% Key: MVA: motor vehicle accident; OSG: operations support group; PPE: personal protective equipment In the mounted unit, the most commonly specified cause of injuries was slips, trips, and falls (23.8%). Repetitive tasks and movements and being struck by an object were also prevalent causes of injury in the mounted police (9.9% and 7.3%, respectively). Physical assault was the specified leading cause of injury for the non-mounted police officers (21.3%), followed by slips, trips, and falls (16.0%) and physical exercise (5.8%) (Table 3 ). Table 3. Injuries by reported cause of the incident Mounted Officers Non-Mounted Officers Number Percentage Cause of Incident Number Percentage Cause of Incident 50 33.1% Other or unspecified 7495 21.3% Physical assault 36 23.8% Slips, trips, and falls 5639 16.0% Slips, trips, and falls 15 9.9% Repetitive tasks and movements 5548 15.7% Other or unspecified 11 7.3% Struck by an object 2041 5.8% Physical exercise 9 6.00% Physical exercise 1933 5.5% Manual handling 7 4.6% Manual handling 1496 4.2% Exposure to bodily fluids 6 4.00% Animal bites 1312 3.7% Motor vehicle collision 5 3.3% Caught in or between objects 1322 3.8% Repetitive tasks and movements 3 2.0% Physical assault 1145 3.3% Struck by an object 3 2.0% Step on/striking an object 1079 3.1% Step on/striking an object 2 1.3% Rubbing and chafing 1039 3.0% Entry/exit vehicle/premises 1 0.7% Exposure to workplace violence 1019 2.9% Exposure to workplace violence 1 0.7% MVA 744 2.1% Caught in or between object 1 0.7% OC spray 562 1.6% Animal bites 1 0.7% Safety equipment 324 0.9% OC spray 301 0.9% Human bites 296 0.8% Exposure to chemicals 250 0.7% Exposure to biological factors 226 0.6% Motorcycle collision 211 0.6% Bicycle accident 197 0.6% Insect bites and stings 181 0.5% Psychological factors 125 0.4% Needle-stick injury 123 0.4% Exposure to noise or vibrations 114 0.3% Exposure to gas or fumes 107 0.3% Other transport 99 0.3% Gun discharged 90 0.3% Rubbing and chafing 89 0.3% Exposure to high temperatures 83 0.2% Safety equipment 22 0.1% Electric shock 21 0.1% Explosion or implosion 19 0.1% PPE failure 2 0.01% Exposure to radiation 151 100% 35,255 100% Key: MVA: motor vehicle accident; OC spray: oleoresin capsicum spray; PPE: personal protective equipment.

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Int. J. Environ. Res. Public Health 2023 , 20 , 1144 6 of 12 In mounted police, falls from heights (15.9%), repetitive tasks (10.6%), and horses (9.3%) were the most commonly specified injury mechanisms. In the non-mounted police officers, the most prevalent specified mechanisms of injuries were physical assault (21.0%), physical exercise (5.2%), and uneven surfaces (5.2%) (Table 4 ). Table 4. Injuries by reported mechanism Mounted Officers Non-Mounted Officers Injuries Percentage Mechanism Injuries Percentage Mechanism 38 25.2% Other or unspecified 7385 21.0% Physical assault 24 15.9% Falls from a height 5329 15.1% Other or unspecified 16 10.6% Repetitive tasks and movements 1832 5.2% Physical exercise 14 9.3% Horses 1815 5.2% Uneven surface 14 9.3% Nature of work 1464 4.2% Lifting/carrying/putting down an object 14 9.3% Struck by an object 1350 3.8% Stepping on/striking an object 5 3.3% Caught in or between object 1211 3.4% Body fluids and blood 4 2.7% Manual handling 1203 3.4% Repetitive tasks and movements 4 2.7% Steps/stairway 1166 3.3% Car 4 2.7% Uneven surface 1091 3.01% Struck by an object 2 1.3% Loose surface 961 2.7% Workplace violence 2 