Prevalence and correlates of needle-stick injuries among activeduty police officers in Tijuana, Mexico

Abstract

Introduction:Police officers are at an elevated risk for needle-stick injuries (NSI), which pose a serious and costly occupationalhealth risk for HIV and viral hepatitis. However, research on NSIs among police officers is limited, especially in low- and middle-income countries. Despite the legality of syringe possession in Mexico, half of people who inject drugs (PWID) in Tijuana reportextrajudicial syringe-related arrests and confiscation by police, which has been associated with needle-sharing and HIV infection.We assessed the prevalence and correlates of NSIs among Tijuana police officers to inform efforts to improve occupationalsafety and simultaneously reduce HIV risks among police and PWID.

Methods:Tijuana’s Department of Municipal Public Safety (SSPM) is among Mexico’s largest. Our binational, multi-sectoral teamanalyzed de-identified data from SSPM’s 2014 anonymous self-administered occupational health survey. The prevalence of NSIand syringe disposal practices was determined. Logistic regression with robust variance estimation via generalized estimatingequations identified factors associated with ever having an occupational NSI.

Results:Approximately one-quarter of the Tijuana police force was given the occupational health survey (N503). Respondentswere predominantly male (86.5%) and 535 years old (42.6%). Nearly one in six officers reported ever having a NSI whileworking at SSPM (15.3%), of whom 14.3% reported a NSI within the past year. Most participants reported encounteringneedles/syringes while on duty (n473, 94%); factors independently associated with elevated odds of NSIs included frequentlyfinding syringes that contain drugs (adjusted odds ratio (AOR): 2.98; 95% confidence interval (CI): 1.565.67) and breaking usedneedles (AOR: 2.25; 95% CI: 1.293.91), while protective factors included being willing to contact emergency services in case ofNSIs (AOR: 0.39; 95% CI: 0.220.69), and wearing needle-stick resistant gloves (AOR: 0.43; 95% CI: 0.190.91).

Conclusions:Tijuana police face an elevated and unaddressed occupational NSI burden associated with unsafe syringe-handlingpractices, exposing them to substantial risk of HIV and other blood-borne infections. These findings spurred the developmentand tailoring of training to reduce NSI by modifying officer knowledge, attitudes and enforcement practices (e.g. syringeconfiscation)factors that also impact HIV transmission among PWID and other members of the community