Page 65 - JSOM Summer 2025

execution, high-risk security, rural operations, movement over specialist police unit from an Australian State Police Force and
urban terrain, clandestine operations, vehicle interceptions, informed by a previously published review of law enforcement
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counter-terrorism response, and water operations, which re- injuries. The final protocol was developed for the Open Sci-
quire officers to remain stationary with heavy loads and equip- ence Framework (OSF) and registered on 2 September 2024. 44
ment for long periods, lift/push/pull heavy objects, discharge
a weapon, breach a door, conduct forced entry searches, and Information Sources and Key Search Terms
respond to situations involving public unrest or riots. 10,29,34 Per- Four key databases, PubMed, CINAHL (EBSCO), Embase
forming these tasks, specialist police will carry heavier loads ( Elsevier), and Ovid MEDLINE, were searched using key
than GD LEOs, with these loads ranging from 22kg 10,30 to search terms. The key search terms were based on input from
>40kg. 10,35 These heavier loads are made up of the additional experts in the field and previously known studies of this pop-
specialist equipment required for these roles, which include, but ulation, as well as previously completed studies of GD law en-
are not limited to, various firearms, breaching equipment, bal- forcement injuries. 1,3,16,18,19,21–26,45,46 Initially, a rapid literature
listic riot shields, body armor, and protective helmets. 6,10,13,30,35 review was completed to trial key search terms in the PubMed
database. The key search terms were developed by examining
Despite the increased demands on specialist police, minimal the key search terms previously used in known specialist po-
research has been conducted to profile their injuries. 21,36 A re- lice and GD LEO research, 1,3,10,13,16,18,19,21–26,29,30,45-51 consulting
port completed by the International Association of Chiefs of subject matter experts and testing various key words within
Police across a 12-month period showed only a small percent- databases. To further refine the search terms, the Search Re-
age of police force injuries occurring in SWAT or other police finery Tool in the Systematic Review Accelerator (SRA) was
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tactical units (3.8% of 1,188 injury occurrences), likely due used . For the PubMed database, the following search terms
to the lower overall numbers of officers within these units, were used: (“specialist police” OR SWAT OR SERT OR PTG
which may account for why little injury research has so far OR TOU OR FBI OR “Police Tactical Group” OR “Riot Po-
been completed in this population. lice” OR “Special Emergency Response Team” OR “Tactical
Operations Unit” OR BOPE) AND (injury OR injuries). These
Conversely, evidence is available in relation to injuries within finalized search terms were adapted for the remaining data-
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Military Special Forces (SF). Research by Lovalekar et al., bases using the SRA polyglot tool. 53
Abt et al., and Hayhurst et al. show incidence rates between
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1.42 and 2.77 per 1,000 personnel per annum for SF person- To increase the literature search reach, a rearward and for-
nel. Of note, the research suggests that up to 77% of total MSI ward snowballing approach was used. For the rearward snow-
in these personnel are preventable. 39,40 Rates may vary depend- balling approach, the reference lists of included studies and
ing on the nature of the SF unit. For example, another study reports were searched, and additional records were sought.
by Lovalekar et al. reported a high incidence rate of 8.46 per Likewise, the included studies and reports were entered into
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1,000 personnel per annum within an Airforce SF unit. The Google Scholar and any records citing these papers were iden-
most common body sites of injury likewise vary between dif- tified and reviewed. All records identified via snowballing
ferent Military SF units, with Navy Sea Air and Land (SEAL) were subject to the same eligibility criteria.
units having reported the upper extremity as the most common
location of injury (38.1%) and the shoulder as the most fre- Eligibility Criteria and Selection of Evidence
quent sub-location (23.8%), whereas, in a population of U.S. All identified records were imported into EndNote 20 (Version
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Army SF and U.K. Military SF the lower extremity was the 20.6, Clarivate Analytics, Philadelphia, PA) and duplicates re-
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most commonly reported location of injury (50% and 40%, moved using the duplicate identification tool in EndNote as
respectively), with the knee the most frequent sub-location well as a manual search. The titles and abstracts of articles
of injury (23.1% and 19%, respectively). A 2021systematic were then screened by the lead reviewer (KL), with decisions
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review by Stannard and Fortington reported that the lower confirmed by a second reviewer (RO). Records clearly not of
extremity was the most common injury location, alongside the relevance to this review were removed. The remaining records
spine, in Military SF generally. The sub-locations most affected were then considered against the dedicated inclusion and ex-
were reported to be the ankle, knee, and lumbar regions. 42 clusion criteria detailed in Table 1. Articles that met the inclu-
sion criteria were subjected to the exclusion criteria and those
Given the differences in occupational tasks and loads carried, that met these latter criteria were excluded with the reasons
it follows that there may be a difference in injuries sustained for exclusion noted. This process was conducted by the lead
by specialist compared to GD LEOs and in specialist police reviewer (KL), with decisions confirmed by a second reviewer
compared to Military SF. However, little is currently known (RO). The remaining articles were used to inform the review.
about specialist police officer injuries. Therefore, the aims of
this scoping review were to identify, collect, and synthesize the Data Charting and Items
available evidence on injuries sustained by specialist police Data from the final studies and reports were extracted and
and to compare their injury profiles with those of GD LEOs tabulated by the lead author (KL). Items extracted included
and the wider SF population. participant demographics inclusive of police unit and country
of service from which participants were drawn, injury defini-
tion, the prevalence, proportions or incidence of injuries, the
Methods
top three anatomical locations of injury, the top three anatom-
Protocol and Registration ical sub-locations, tasks at the time of injury and mechanisms
The Preferred Reporting Items for Systematic Reviews and Me- of injury. These items were selected to allow for comparison
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ta-Analyses extension for Scoping Reviews (PRISMA-ScR) against previous research on law enforcement injuries. Lev-
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was used to guide this scoping review. The protocol was devel- els of evidence were graded against the Australian National
oped by the research team in conjunction with members of a Health and Medical Research Council (NHMRC) guidelines. 54
Injuries in Specialist Police Officers | 63