1.3% Physical assault 902 2.6% Steps/stairway 2 1.3% Rubbing or chafing 871 2.5% Nature of work 2 1.3% Stepping on/striking an object 711 2.0% Uniform (belt, vest, etc.) 1 0.7% Car 676 1.9% Body fluids and saliva 1 0.7% OC spray 658 1.9% Sharp object (other than a needle) 1 0.7% Physical exercise 478 1.4% Wet/oily/icy surface 1 0.7% Safety (inc. P.P.E.) 475 1.4% Falls from a height 1 0.7% Uniform (belt, vest etc.) 463 1.3% Dogs 1 0.7% Unknown 449 1.3% Entry/exit vehicle 408 1.2% Caught in or between object 404 1.2% Unknown 375 1.1% Loose surface 340 1.0% OC spray effects 263 0.8% Human bites 242 0.7% Entry/exit premises 238 0.7% Chemicals 218 0.6% Bicycle accident 210 0.6% Other biological factors 200 0.6% Fire 200 0.6% Hole in the ground 179 0.5% Road bike 178 0.5% Single attendant at a specific traumatic event 167 0.5% Insects 163 0.5% Body fluids 110 0.3% Gas fumes 102 0.3% Needle stick injury 93 0.3% Rubbing/chafing 93 0.3% Gun discharged 93 0.3% Noise/vibration 77 0.2% Extreme temperatures 64 0.2% Safety (including PPE) 52 0.2% Organizational 33 0.1% Trail bike 26 0.1% Truck 25 0.1% Spiders 24 0.1% Multiple attendances at trauma sites 23 0.1% Cats 22 0.1% Electric shock 15 0.04% Org-internal investigation 15 0.04% Org-performance management

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Int. J. Environ. Res. Public Health 2023 , 20 , 1144 7 of 12 Table 4. Cont Mounted Officers Non-Mounted Officers Injuries Percentage Mechanism Injuries Percentage Mechanism 15 0.04% Trapped in a confined space 14 0.04% Explosion or implosion 13 0.04% Boat 13 0.04% Electronic discharge weapon (taser) 10 0.03% Organization-staffing workload 8 0.02% Bus 6 0.02% Horses 6 0.02% Variation in pressure (other than sound) 5 0.01% Snow vehicle 4 0.01% Marine animals 4 0.01% Organizational-discipline/dismissal 3 0.01% Caving/landslide 3 0.01% Snakes 3 0.01% Train 2 0.01% Organizational-transfer/redundancy 2 0.01% Radiation 1 0.00% Improvised explosive device 1 0.00% Slips, trips, and falls 151 100% 35,525 100% Key: PPE: personal protective equipment; OC spray: oleoresin capsicum spray Sprains and strains and “bruises and swelling” were the leading natures of injuries for both mounted (44.4% and 29.1%, respectively) and non-mounted (36.6% and 21.2%, respectively) personnel (Table 5 ). Table 5. Injuries by reported nature Mounted Officers Non-Mounted Officers Injuries Percentage Main Nature of Injury Injuries Percentage Main Nature of Injury 67 44.4% Sprains and strains 12,887 36.6% Sprains and strains 44 29.1% Bruises and swelling 7472 21.2% Bruises and swelling 15 9.9% Other or unspecified 4107 11.7% Abrasions and superficial injuries 9 6.0% Abrasions and superficial injuries 3757 10.7% Other or unspecified 4 2.7% Lacerations or open wounds 2469 7.0% Laceration 3 2.0% Internal injury 1079 3.1% Internal injury 2 1.3% Concussion and cranial injuries 817 2.3% Fracture or dislocation 2 1.3% Fracture or dislocation 795 2.3% Infectious diseases 2 1.3% OOS 428 1.2% Foreign bodies 1 0.7% Burns and scalds 209 0.6% Respiratory disease 1 0.7% Eye disorders 196 0.6% Burns and scalds 1 0.7% Multiple injuries 179 0.5% Multiple injuries 173 0.5% OOS 158 0.5% Concussion and cranial injuries 160 0.5% Hearing damage 120 0.3% Eye disorders 76 0.2% Fatality 66 0.2% Skin disease 43 0.1% Parasitic disease 39 0.1% Heart attack or heart disease 13 0.04% Amputation and crushing 11 0.03% Cancer 1 0.00% Firearm discharge and tinnitus 151 100% 35,255 100% Key: OOS: occupational overuse syndrome.

