Robyn Gershon

Clinical Professor of Epidemiology

Professional overview

Dr. Gershon is an interdisciplinary occupational and environmental health and safety researcher with extensive experience in the areas of disaster preparedness, healthcare safety, and risk assessment and management in high-risk work occupations. She earned her doctorate in Public Health from Johns Hopkins University, School of Public Health, where she was on faculty for several years.  

Subsequently, Dr. Gershon was a Professor at the Mailman School of Public Health at Columbia University, with a joint appointment in the School of Nursing.

At the Mailman School, she also served as the Associate Dean for Research and was the Director of the Mentoring Program. Her most recent faculty appointment prior to joining NYU GPH was Professor of Epidemiology and Biostatistics and the Philip R. Lee Institute for Health Policy Studies at University of California, San Francisco (UCSF). She was also an Adjunct Professor in the UCSF School of Nursing, as well as at UC Berkeley where she taught public health disaster courses.

Dr. Gershon and her team conducted numerous ground breaking studies to develop and test new metrics of preparedness. Importantly, Dr. Gershon’s work has influenced the adoption of safe work practices and regulatory control measures, such as national needlestick prevention guidelines and high-rise building fire safety laws. Her numerous research studies encompass a wide range of topics, including, (to name a few): bloodborne pathogen exposure; hospital safety climate; psychosocial work stress in law enforcement; “ability and willingness” of essential workforce employees to report to duty during natural and man-made disasters; preparedness of responders for terrorist incidents; emergency high–rise building evacuation- (including the World Trade Center Evacuation Study); emergency preparedness of the elderly and disabled; mass fatality management infrastructure in the US; adherence to emergency public health measures among the general public;  hearing loss risk in subway ridership; and noise exposure in urban populations.

Dr. Gershon recently completed a four-year, longitudinal intervention NIH-funded study on motivation and persistence in pursuing STEM research careers among underrepresented doctoral students. (the BRIDGE Project). 

As a committed advocate for junior faculty and graduate students, Dr. Gershon will play an active role in research mentorship and advisement. 

Education

BS, Medical Technology, Quinnipiac University, Hamden, CT

MHS, Medical Microbiology, Quinnipiac University, Hamden, CT

DrPH, Environmental and Occupational Health, Johns Hopkins University, Baltimore, MD

Honors and awards

Recipient, American Society of Safety Engineers, Membership Award, Oakland, CA (2016)

Recipient, John L. Ziegler Capstone Mentor Award, Global Health Sciences, University of California San Francisco (2015)

Recipient, City of New York Fire Commissioner's Special Commendation Certificate of Appreciation (2006)

Recipient, Survivors' Salute, World Trade Center Survivors' Network (2006)

Recipient, Annual International Sharps Injury Prevention Award (2005)

Delta Omega (Public Health) Honorary Society (1997)

Phi Theta Kappa Honor Society (Microbiology) (1976)

Lambda Tau Mu Honor Society (Laboratory Science) (1976)

Areas of research and study

Disaster Health

Disaster Impact and Recovery

Disaster Preparedness

Environmental Public Health Services

Epidemiology

Healthcare Safety

Occupational Health

Risk Assessment and Management

Publications

Publications

Impact of heath information technology on the quality of patient care

Hessels, A., Flynn, L., Cimiotti, J. P., Bakken, S., & Gershon, R. (n.d.).

Publication year

2016

Journal title

Online Journal of Nursing Informatics

Volume

19

Issue

3

Page(s)

