EVALUATION OF THE POLICE OPERATIONAL TACTICAL PROCEDURES FOR REDUCING OFFICER INJURIES RESULTING FROM PHYSICAL INTERVENTIONS IN PROBLEMATIC ARRESTS. THE CASE OF THE MUNICIPAL POLICE OF CÁDIZ (SPAIN) O R I G I N A L P A P E R

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ORIGINAL PAPER
Nofer Institute of Occupational Medicine, Łódź, Poland
International Journal of Occupational Medicine and Environmental Health 2020;33(1):35 – 43
https://doi.org/10.13075/ijomeh.1896.01422
EVALUATION OF THE POLICE OPERATIONAL
TACTICAL PROCEDURES FOR REDUCING
OFFICER INJURIES RESULTING FROM PHYSICAL
INTERVENTIONS IN PROBLEMATIC ARRESTS.
THE CASE OF THE MUNICIPAL POLICE OF CÁDIZ
(SPAIN)
JOSE CARLOS VERA JIMÉNEZ1, FRANCISCO FERNANDEZ2, JESUS AYUSO3,
and JOSE ANTONIO LORENTE ACOSTA4
1 City Hall of Cádiz, Cádiz, Spain
2 University of Cádiz, Cádiz, Spain
Department of Industrial Engineering and Civil Engineering
3 University of Cádiz, Cádiz, Spain
Physical Chemistry Department
4 Pzer-University of Granada-Junta de Andalucía Centre for Genomics
and Oncological Research (GENYO), Granada, Spain
Abstract
Objectives: This paper describes some operational tactical procedures (OTP) and discusses the results of a 14-year-long study, spanning the period
2003–2016, conducted by the Municipal Police of Cádiz, Spain, which comprised 3 time periods: 2003–2006, when the ofcers were trained in traditional
policing procedures; 2007–2013, when the ofcers were taught an innovative set of OTP in the form of a basic set of self-defense and arrest mechanisms,
different from the traditional policing procedures that rely on martial arts and combat sports; and nally 2014–2016, when the OTP training was discon-
tinued. The aim of this study was to improve policing and reduce ofcer injuries resulting from interventions in controversial or violent situations, such
as problematic arrests. Material and Methods: The study involved 162 police ofcers and commanders of the Municipal Police of Cádiz, who were in
street duty for their rst time. There were 8 females and 154 males aged 24–55 years. Three OTP stages are shown as examples. Results: Based on the
analysis of “training hours” and “physical interventions in problematic arrests,” the results were: 1) the number of sick leaves in the police was identi-
cal according to the number of arrests, and 2) data on sick leaves show remarkable differences among the 3 periods under analysis. Conclusions: The
OTP-based training substantially reduced ofcer sick leaves. The overall reduction in sick leaves in the period 2007–2013 was observed that cannot be
ascribed to a decrease in criminal acts, and hence in police physical interventions. Int J Occup Med Environ Health. 2020;33(1):35 – 43
Key words:
use of police force, operational tactical procedures, arrest and self-defense skills, injury leaves prevention, prevention of labor risks, criminology
Funding: this study was supported by the University of Cádiz (grant No. PR2017-007 entitled “Plan Propio,” grant manager: Prof. Jesus Ayuso).
This study was supported by the UCA 2017 program for the promotion of research and their transfer.
Received: January 9, 2019. Accepted: September 6, 2019.
Corresponding author: Jose Carlos Vera Jimenez, City Hall of Cádiz, Plaza San Juan de Puerto Rico, s/n, 11010 Cádiz, Spain (e-mail: josecarlos.verajimenez@cadiz.es).