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Int. J. Environ. Res. Public Health 2023 , 20 , 1144 8 of 12 The mounted officers mostly reported suffering injuries to their lower back (13.9%), neck (7.3%), and shoulders (7.3%), while the non-mounted officers reported suffering injuries to their knees (13.9%), lower back (10.0%), and hands (8.2%) (Table 6 ). Table 6. Injuries by body location Mounted Officers Non-Mounted Officers Injuries Percentage Location Injuries Percentage Location 21 13.9% Lower back 4909 13.9% Knee 11 7.3% Neck 3525 10.0% Lower back 11 7.3% Shoulder 2889 8.2% Hand 10 6.6% Ankle 2372 6.7% Fingers or thumb 10 6.6% Elbow 2332 6.6% Shoulder 9 6.0% Fingers or thumb 1825 5.2% Lower arm 9 6.0% Foot 1497 4.3% Neck 8 5.3% Hip/s 1390 3.9% Ankle 7 4.6% Hand 1326 3.8% Wrist 7 4.6% Lower leg 1263 3.6% Lower leg 6 4.0% Knee 1248 3.5% Head 4 2.7% Upper arm 1171 3.3% Elbow 4 2.7% Face 876 2.5% Upper leg 4 2.7% Groin 833 2.4% Face 4 2.7% Upper leg 810 2.3% Eye 3 2.0% Back (multiple) 802 2.3% Upper arm 3 2.0 Chest 738 2.1% Foot 3 2.0% Head 653 1.9% Other 3 2.0% Pelvic region 592 1.7% Chest 3 2.0% Wrist 549 1.6% Mouth (not teeth) 2 1.3% Upper back 498 1.4% Upper back 2 1.3% Other 489 1.4% Back-multiple 2 1.3% Toe/s 453 1.3% Hip/s 1 0.7% Arm lower 329 0.9% Groin 1 0.7% Eye 261 0.7% Ear 1 0.7% Mouth (not teeth) 257 0.7% Nose 1 0.7% Multiple locations 231 0.7% Abdomen 1 0.7% Nose 213 0.6% Internal organs 212 0.6% Multiple locations 199 0.6% Psychological 134 0.4% Toe/s 106 0.3% Arm, not classified 103 0.3% Nil 81 0.2% Leg, not classified 67 0.2% Pelvic region 22 0.1% Nervous system 151 100% 35,255 100% Most injuries occurred between 4 and 12.5 h after a shift commenced (67.3%) for the non-mounted police, with more than half of those (34.5%) occurring after 8 h on the job (Table 6 ). In the mounted police, most injuries occurred within eight hours of the shift commencing (72.2%), with 41.1% occurring within the first four hours of the shift (Table 7 ).

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Int. J. Environ. Res. Public Health 2023 , 20 , 1144 9 of 12 Table 7. Injury incident timepoint within a shift Mounted Officers Non-Mounted Officers Injuries Percentage Hours Worked Injuries Percentage Hours Worked 62 41.1% <4 h 12,149 34.5% 8–12.5 h 47 31.1% 4–8 h 11,558 32.8% 4–8 h 41 27.2% 8–12.5 h 10,865 30.8% <4 h 1 0.7% Unknown 442 1.3% Unknown 241 0.7% 12.5 h+ 151 100% 35,255 100% 4. Discussion The aim of this study was to describe the policing injuries suffered by mounted police officers. Notably, mounted police officers suffered injuries at approximately two to three times higher rates than non-mounted police, with the incidence rates suggesting that the majority of mounted officers suffered injuries each year. Similar to the non-mounted police officers, the mounted officers were found to experience sprains, strains, bruises, and swelling as their most common nature of injury. However, the profiles of the activities performed at the time of injury occurrence, the reported causes and mechanisms of injury, and the body sites of injury were notably different in the mounted police officers when compared to the non-mounted police officers For the mounted police officers, the incidence rate for the injuries reported in this study ranged from 626 to 952 injuries per 1000 personnel per year, a rate notably higher than that for non-mounted officers, ranging from 338 to 364 injuries per 1000 personnel per year. A review of the injuries in law enforcement populations by Lyons et al. [ 4 ] found that the reported incidence of injuries among law enforcement personnel varied from 240 [ 21 ] to 2500 [ 22 ] injuries per 1000 person-years. While both the mounted and non-mounted incidence rates observed in this study fell within this range, variations in the reported injury incidence rates between the studies included in the review could, in many instances, be attributed to research design factors, such as the included injury types, nature of the studies compared, sources of data, data collection procedures (e.g., self-reported, workplace databases, etc.), and injury definitions employed [ 4 ]. Regardless, given that in this study, the data for both mounted and non-mounted police originated from the same organization using the same data collection protocols, the nearly two to three times higher incidence rate for the injuries in mounted police as opposed to their non-mounted counterparts likely represents a true difference and is of concern Although making up a higher percentage of injuries in mounted police officers when compared to non-mounted officers (44.4% versus 36.6%), the leading nature of injuries in both elements was musculoskeletal sprains and strains. This finding is supported by the wider literature detailing injuries in law enforcement [ 4 ]. Following sprains and strains, both mounted and non-mounted officers next most commonly reported suffering bruises and swelling. Again, the proportion of all injuries these represented was higher in mounted than non-mounted officers (29.1% versus 21.2%) When considering the activity reportedly being undertaken at the time of injury, animal handling was the leading activity associated with injuries suffered by mounted officers, accounting for 64.9% of injuries, followed by police training (6.0%). The specified leading causes of injury were a slip, trip, or fall (23.8%) or repetitive tasks and movements (9.9%). The specified leading mechanism of injury was a fall from heights (15.9%), followed by repetitive tasks and movements (10.6%). There appears to be a good alignment between the reported activities, causes, and mechanisms involved in the injury occurrences. For example, mounted police training would likely involve interactions with their equine mounts and slips, trips, and falls, and repetitive tasks and movements could be associated with both horse handling and mounted police training. However, it should also be noted that for mounted police, 33% of injury causes and 25% of injury mechanisms were reported

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Int. J. Environ. Res. Public Health 2023 , 20 , 1144 10 of 12 as “other or unspecified”; this may indicate that many actual causes and mechanisms were difficult to code using existing categories in the database and future research would benefit from open-ended questions allowing free text responses that enabled the accurate reporting of the causes and mechanisms in the mounted police. Regardless, the activities most commonly undertaken at the time of injury in mounted police, as well as the causes and mechanisms of injury, were different from those most commonly reported in nonmounted police; the most common activity in the latter was arresting an offender (31.2%), with physical assault being both the leading cause (21.3%) and mechanism (21.0%) of injury Dealing with an offender is typically a leading mechanism of injury reported by police in the wider literature [ 4 , 23 ], and as such, it is not unexpected for the non-mounted officers in this study. Finally, while slips, trips, and falls were also the second most common cause of injury reported in non-mounted officers, they represented only 16.0% of the reported injuries, as opposed to the 23.8% of injuries for which they were the reported cause in the mounted police The body sites of injuries reported in non-mounted officers were similar to those previously reported in the literature [ 4 ]. Previous research in New Zealand [ 24 ] and Canadian [ 23 ] police and in a literature review reporting on several agencies [ 4 ] found the upper extremity was the leading body site of injury in law enforcement. In this study, four of the top six most common body sites of injuries, equating to over a quarter of injuries (26.7%), were to the upper extremity, with the knee (13.9%) and lower back (10.0%) also commonly reported as injured in the non-mounted police. A study reporting on lower limb injuries, specifically in an Australian state police force, also identified the knee as the leading body site of lower limb injury [ 25 ], consistent with the findings of this study In contrast to the non-mounted police and findings from the non-mounted police forces reported in the broader literature, the mounted police officers’ leading body sites of injury were different, with the lower back (13.9%) followed by the neck (7.3%) reported as the leading body sites of injury. Thus, the top two sites of bodily injury for mounted officers (together representing 21.2% of the injuries) were the torso, which includes the spinal system. Of note, a study by Hua et al. [ 26 ] investigating the injuries suffered by police officers seeking in-house physiotherapy treatments noted that the leading body site of injury was the lower back, accounting for 40.5% of the injuries and 40.2% of all treatment sessions. Also, unlike the non-mounted officers, the leading site of lower extremity injury in the mounted officers was the ankle (mounted = 6.6%; non-mounted = 3.9%) rather than the knee (mounted = 4.0%; non-mounted officers = 13.9%). Thus, the leading body sites of injuries reported by the mounted police officers differed from those reported by the non-mounted police in this study and were typically reported by non-mounted police considered in the broader literature. These differences may arise due to differences in tasks performed and risks faced by the mounted police compared to non-mounted police, and further research is warranted to explore this possibility further Finally, the mounted police officers appeared more likely to suffer injuries during the first four hours of a twelve-hour shift (41.1%) than in the last four hours (27.2%) This differed from the non-mounted officers, whose injuries were fairly evenly spread across the shift. Potential reasons for this difference are unclear, and further investigation is warranted While this is the first known investigation to compare the injuries between mounted and non-mounted police officers, several limitations should be acknowledged. First, the injury data were limited to one police agency in one Australian state. Consequently, the types of injuries sustained may have been influenced by the frequency and types of incidents officers were required to respond to in this region. Thus, the injury types and frequencies may vary among other organizations based on population size, policing techniques, and local laws. Additionally, this analysis is based on those injuries reported. Injuries considered minor in severity or those not requiring medical care may not have been reported and instead may have been self-managed, as is common in tactical populations [ 27 ]. Finally, as the proportions of the underlying population comprising each element that was