1

Abstract

Abstract

Objective To examine the relationships among Electronic Health Record (EHR) adoption and adverse outcomes and satisfaction in hospitalized patients. Materials and Methods This secondary analysis of cross-sectional data was compiled from four sources: (1) State Inpatient Database from the Healthcare Cost Utilization Project; (2) Healthcare Information and Management Systems Society (HIMSS) Dorenfest Institute; (3) Hospital Consumer Assessment of Healthcare Providers and Systems Survey (HCAHPS) and (4) New Jersey nurse survey data. The final analytic sample consisted of data on 854,258 adult patients discharged from 70 New Jersey hospitals in 2006 and 7,679 nurses working in those same hospitals. The analytic approach used ordinary least squares and multiple regression models to estimate the effects of EHR adoption stage on the delivery of nursing care and patient outcomes, controlling for characteristics of patients, nurses, and hospitals. Results Advanced EHR adoption was independently associated with fewer patients with prolonged length of stay and seven-day readmissions. Advanced EHR adoption was not associated with patient satisfaction even when controlling for the strong relationships between better nursing practice environments, particularly staffing and resource adequacy, and missed nursing care and more patients reporting "Top-Box," satisfaction ratings. Conclusions This innovative study demonstrated that advanced stages of EHR adoption show some promise in improving important patient outcomes of prolonged length of stay and hospital readmissions. Strongly evident by the relationships among better nursing work environments, better quality nursing care, and patient satisfaction is the importance of supporting the fundamentals of quality nursing care as technology is integrated into practice.

Quality of graduate school life: do perceptions differ among majority/minority students?

Gershon, R., Gregory, L., Nwankwo, E. M., Zhi, Q., Ozer, E., & Estrada, M. (n.d.).

Publication year

2016

Journal title

Journal of cultural diversity

Quality of life of persons injured on 9/11: Qualitative analysis from the world trade center health registry

Garagano, L. M., Gershon, R. R., & Brackbill, R. (n.d.).

Publication year

2016

Journal title

PLoS Currents

Volume

8

10.1371/currents.dis.7c70f66c1e6c5f41b43c797cb2a04793

Abstract

Abstract

Introduction: A number of studies published by the World Trade Center Health Registry (Registry) document the prevalence of injuries sustained by victims of the World Trade Center Disaster (WTCD) on 9/11. Injury occurrence during or in the immediate aftermath of this event has been shown to be a risk factor for long-term adverse physical and mental health status. More recent reports of ongoing physical health and mental health problems and overall poor quality of life among survivors led us to undertake this qualitative study to explore the long-term impact of having both disaster-related injuries and peri-event traumatic exposure on quality of life in disaster survivors.Methods: Semi-structured, in-depth individual telephone interviews were conducted with 33 Registry enrollees who reported being injured on 9/11/01. Topics included: extent and circumstance of the injury(ies), description of medical treatment for injury, current health and functional status, and lifestyle changes resulting from the WTCD. The interviews were recorded, transcribed, and inductively open-coded for thematic analysis. Results: Six themes emerged with respect to long term recovery and quality of life: concurrent experience of injury with exposure to peri-event traumatic exposure (e.g., witnessing death or destruction, perceived life threat, etc.); sub-optimal quality and timeliness of short- and long-term medical care for the injury reported and mental health care; poor ongoing health status, functional limitations, and disabilities; adverse impact on lifestyle; lack of social support; and adverse economic impact. Many study participants, especially those reporting more serious injuries, also reported self-imposed social isolation, an inability to participate in or take enjoyment from previously enjoyable leisure and social activities and greatly diminished overall quality of life. Discussion: This study provided unique insight into the long-term impact of disasters on survivors. Long after physical injuries have healed, some injured disaster survivors report having serious health and mental health problems, economic problems due to loss of livelihood, limited sources of social support, and profound social isolation. Strategies for addressing the long-term health problems of disaster survivors are needed in order to support recovery.

Musculoskeletal Symptoms in Nurses in the Early Implementation Phase of California's Safe Patient Handling Legislation

Lee, S. J., Lee, J. H., & Gershon, R. R. (n.d.).

