Routine Ongoing Evaluations and Surveillance

Author: Fabrice Czarnecki, MD, MPH, MA, FACOEM, FAAFP, FIAIME


This chapter covers the routine medical evaluation and surveillance of all law enforcement officers (LEOs). For LEOs with specific medical conditions, consult the relevant chapter(s) of the LEO guidance.

1. Periodic Evaluations
It is the consensus of the Public Safety Medicine Task Group that an annual medical questionnaire, body mass index (BMI) determination, and blood pressure measurement should be completed. The medical questionnaire used for the initial evaluation can be used for this purpose. It is also the consensus of the Task Group that routine in-person physical examinations may not be indicated. In-person physical examinations may be indicated for particular medical concerns identified on the questionnaire or as indicated for ongoing evaluation of LEOs with specific medical conditions (see individual chapters – e.g., heart disease, diabetes, etc.). Routine preventive care should follow the recommendations of the U.S. Preventive Services Task Force).

2. Immunizations
It is the consensus of the Public Safety Medicine Task Group that LEOs should be immunized according to U.S. Centers for Disease Control and Prevention (CDC) Advisory Committee on Immunization Practices (ACIP) recommendations for adult immunizations. The Task Group strongly encourages LEOs and agency medical providers to follow these vaccination recommendations.

3. Eye Exams
It is the Task Group’s consensus that periodic eye examinations are recommended at a frequency of at least every 5 years (increasing frequency with increasing age) with near and distant visual acuity and peripheral vision in each eye. Medical conditions (e.g., diabetes, glaucoma, hypertension, ocular trauma) and medications that affect vision require more frequent and/or more comprehensive evaluations.

4. Respiratory Protection
LEOs who use respirators should be in a respiratory surveillance program consistent with 29 CFR 1910.134 or other governmental standards. They should be fit tested with issued respirators annually as required by 29 CFR 1910. 134. Task Group’s consensus is that routine periodic spirometry is not indicated unless clinically indicated, or the LEO is using a negative pressure air purifying elastomeric respirator or SCBA.

5. Surveillance Programs
Hazardous Waste Operations and Emergency Response
In the rare occurrence that the agency has determined that LEOs (typically tactical team members and bomb technicians) are regulated by 29 CFR 1910.120 hazardous waste operations and emergency response; this standard (or other governmental standards) must be followed. Additional guidance regarding specific medical evaluation components can be found in the Occupational Safety and Health Guidance Manual for Hazardous Waste Site Activities. For tactical teams and bomb technicians, see relevant documents of the Public Safety Medicine Guidance.

Hearing Testing
If the agency has determined that LEOs must be in a hearing conservation program, the components of that program should follow 29 CFR 1910.95 or other governmental standards.

Lead Testing
If the agency has determined that LEOs must be in a lead-testing program, the components of the program should follow 29 CFR 1910.1025 or other governmental standards.