ORIGINAL PAPER J.C. VERA JIMÉNEZ ET AL.
IJOMEH 2020;33(1)
36
tinues to be favored in many countries, particularly in east-
ern regions [6], but drastic interventions leading to oppo-
nents being defeated in an extreme form are discouraged.
Like the military training which caused so many problems
in the past [7], these police training procedures can be
deemed obsolete in the 21st century.
In response to the increasing criticism of former tactics,
the police adopted non-lethal weapons such as taser, tear
gas, pepper spray or batons. These devices also met with
some criticism [8,9] and, fortunately, were not thoroughly
adopted.
Police training based on reex-based self-defense mecha-
nisms for acting in high-pressure arrest situations has been
recently found to improve ASDS [10]. The operational
procedures examined in this work may be similarly ef-
cient for this purpose [3].
Police OTP are intended to avoid physical damage even in
those situations where problematic arrests generate no anx-
iety. These procedures rely on the internalization of a series
of body movements allowing ofcers to deliver specic tac-
tical reex responses in physical interventions during prob-
lematic arrests. These reex skills are designed to avoid the
overloading of the ofcer’s body as a result of using force,
being replaced with a change in weights. Blows, pressures
and manipulations target non-vital areas of the opponent’s
body to facilitate reduction and beating, but without caus-
ing serious or even fatal injuries. Also, being a man or wom-
an, tall or short, strong or weak, is not decisive for achieving
the primary goal. However, these tactical procedures are
the result of the sustained updating of former procedures
since 1997, when training in defense techniques based on
martial arts prevailed. Progress in OTP has run in parallel
with research into the topic by such authors as Nieuwen-
huys et al. [2] and Renden et al. [4,10], who have concluded
that improving police performance in problematic arrests
requires training ofcers in specic tactics.
Police training in physical intervention techniques is usu-
ally too short for the taught procedures to be properly
INTRODUCTION
Comprehensive Occupational Health and Safety (OHS)
programs comprise 3 essential elements, namely [1]:
– knowledge (to identify and evaluate threats),
– control and prevention (through training, exercise and
education),
– maintenance and improvement (through research, the
analysis of results, the revision of procedures and poli-
cies, and communication).
This paper discusses the results of the rst 2 stages of
a non-comprehensive OHS program implemented by the
Municipal Police of Cádiz (southern Spain) in 2005–2013
to facilitate the acquisition of effective arrest and self-
defense skills (ASDS), with a view to reducing sick leaves
among police ofcers, and a comparison of 3 years without
any training. The program was based on a study of po-
lice ofcers that suggested the need for specic training
in physical interventions during problematic arrests to
replace previous procedures based on regular ASDS [2].
The new so-called “operational tactical procedures”
(OTP) are a set of primary responses in the form of tacti-
cal movements, according to Vera-Jiménez [3].
Most of the police training in physical interventions dur-
ing problematic arrests has so far relied on martial arts
and combat sports. Some studies endorse the use of mar-
tial arts for improved police performance as regards anxi-
ety control [4]. However, the actual use of these arts or
combat sport techniques in police interventions has been
questioned because it can result in severe damage to both
ofcers and their opponents. The true value of experience
in martial arts has also been questioned, especially in situ-
ations of high anxiety [4].
Aggressive approaches to police intervention were
deemed highly useful more than half a century ago. For ex-
ample, like other countries had done before, the U.S. De-
fensive Tactics Manual [5] recommended attacking vital
body parts or organs (liver, spleen, solar plexus, head) to
reduce opponents. This traditional tactical approach con-

not wear loose and comfortable apparel, and they often
have to land on hard ground or asphalt, rather than on
soft tatami. In addition, they have no chance to warm up
before acting, which frequently leads to injuries. The types
of injuries resulting from police interventions have been
the subject of some research [15,16], especially prominent
of which is a statistical review [17,18] which is consistent
with the medical diagnosis of the injuries observed in the
Municipal Police of Cádiz. As in many other situations,
however, prevention is better than cure in order to avoid
ofcer injuries and the ensuing sick leaves. Faced with the
fatal consequences of the decreasing number of active po-
lice ofcers, attempting to reduce injuries is the reason for
the present work.
This paper examines the results of a 14-year-long follow-
up study of the number of injury leaves among ofcers of
the Municipal Police of Cádiz, resulting from physical in-
terventions in problematic arrests, over 3 periods where
EVALUATION OF THE POLICE OTP IN CÁDIZ (SPAIN) ORIGINAL PAPER
IJOMEH 2020;33(1) 37
internalized, and hence their effectiveness is dubious.
For example, the basic course for admission to the An-
dalusian Public Safety School allocates only 30/1800 h to
this type of training and yet ofcers are expected to act
efciently, but also sensibly and moderately, in all violent
situations [10].
Police OTP have so far been regulated by the Spanish na-
tional OHS law. Soon, however, they will be placed un-
der the umbrella of the Municipal Police OHS law to be
passed by the Andalusian Regional Parliament [11].
Operational tactical procedures are based on 3 pillars:
1) what is established in the international and Spanish leg-
islation on the use of force;
2) the limits established by legal medicine on the possible
injuries that may be caused during a physical intervention,
following the principles of proportional use of force;
3) the reduction of injuries in the police ofcers in said
actions.
With respect the rst one, the authors highlight:
– The Code of Conduct for Law Enforcement Ofcials
of the United Nations (resolution No. 34/169 of De-
cember 17, 1979) [12], with Article 3 reading as follows:
“Law enforcement ofcials may use force only when
strictly necessary and to the extent required for the per-
formance of their duty.”
– Resolution 690 (1979) of the Parliamentary Assembly of
the Council of Europe, Declaration on the Police [13]
and Recommendation Rec(2001)10 of the Committee
of Ministers to Member States on the European Code
of Police Ethics [14].
Regarding the second pillar, legal medicine provides
enough knowledge about the kind of injures which can af-
fect citizens, depending on the area of the human body
which is hit or pressed, taking into account a series of cri-
teria (Figure 1) [3].
Regarding the third pillar, police ofcers are usually
trained in martial arts in well-equipped, large gyms.
By contrast, when acting in problematic arrests, they do
Very dangerous, serious injury or death
Dangerous, serious injury or permanent damage
No serious injury or permanent damage when these areas are hit or pressed
Figure 1. Three areas of the human body
where different levels of damage can be generated