Publication year

2015

Journal title

Research in Nursing and Health

Volume

38

Issue

3

Page(s)

183-193

10.1002/nur.21657

Abstract

Abstract

Musculoskeletal injuries and symptoms are prevalent in nurses and are largely associated with strenuous patient handling. In 2011, California enacted legislation that required acute-care hospitals to implement safe patient handling (SPH) policies and programs. To assess the early phase of this legislation, we conducted an epidemiological assessment of organizational SPH practices, musculoskeletal symptoms, and perceptions in a random sample of 396 registered nurses. Among those who worked in hospitals and had patient handling duties (n=220), the 12 month prevalence of work-related musculoskeletal symptoms was 69% (lower back 54%, neck 41%, shoulders 34%, and hands/wrists 26%). Twenty-two percent of the nurses reported that their hospitals had a "no-lift" policy, 37% reported that their hospitals had lift teams, and 61% reported the availability of mechanical lift equipment such as floor or ceiling lifts. Nurses whose facilities employed lift teams were significantly less likely to report low back pain (OR=0.54, 95% CI [0.30-0.97]). Nurses whose units had ceiling lifts were significantly less likely to report shoulder pain than nurses with no access to lifts (OR=0.32, 95% CI [0.10-0.98]). Roughly 60% of respondents were aware of the SPH law, and 33% reported changes in their hospital's patient handling policies or programs since the law went into effect. Hospital SPH practices reported by the nurses in our sample were generally sub-optimal, but our findings suggest positive effects of elements required by SPH legislation. These data will serve as the baseline for future evaluation of the impact of this law in California.

Street-level noise in an urban setting: Assessment and contribution to personal exposure

McAlexander, T. P., Gershon, R. R., & Neitzel, R. L. (n.d.).

Publication year

2015

Journal title

Environmental Health: A Global Access Science Source

Volume

14

Issue

1

10.1186/s12940-015-0006-y

Abstract

Abstract

Background: The urban soundscape, which represents the totality of noise in the urban setting, is formed from a wide range of sources. One of the most ubiquitous and least studied of these is street-level (i.e., sidewalk) noise. Mainly associated with vehicular traffic, street level noise is hard to ignore and hard to escape. It is also potentially dangerous, as excessive noise from any source is an important risk factor for adverse health effects. This study was conducted to better characterize the urban soundscape and the role of street level noise on overall personal noise exposure in an urban setting. Methods: Street-level noise measures were obtained at 99 street sites located throughout New York City (NYC), along with data on time, location, and sources of environmental noise. The relationship between street-level noise measures and potential predictors of noise was analyzed using linear and logistic regression models, and geospatial modeling was used to evaluate spatial trends in noise. Daily durations of street-level activities (time spent standing, sitting, walking and running on streets) were estimated via survey from a sample of NYC community members recruited at NYC street fairs. Street-level noise measurements were then combined with daily exposure durations for each member of the sample to estimate exposure to street noise, as well as exposure to other sources of noise. Results: The mean street noise level was 73.4 dBA, with substantial spatial variation (range 55.8-95.0 dBA). Density of vehicular (road) traffic was significantly associated with excessive street level noise levels. Exposure duration data for street-level noise and other common sources of noise were collected from 1894 NYC community members. Based on individual street-level exposure estimates, and in consideration of all other sources of noise exposure in an urban population, we estimated that street noise exposure contributes approximately 4% to an average individual's annual noise dose. Conclusions: Street-level noise exposure is a potentially important source of overall noise exposure, and the reduction of environmental sources of excessive street- level noise should be a priority for public health and urban planning.

Family and partner interpersonal violence among American Indians/Alaska Natives

Sapra, K. J., Jubinski, S. M., Tanaka, M. F., & Gershon, R. R. (n.d.).

Publication year

2014

Journal title

Injury Epidemiology

Volume

1

Issue

1

10.1186/2197-1714-1-7

Abstract

Abstract

Family and partner interpersonal violence are common among American Indian/Alaska Native (AI/AN) populations. AI/AN women have the second highest prevalence of violence against women among all racial/ethnic groups in the United States, and child abuse prevalence rates in AI/AN populations are among the highest. Elder abuse in AI/AN is also an important concern, although data on this are sparse. This review describes the epidemiology of child abuse, violence against women, and elder abuse among AI/AN, including prevalence and associated risk factors. The authors discuss potential reasons for the high burden of interpersonal violence among AI/AN, including common risk factors. Important limitations in existing literature are also highlighted, along with recommendations for future research on this topic.

