• Research has shown that police officers are over twice as likely as people in other occupations to develop cardiovascular disease.
  
• Being employed in law enforcement places one at a greater risk of developing cardiovascular disease than having high blood pressure, diabetes, being overweight or smoking.
  
• Police have also been found to die at a higher rate from cancer than the general population.
  
• At the psychological level, the stress of police work may result in chronic negative emotions such as anger, anxiety or depression, which can lead to burnout or emotional exhaustion.
  
• California Police Chiefs report that their greatest concerns include the liabilities attached to automobile accidents, rapid decision-making, citizen complaints, inappropriate use of force, workers compensation, and the high post-retirement mortality rates.
  
• Shift schedules that disrupt normal sleep patterns and social life, authoritarian management styles, poor interpersonal relationships with supervisors, interdepartmental politics, lack of adequate planning and resources, lack of promotion and transfer opportunities, excessive paperwork, lack of autonomy in performing duties and lack of recognition for work accomplishments are among the organizational stressors faced by members of the police force.

Study Measures
Areas assessed in this study included: physical health and vitality, emotional well being, coping and interpersonal skills, work performance, workplace effectiveness and climate, family relationships, and physiological and psychological recalibration following acute stress. In addition, physiological measurements using heart rate variability analysis were obtained to determine the real-time cardiovascular impact of acutely stressful situations encountered in simulated police calls used in police training, and to identify officers at increased risk of cardiovascular disease and premature mortality. For the psychological measurements, HeartMath technicians carried out a Personal and Organizational Quality Assessment (POQA) survey and a Program Impact Assessment. In addition, scenario stress level and participants' performance analysis was conducted during and after each scenario by Sunnyvale Public Safety training officers who asked participants to rate each simulation according to how stressful it was for them.

Scenario Evaluation Design
Subgroups from the experimental and control group underwent 3 simulated scenarios while wearing a 24-hour holter recorder, so that we could observe the effects of various levels of stress on heart rate variability. These scenarios were common to normal training carried out by Sunnyvale Public Safety at Moffet Airfield. Two of the scenarios (building search and high speed pursuit) were run on the same day, 5 weeks after baseline measurements were taken and before the experimental group received the HeartMath training. One scenario (domestic violence episode) was conducted 11 weeks after the HeartMath training was completed. Scenarios included the actual use of firearms "simmunition."

General Results
Post study analysis showed that the HeartMath training improved officers' capacity to recognize and manage their stress and negative emotions in both work and personal contexts. Over the course of the study, officers trained in the stress management techniques experienced reduction in stress, negative emotions and physical stress symptoms, as well as increased positive emotions and physical vitality as compared to a control group that did not receive the training. Improvements in family relationships, more effective communication and cooperation within work teams and enhanced work performance were also noted.

Program Impact Assessment Results
This graph shows coping skills for the experimental group and the control group; likewise for family relationships, work performance and interpersonal skills. Note particularly the improvement in family relationships and work performance. Officers trained in the HeartMath techniques showed improvements in all areas as compared to the control group that did not receive the training. Results were obtained from semi-structured interviews by a clinical psychologist.

Personal and Organizational Quality Assessment (POQA) Results: physical / emotional stress symptoms
Changes were compared in 5 physical stress symptoms among the experimental and control groups following the HeartMath training. There was a reduction in sleeplessness, anxiety and indigestion in the HeartMath group. The HeartMath group also reported more rapid heartbeats than the control group, which may be due to an increased awareness of their heartbeats after the training program.

Systolic Blood Pressure
This graph shows the increase in blood pressure experienced by each of the officers tested during the domestic violence scenario. Officers reported this scenario to be the most stressful.

Heart Rhythm Changes during Stress Event
This graph provides a typical example of an office's heart rate variability (beat-to-beat changes in heart rate) during the domestic violence scenario. Heart rate begins to rise as the officer prepares to enter the residence. There is an extremely sharp, further increase in heart rate as the participant spots the armed suspect. During the peak stress of the scenario, as gun shots are fired between the officer and suspect, the officer's heart is beating at over 200 beats a minute—faster than 3 beats a second. Heart rate begins to decrease once the scenario has ended, but still remains elevated at a level substantially above baseline. In this particular participant, it took over 2 hours after the scenario ended for heart rate to return to normal.

Personal and Organizational Quality Assessment (POQA) Results: stress, emotions and physical stress symptoms
Participants trained in the HeartMath techniques exhibited considerable reductions in stress, negative emotions, depression and fatigue, and increases in positive emotions, peacefulness and vitality over the 16-week study period. The control group showed minimal positive changes and some indications of the worsening of symptoms.