ORIGINAL PAPER J.C. VERA JIMÉNEZ ET AL.
IJOMEH 2020;33(1)
38
Finally, an analysis based on the Mann-Whitney U test
(since variances were unequal) was carried out.
Description of OTP
Theoretical and practical studies about the needs of police
interventions over citizens in a democratic society under
the rule of law, according to the guidelines of interna-
tional rules in order to protect citizens, have been devel-
oped from the point of view [12–14] of the prevention of
occupational risks, and the prevention of risks in general,
offering protocols, techniques and procedures of the po-
lice interventions specically focused on the work of these
forces and security units, which are referred to as opera-
tional tactical procedures. These procedures were created
to supply the agents with:
– safety during the intervention,
– condence and faith in the colleagues,
– minimizing stress,
– improving the social image of the police force,
– improving social services,
– high police quality,
– avoiding injuries during police interventions,
– decreasing sick leaves,
– decreasing injuries of citizens.
The objectives that the OTP training program is intended
to achieve are:
– creating an operative intervention system applied to
the needs of policemen;
– respecting the fundamental rights of citizens, taking
detailed care of critical points in the case of detention
while respecting legal medicine;
– developing risk prevention of policemen, deepening
safety measures;
– reducing sick leaves which, according to the crimino-
logical research, are related to the hours of training;
– decreasing the complaints against the police due to
the inappropriate use of physical strength, apply-
ing changes of techniques that the police were using
the ofcers received no specic training, OTP training
and no training. No personal information about the par-
ticipating ofcers was collected. Also, the Spanish law on
data protection was abided by, and the applicable ethical
principles regarding the use and dissemination of sensitive
information were adhered to at all times [19].
In the period in which the OTP training program was car-
ried out, other expert training courses (instructions in spe-
cic techniques of the prevention of occupational risks in
the police and the military) were also taught by the Uni-
versity of Cádiz in Spain, Mexico, Costa Rica, Dominican
Republic, Colombia, Argentina and Portugal. All of them
were based on the same procedures of OTP training.
MATERIAL AND METHODS
Statistics
Some statistical tests were necessary to prove the results
obtained in a contrasted way. Prior to the analysis, the nu-
merical variable “training hours” was converted into the
following 3 categorical variables according to the training
stage:
– “no specic training,”
– “OTP training,”
– “no training.”
Likewise, the variable “physical interventions in problem-
atic arrests” was converted into 2 categorical variables ac-
cording to the number of arrests, namely:
– “greater than average,”
– “smaller than average.”
The ideal data treatment would have been 2-way analysis
of variance (ANOVA) with the number of “sick leaves” as
the dependent variable, and those of “training hours” and
“physical interventions in problematic arrests” as factors
or independent variables. However, sick leaves exhibited
a non-normal distribution for these factors (p-values for
the Shapiro-Wilk tests were <0.05), and non-parametric
Kruskal-Wallis tests had to be applied instead. These tests
were done with the SPSS software [20].

EVALUATION OF THE POLICE OTP IN CÁDIZ (SPAIN) ORIGINAL PAPER
IJOMEH 2020;33(1) 39
– Number of arrests for disobeying, offending, resisting
or attacking the police in Cádiz over the period 2005–
2016 (Figure 5). These data oscillate smoothly in the
period and the values range approx. 267±25.
A breakdown of the types of police interventions and the
types of injuries in the police are summarized in Table 1,
together with baseline data of the police ofcers.
during physical interventions prior to the imparted
training.
The OTP training described in Figure 2 was conducted in
a sequence of 3 stages.
RESULTS
The study involved 162 police ofcers and commanders
of the Municipal Police of Cádiz, who were in street duty
for their rst time. There were 8 females and 154 males
aged 24–55 years. Data were obtained from the Occupa-
tional Health Ofce of the City Council, attestation re-
ports of the Municipal Police and the Public Safety School
of Cádiz.
The occupational health data used were as follows:
– Number of training hours. A distinction was made be-
tween a pre-OTP stage (2003–2006) and an OTP train-
ing stage (2007–2013) (Figure 3). On average, each
module was attended by around 45 ofcers. By way of
example, Figure 4 shows the number of ofcers in each
module in the 2013 course, which was similar to those
for the previous years. There was no training after that.
– Number of sick leaves resulting from injury in physi-
cal interventions, recorded for the period 2005–2016
(Figure 5).
Operational tactical procedures (OTP)
Stage 1
Defensive procedures
Stage 2
Basic Techniques for Immobilization
Stage 3
Against physical aggressions
Figure 2. The rst 3 stages of the operational tactical
procedures (OTP) examined in the study on OTP
that involved 162 police ofcers and commanders
of the Municipal Police of Cádiz, Spain
2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013
Year
0
50
100
150
200
250
300
Training time [h]
Pre-OTP training stage
OTP-based training stage
OTP – operational tactical procedures.
Figure 3. Time in the pre-operational tactical procedures (OTP)
training stage and the OTP training stage each year,
in the study on OTP that involved 162 police ofcers
and commanders of the Municipal Police of Cádiz, Spain
Training time [h]
Police officers trained [n]
21 21 21 21 21
41
36 36 35 33
Module 1 Module 2 Module 3 Module 4 Module 5
Figure 4. Distribution of training hours among modules
in the last year of operational tactical procedures (OTP)
training (2013), and the number of ofcers trained, in the study
on OTP that involved 162 police ofcers and commanders
of the Municipal Police of Cádiz, Spain