Mass fatality preparedness among medical examiners/coroners in the United States: A cross-sectional study

Gershon, R. R., Orr, M. G., Zhi, Q., Merrill, J. A., Chen, D. Y., Riley, H. E., & Sherman, M. F. (n.d.).

Publication year

2014

Journal title

BMC public health

Volume

14

Issue

1

10.1186/1471-2458-14-1275

Abstract

Abstract

Background: In the United States (US), Medical Examiners and Coroners (ME/Cs) have the legal authority for the management of mass fatality incidents (MFI). Yet, preparedness and operational capabilities in this sector remain largely unknown. The purpose of this study was twofold; first, to identify appropriate measures of preparedness, and second, to assess preparedness levels and factors significantly associated with preparedness. Methods: Three separate checklists were developed to measure different aspects of preparedness: MFI Plan Elements, Operational Capabilities, and Pre-existing Resource Networks. Using a cross-sectional study design, data on these and other variables of interest were collected in 2014 from a national convenience sample of ME/C using an internet-based, anonymous survey. Preparedness levels were determined and compared across Federal Regions and in relation to the number of Presidential Disaster Declarations, also by Federal Region. Bivariate logistic and multivariable models estimated the associations between organizational characteristics and relative preparedness. Results: A large proportion (42%) of respondents reported that less than 25 additional fatalities over a 48-hour period would exceed their response capacities. The preparedness constructs measured three related, yet distinct, aspects of preparedness, with scores highly variable and generally suboptimal. Median scores for the three preparedness measures also varied across Federal Regions and as compared to the number of Presidential Declared Disasters, also by Federal Region. Capacity was especially limited for activating missing persons call centers, launching public communications, especially via social media, and identifying temporary interment sites. The provision of staff training was the only factor studied that was significantly (positively) associated (p < .05) with all three preparedness measures. Although ME/Cs ranked local partners, such as Offices of Emergency Management, first responders, and funeral homes, as the most important sources of assistance, a sizeable proportion (72%) expected federal assistance. Conclusions: The three measures of MFI preparedness allowed for a broad and comprehensive assessment of preparedness. In the future, these measures can serve as useful benchmarks or criteria for assessing ME/Cs preparedness. The study findings suggest multiple opportunities for improvement, including the development and implementation of national strategies to ensure uniform standards for MFI management across all jurisdictions.

Emergency preparedness in a sample of persons with disabilities.

Gershon, R. R., Kraus, L. E., Raveis, V. H., Sherman, M. F., & Kailes, J. I. (n.d.).

Publication year

2013

Journal title

Unknown Journal

Volume

8

Issue

1

Page(s)

35-47

10.5055/ajdm.2013.0109

Abstract

Abstract

The objective of this study was to characterize emergency preparedness in this vulnerable population, and to ascertain the role of the personal assistant (PA) and the potential impact of prior emergency experience on preparedness efforts. Cross-sectional Internet-based survey conducted in 2011. Convenience sample. Two-hundred fifty-three community residents with cognitive and /or physical disabilities, all receiving personal assistance services. Emergency preparedness, operationalized as responses to a seven-item scale. The mean score for the emergency preparedness scale was 2.32 (SD = 2.74), range 0-7. Even though 62.8 percent (n = 159) of the participants had previously experienced one or more large-scale emergencies, only 47.4 percent (n = 120) of the entire sample and 55.3 percent (n = 88) of those with actual emergency experience reported preparing an emergency plan. Sixty-three percent (n = 76) of those reporting a plan had involved their PA in its development. Participants who reported such involvement were significantly more likely to have higher scores on the emergency preparedness scale (p < 0.001). Participants who had experienced a prior emergency were also more likely to score higher on the emergency preparedness scale (p < 0.001). In general, participants reported limited attention to other basic preparedness recommendations: only 28 percent (n = 70) had prepared a "go-bag" with necessary supplies, 29 percent (n = 74) had developed a strategy for communicating with their PA during emergencies, and 32 percent (n = 81) had stockpiled emergency supplies. Of particular importance, only 26 percent (n = 66) had made alternative back-up plans for personal assistance. Involving the PA in the planning process and experiencing an emergency were both significantly associated with higher emergency preparedness scores in this sample of people living with disabilities. However, critical deficiencies in preparedness were noted, such as lack of back-up plans for replacing their PA. Despite a concerted national effort to improve preparedness in the population of people living with disabilities, important preparedness gaps remain. These findings highlight the need for additional study on emergency preparedness barriers in people living with disabilities so that effective strategies to reduce vulnerabilities can be identified.