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Int. J. Environ. Res. Public Health 2023 , 20 , 1144 11 of 12 of each gender were not available, it was not possible to further explore the injury incidence rates for each gender nor compare these rates across the different law enforcement elements 5. Conclusions Mounted police officer injury profiles differed in a variety of ways from those of non-mounted police officers, and the injuries appeared to occur at a substantially higher rate in the mounted police. These results highlight a need to approach injury prevention and mitigation programs differently in mounted police units as opposed to the general duties of officers and denote potentially different injury rehabilitation and return-to-work requirements. For example, with the torso and spine (notably the lower back) being the leading body sites of injury in the mounted police and the nature of these injuries, most commonly musculoskeletal in nature, means of reducing the musculoskeletal load to the lower back, deserve investigation. Likewise, the means of optimizing the physical resilience of the lower back (e.g., strengthening of the trunk) may be of benefit. Finally, to better inform research specific to this population, a review of the police injury database and data entry procedures should be undertaken with a focus on reducing or supplementing with open-ended questions the use of the “other” category for recording both the causes and mechanisms of injury Author Contributions: Conceptualization, R.O. and R.P.; Methodology, R.O., R.P. and B.S.; Investigation, R.O., B.S. and E.F.D.C.; Data Curation, R.O.; Writing—Original Draft Preparation, R.O., J.J.D. and R.G.L.; Writing—Review and Editing, R.O., R.P., B.S., R.G.L., J.J.D. and E.F.D.C. Supervision; R.P All authors have read and agreed to the published version of the manuscript Funding: This research received no external funding Institutional Review Board Statement: This study received ethics approval from the Bond University Human Research Ethics Committee (BS 02126) approved 19 December 2019 Informed Consent Statement: Consent for publication was provided by the state police force in which this research was undertaken. No individual consent was sought as this study used nonidentifiable data provided retrospectively Data Availability Statement: Requests for access to the datasets generated and analyzed during this study may be directed to the corresponding author, who will request permission from the stage police force from which the data were provided Acknowledgments: The authors would like to thank the staff at the law enforcement agency for their assistance with this project Conflicts of Interest: The authors declare no conflict of interest References 1 Orr, R.; Hinton, B.; Wilson, A.; Pope, R.; Dawes, J. Investigating the Routine Dispatch Tasks Performed by Police Officers Safety 2020 , 6 , 54. [ CrossRef ] 2 Dulla, J.; Baran, K.; Pope, R.; Orr, R. Duty loads carried by the LA sheriff’s department officers J. Sci. Med. Sport 2017 , 20 , S 5–S 6 [ CrossRef ] 3 Dawes, J.J.; Orr, R.M.; Flores, R.R.; Lockie, R.G.; Kornhauser, C.; Holmes, R. A physical fitness profile of state highway patrol officers by gender and age Ann. Occup. Environ. Med 2017 , 29 , 16. [ CrossRef ] [ PubMed ] 4 Lyons, K.; Radburn, C.; Orr, R.; Pope, R. A Profile of Injuries Sustained by Law Enforcement Officers: A Critical Review Int. J Environ. Res. Public Health 2017 , 14 , 142. [ CrossRef ] [ PubMed ] 5 Nowrouzi-Kia, B.; Gohar, B.; Casole, J.; Chidu, C.; Dumond, J.; McDougall, A.; Nowrouzi-Kia, B. A systematic review of lost-time injuries in the global mining industry Work 2018 , 60 , 49–61. [ CrossRef ] [ PubMed ] 6 Larsen, B.; Aisbett, B.; Silk, A. The Injury Profile of an Australian Specialist Policing Unit Int. J. Environ. Res. Public Health 2016 , 13 , 370. [ CrossRef ] 7 Fuller, C.M.; New South Wales Police Force Annual Report 2018–2019. New South Wales Police Force 2019. Available online: https://www.police.nsw.gov.au/__data/assets/pdf_file/0010/658513/NSWPF_2018-19_Annual_Report.pdf (accessed on 14 January 2021) 8 Sefton, J.M.; Lohse, K.R.; McAdam, J.S. Prediction of Injuries and Injury Types in Army Basic Training, Infantry, Armor, and Cavalry Trainees Using a Common Fitness Screen J. Athl. Train 2016 , 51 , 849–857. [ CrossRef ] [ PubMed ]

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