ORIGINAL PAPER J.C. VERA JIMÉNEZ ET AL.
IJOMEH 2020;33(1)
40
gers – a likely result of gripping during struggle – and also
those of muscles due to blows, falls, etc. The latter were
more common in the rst 3 years, and probably resulted
from ofcers not having as much space as when applying
conventional reduction procedures based on martial arts
in places where police interventions occurred. Also, police
uniforms proved less suitable than the training apparel to
apply such procedures, and the ground and objects on the
streets were much harder than tatami in the gym.
Traumatic injuries (cervical vertebrae, hip, and tho-
rax) were less common. Consistent with previous results
The results suggest the importance of OTP for the reduc-
tion of injuries in the police ofcers of Cádiz when they
had interventions in problematic arrests. However, such
conclusions could be more clearly evidenced by a study
based on statistical inference.
After applying the Kruskal-Wallis tests, the results suggest
the importance of OTP for the reduction of injuries in the
police ofcers of Cádiz when they had interventions in
problematic arrests:
– the number of sick leaves between the 2 categories of phys-
ical interventions in problematic arrests was identical,
– data on sick leaves show remarkable differences among
the 3 categories of training hours.
The Shapiro-Wilk and Kruskal-Wallis tests were done with
the SPSS software [20]. Table 2 summarizes the statistical
results for the non-parametric test.
DISCUSSION
The common injuries resulting from physical interventions
in problematic arrests were those of the hands and n-
Table 1. Characteristics of the variables in the study on operational
tactical procedures (OTP) that involved 162 police ofcers
and commanders of the Municipal Police of Cádiz, Spain
Variable Participants
(N = 162)
Baseline police ofcers
male [%] 95
age [years] (range) 24–55
race (white) [%] 100
employed [%] 100
educational level (≥ graduated) [%] 35
previous injury treatment [%] 0
Type of police intervention [%]
faults 33
disobedience 19
disparagement 2
insults 8
threats 5
resistance 20
attacks 12
Type of injuries in the police [%]
ngers-hand 38
back 21
arm-forearm 17
thorax-chest 8
cervical-neck 8
hip-leg 8
2
0
4
50
6
100
8
150
10 200
12 250
14 300
16 350
0
2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
Year
Sick leaves [n]
Arrests [n]
Officer sick leaves
Arrests
Figure 5. Ofcer sick leaves by injury resulting from physical
interventions during problematic arrests in the training stage
(2005–2006), the operational tactical procedures (OTP)
training stage (2007–2013) and the no-training stage (2014–2016),
and arrests performed by the Municipal Police of Cádiz
during problematic physical interventions in 2005–2016,
in the study on OTP, that involved 162 police ofcers
and commanders of the Municipal Police of Cádiz, Spain

EVALUATION OF THE POLICE OTP IN CÁDIZ (SPAIN) ORIGINAL PAPER
IJOMEH 2020;33(1) 41
provide some degree of subjectivity in the injury report
(attaching a greater or lesser importance).
Despite these limitations, the current ndings reect an
important step in reducing injuries suffered by police of-
cers when they are on duty if OTP techniques are applied.
CONCLUSIONS
The conclusions reached according to the objectives are
as follows.
1. A specic training program was implemented in 2003–
2013 to reduce the number of injury leaves resulting
from physical interventions in problematic arrests
by the municipal police ofcers in the city of Cádiz.
An innovative set of operational tactical procedures was
introduced in the last stage of this period (2007–2013).
2. The overall reduction in sick leaves in 2007–2013 was
observed that cannot be ascribed to a decrease in crimi-
nal acts, and hence to a decrease in police physical
interventions.
Despite these results, more extensive studies are required
to conrm the usefulness of specic police training based
on innovative procedures like OTP for such purposes as
reducing injuries among citizens.
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