Estimation of permanent noise-induced hearing loss in an urban setting

Lewis, R. C., Gershon, R. R., & Neitzel, R. L. (n.d.).

Publication year

2013

Journal title

Environmental Science and Technology

Volume

47

Issue

12

Page(s)

6393-6399

10.1021/es305161z

Abstract

Abstract

The potential burden of noise-induced permanent threshold shift (NIPTS) in U.S. urban settings is not well-characterized. We used ANSI S3.44-1996 to estimate NIPTS for a sample of 4585 individuals from New York City (NYC) and performed a forward stepwise logistic regression analysis to identify predictors of NIPTS >10 dB. The average individual is projected to develop a small NIPTS when averaged across 1000-4000 Hz for 1-to 20-year durations. For some individuals, NIPTS is expected to be substantial (>25 dB). At 4000 Hz, a greater number of individuals are at risk of NIPTS from MP3 players and stereos, but risk for the greatest NIPTS is for those with high occupational and episodic nonoccupational (e.g., power tool use) exposures. Employment sector and time spent listening to MP3 players and stereos and participating in episodic nonoccupational activities associated with excessive noise levels increased the odds of NIPTS >10 dB at 4000 Hz for 20-year durations. Our results indicate that the risk of NIPTS may be substantial for NYC and perhaps other urban settings. Noise exposures from "noisy" occupational and episodic nonoccupational activities and MP3 players and stereos are important risk factors and should be a priority for public health interventions.

Factors related to essential workers' ability and willingness to work and comply with personal infection control protocol during a large scale influenza pandemic in Hawaii

Qureshi, K. A., Gershon, R., Li, D., & Yamada, S. (n.d.).

Publication year

2013

Journal title

Journal of Emergency & Disaster Medicine

Mass transit ridership and self-reported hearing health in an urban population

Gershon, R. R., Sherman, M. F., Magda, L. A., Riley, H. E., McAlexander, T. P., & Neitzel, R. (n.d.).

Publication year

2013

Journal title

Journal of Urban Health

Volume

90

Issue

2

Page(s)

262-275

10.1007/s11524-012-9734-2

Abstract

Abstract

Information on prevalence and risk factors associated with self-reported hearing health among mass transit riders is extremely limited, even though evidence suggests mass transit may be a source of excessive exposure to noise. Data on mass transit ridership were collected from 756 study participants using a self-administered questionnaire. Hearing health was measured using two symptom items (tinnitus and temporary audiometric threshold shift), two subjective measures (self-rated hearing and hearing ability), and two medical-related questions (hearing testing and physician-diagnosed hearing loss). In logistic regression analyses that controlled for possible confounders, including demographic variables, occupational noise exposure, nonoccupational noise exposure (including MP3 player use) and use of hearing protection, frequent and lengthy mass transit (all forms) ridership (1,100 min or more per week vs. 350 min or less per week) was the strongest predictor of temporary threshold shift symptoms. Noise abatement strategies, such as engineering controls, and the promotion of hearing protection use should be encouraged to reduce the risk of adverse impacts on the hearing health of mass transit users.

Prevalence and factors associated with 2009 to 2011 influenza vaccinations at a university medical center

Crowley, K. A., Myers, R., Magda, L. A., Morse, S. S., Brandt-Rauf, P., & Gershon, R. R. (n.d.).

