Occupational Safety in the Age of the Opioid Crisis: Needle Stick Injury among Baltimore Police


At a time of resurgence in injection drug use and injection-attributable infections, needle stick injury (NSI) risk and its correlates among police remain understudied. In the context of occupational safety training, a convenience sample of 771 Baltimore city police officers responded to a self-administered survey. Domains included NSI experience, protective behaviors, and attitudes towards syringe exchange programs. Sixty officers (8%) reported lifetime NSI. Officers identifying as Latino or other race were almost three times more likely (aOR 2.58, 95% CI 1.12–5.96) to have experienced NSI compared to whites, after adjusting for potential confounders. Findings highlight disparate burdens of NSIs among officers of color, elevating risk of hepatitis, HIV, and trauma. Training, equipment, and other measures to improve occupational safety are critical to attracting and safeguarding police, especially minority officers.

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The authors gratefully acknowledge the contribution of the following: Baltimore City Health Department Needle Exchange Program (NEP) staff and volunteers; Baltimore City Department of Health Risk Reduction Services; Baltimore Police Department, and all participants in the study.

Authors’ Contributions

J.A.C and L.B led the conceptualization of the analysis and drafting of the manuscript. A.S, M.S, N.R, and J.H implemented the research and processed the data. J.A.C conducted all statistical analyses with input from L.B and S.S. All authors contributed to the writing of the article and approved the final version. J.A.C is accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.


Funding was provided by the Open Society Foundations Criminal Justice Fund and the Campaign for the New Drug Policy. J. A. Cepeda is supported by the National Institute on Drug Abuse (T32DA023356, PI: Strathdee) and Fogarty International Center (R25TW009343, PI: Cohen, Strathdee). L. Beletsky is also supported in part by National Institute of Drug Abuse awards number R01DA039073 (MPIs: Beletsky, Strathdee) and R37DA019829 (PI: Strathdee).

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Correspondence to Javier A. Cepeda.

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Participants self-administered a 13-item pre-training survey under ethical approval from Johns Hopkins University.



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Cepeda, J.A., Beletsky, L., Sawyer, A. et al. Occupational Safety in the Age of the Opioid Crisis: Needle Stick Injury among Baltimore Police. J Urban Health 94, 100–103 (2017). https://doi.org/10.1007/s11524-016-0115-0

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  • Needle stick injury
  • Police
  • People who inject drugs