Scenario Results
A portion of the study conducted by Sunnyvale Public Safety role players, shows officers’ ability to maintain focus during all three scenarios for both the experimental and control groups. Note that the experimental group scored lower than the control group in the 2 scenarios that were conducted prior to the HeartMath training (the building search and high-speed pursuit). After they received training in the HeartMath techniques, this trend reversed; the experimental group scored higher than the control group in the final scenario (domestic violence), which officers reported to be the most stressful.

Heart Rate Variability (HRV)
Officers' autonomic function was assessed by the analysis of heart rate variability. The normal resting heart rate in healthy individuals varies dynamically from moment to moment. Heart rate variability, which is derived from the electrocardiogram (ECG), is a measure of these naturally-occurring, beat-to-beat changes in heart rate and is an important indicator of health and fitness. The analysis of HRV is a powerful predictor of future heart disease, and increased risk of sudden death as well as all-cause mortality. Of the officers tested, 11% exhibited substandard heart rate variability and were so informed privately. (See next page for charts)

Recalibration after Stress Event
This graph provides an example of the change in heart rate experienced by one officer who used the FREEZE-FRAME® technique to help recalibrate after the domestic violence scenario. Note that when the scenario ends, the participant's heart rate begins to drop, but remains elevated in a range above its normal baseline range. As the officer uses the FREEZE-FRAME technique, there is an immediate, further reduction in heart rate back to baseline.

These graphs show 2 of 6 key measures derived from 24 hour Heart Rate Variability analysis plotted for each officer in the study. Power is plotted on the vertical axis and age is plotted on the horizontal axis. You will note that 3 individuals are outside the reference zone and are thus at elevated risk in terms of autonomic and cardiac function.

Conclusions
In particular, significant improvements occurred in communication difficulties at work and in strained family relationships. Results suggest that the techniques provided in this study were effective in reducing the most fundamental source of participants' stress by giving them greater ability to manage and transform stress-producing perceptions and negative, emotional reactive patterns.

This study also provides important insight into the physiological impact of acute on-the-job stress as experienced in real time by police officers, as measured by cardiovascular response to simulated police call scenarios. The acute stress of the scenarios produced rapid and pronounced increases in heart rate and blood pressure, from which it took officers a considerable amount of time to recover. The HeartMath interventions helped officers maintain greater clarity and inner balance under the pressure of these high-stress situations and enabled them to recalibrate more quickly afterwards, both psychologically and physiologically.

In addition, this study points to 24-hour HRV analysis as a useful screening tool to identify officers who are at increased risk of developing serious, long-term health problems, so that efforts can be made to reverse or prevent the onset of disease in these individuals. Intensive training in stress management interventions known to increase HRV and improve autonomic nervous system balance can be of particular benefit for officers who are at-risk.

While additional research is clearly needed to explore the longer-term effects of the interventions employed in this study, the results of this initial investigation suggest that in the long term, gaining increased levels of emotional self-management could potentially benefit police officers in a wide range of capacities.

The integration in police training of the HeartMath program can provide officers with practical and effective self-management techniques for enabling them to perform their jobs with greater effectiveness, to preserve and enhance their physical and emotional health, and ultimately providing better protection to the citizens whom they serve.

(References from p. 1) Another option for positioning: Brown J, Campbell E. Stress and Policing: Sources and Strategies. Chichester: John Wiley & Sons; 1994; Gaines J, Jermier J. Emotional exhaustion in a high stress organization. Academy of Management Journal 1983; 26(4):567-586; Cooper CL, Davidson MJ, Robinson P. Stress in the police service. J Occup Med 1982; 24(1):30-36; Stotland E, Pendleton M. Workload, stress, and strain among police officers. Behav Med 1989; 15(1):5-17; Franke WD, Collins SA, Hinz PN. Cardiovascular disease morbidity in an Iowa law enforcement cohort, compared with the general Iowa population. J Occup Environ Med 1998; 40(5):441-444; Vena JE, Violanti JM, Marshall J, Fiedler RC. Mortality of a municipal worker cohort: III. Police officers. Am J Ind Med 1986; 10(4):383-397; Burke R, Shearer J, Deszca G. Burnout among men and women in policework: an examination of the Cherniss model. Journal of Health and Human Resource Administration 1984; 7:162-188; Notes from conversations with Police Chiefs Larry Todd, Lucy Carlton, and members of the Santa Clara County Police Chiefs Association. Fall 1998.

© 2002, HeartMath LLC