Publication year

2013

Journal title

American Journal of Infection Control

Volume

41

Issue

9

Page(s)

824-830

10.1016/j.ajic.2012.11.020

Abstract

Abstract

Background: Information on the rates and factors associated with influenza vaccinations, although limited, is important because it can inform the development of effective vaccination campaigns in a university medical center setting. Methods: A study was conducted in 2011 to identify individual and organizational level barriers and facilitators to influenza vaccination among clinical and nonclinical personnel (N = 428) from a major university medical center. Results: Seventy-one percent of clinical personnel (n = 170) reported pandemic H1N1 vaccination compared with 27% of nonclinical personnel (n = 258), even though vaccine was made widely available to all personnel at no cost. Similarly, disparate rates between clinical and nonclinical personnel were noted for the 2009/2010 seasonal influenza vaccine (82% vs 42%, respectively) and 2010/2011 combination (pandemic plus seasonal) influenza vaccine (73% vs 28%, respectively). Factors associated with pandemic vaccination in nonclinical personnel included the following: high level of influenza-related knowledge, concern regarding influenza contagion, history of previous influenza vaccinations or influenza illness, participation in vaccine-related training, and awareness of the institution's written pandemic plan. For clinicians, past history of seasonal influenza vaccination was associated with pandemic vaccination. For all participants, taking any 1 or more of the 3 influenza vaccines available in 2009 to 2011 was associated with intent to take a hypothetical future novel pandemic vaccine (odds ratio, 6.7; 95% confidence interval: 4.32-10.44; P <.001). Conclusion: Most of the risk factors associated with lack of vaccination uptake are amenable to organizational strategies.

Using participatory action research to identify strategies to improve pandemic vaccination.

Crowley, K. A., Myers, R., Riley, H. E., Morse, S. S., Brandt-Rauf, P., & Gershon, R. R. (n.d.).

Publication year

2013

Journal title

Disaster medicine and public health preparedness

Volume

7

Issue

4

Page(s)

424-430

10.1017/dmp.2013.72

Abstract

Abstract

Developing and implementing effective strategies to increase influenza vaccination rates among health care personnel is an ongoing challenge, especially during a pandemic. We used participatory action research (PAR) methodology to identify targeted vaccination interventions that could potentially improve vaccine uptake in a medical center. Front-line medical center personnel were recruited to participate in 2 PAR teams (clinical and nonclinical staff). Data from a recent medical center survey on barriers and facilitators to influenza (seasonal, pandemic, and combination) vaccine uptake were reviewed, and strategies to increase vaccination rates among medical center personnel were identified. Feasible, creative, and low-cost interventions were identified, including organizational strategies that differed from investigator-identified interventions. The recommended strategies also differed by team. The nonclinical team suggested programs focused on dispelling vaccination-related myths, and the clinical team suggested campaigns emphasizing the importance of vaccination to protect patients. PAR methodology was useful to identify innovative and targeted recommendations for increasing vaccine uptake. By involving representative front-line workers, PAR may help medical centers improve influenza vaccination rates across all work groups.

Exposures to transit and other sources of noise among New York City residents

Neitzel, R. L., Gershon, R. R., McAlexander, T. P., Magda, L. A., & Pearson, J. M. (n.d.).

Publication year

2012

Journal title

Environmental Science and Technology

Volume

46

Issue

1

Page(s)

500-508

10.1021/es2025406

Abstract

Abstract

To evaluate the contributions of common noise sources to total annual noise exposures among urban residents and workers, we estimated exposures associated with five common sources (use of mass transit, occupational and nonoccupational activities, MP3 player and stereo use, and time at home and doing other miscellaneous activities) among a sample of over 4500 individuals in New York City (NYC). We then evaluated the contributions of each source to total noise exposure and also compared our estimated exposures to the recommended 70 dBA annual exposure limit. We found that one in ten transit users had noise exposures in excess of the recommended exposure limit from their transit use alone. When we estimated total annual exposures, 90% of NYC transit users and 87% of nonusers exceeded the recommended limit. MP3 player and stereo use, which represented a small fraction of the total annual hours for each subject on average, was the primary source of exposure among the majority of urban dwellers we evaluated. Our results suggest that the vast majority of urban mass transit riders may be at risk of permanent, irreversible noise-induced hearing loss and that, for many individuals, this risk is driven primarily by exposures other than occupational noise.

Safety in the home healthcare sector: Development of a new household safety checklist

Gershon, R. R., Dailey, M., Magda, L. A., Riley, H. E., Conolly, J., & Silver, A. (n.d.).

Publication year

2012

Journal title

Journal of Patient Safety

Volume

8

Issue

2

Page(s)

51-59

10.1097/PTS.0b013e31824a4ad6

Abstract

Abstract

Objectives: Unsafe household conditions could adversely affect safety and quality in home health care. However, risk identification tools and procedures that can be readily implemented in this setting are lacking. To address this need, we developed and tested a new household safety checklist and accompanying training program. Methods: A 50-item, photo-illustrated, multi-hazard checklist was designed as a tool to enable home healthcare paraprofessionals (HHCPs) to conduct visual safety inspections in patients' homes. The checklist focused on hazards presenting the greatest threat to the safety of seniors. A convenience sample of 57 HHCPs was recruited to participate in a 1-hour training program, followed by pilot testing of the checklist in their patients' households. Checklist data from 116 patient homes were summarized using descriptive statistics. Qualitative feedback on the inspection process was provided by HHCPs participating in a focus group. Results: Pretesting and posttesting determined that the training program was effective; participating HHCPs' ability to identify household hazards significantly improved after training (P < 0.001). Using the checklist, HHCPs were able to identify unsafe conditions, including fire safety deficiencies, fall hazards, unsanitary conditions, and problems with medication management. Home healthcare paraprofessionals reported that the checklist was easy to use and that inspections were well accepted by patients. Inspections took roughly 20 minutes to conduct. Conclusions: Home healthcare paraprofessionals can be effectively trained to identify commonplace household hazards. Using this checklist as a guide, visual household inspections were easily performed by trained HHCPS. Additional studies are needed to evaluate the reliability of the checklist and to determine if hazard identification leads to interventions that improve performance outcomes.

The World Trade Center evacuation study: Factors associated with initiation and length of time for evacuation

Gershon, R. R., Magda, L. A., Riley, H. E., & Sherman, M. F. (n.d.).

Publication year

2012

Journal title

Fire and Materials

Volume

36

Issue

5

Page(s)

481-500

10.1002/fam.1080

Abstract

Abstract

On 11 September 2001, one of the largest workplace evacuations in the U.S. history took place. The evacuation was largely successful: an estimated 87% of all occupants in World Trade Center (WTC) Towers 1 and 2 exited in less than two hours. Evacuation times, however, were highly variable and not entirely explained by the engineering parameters of the buildings. To understand the complexity of factors that potentially influenced the evacuation time on 11 September, 2001, an interdisciplinary research study was conducted by public health scientists from the Mailman School of Public Health at the Columbia University in the New York City. Analysis of survey data collected from a sample of 1444 evacuees identified several facilitators and barriers to length of time to initiate and fully evacuate from WTC Towers 1 and 2. At the individual level, these included sociodemographic and occupational variables, health status, sensory cues, risk perception, delaying behaviors, and following a group or an emergent leader. At the organizational level, factors included emergency preparedness safety climate variables. Structural (environmental) factors included egress route barriers, poor signage, congestion, and communication system failures. Many factors identified in the study are modifiable. Therefore, these data have the potential to inform high-rise preparedness and response policies and procedures.

Genes, jobs, and justicCe: Occupational medicine physicians and the ethical, legal, and social issues of genetic testing in the workplace

Brandt-Rauf, S. I., Brandt-Rauf, E., Gershon, R., Li, Y., & Brandt-Rauf, P. W. (n.d.).

Publication year

2011

Journal title

Ethics and Medicine

Volume

27

Issue

1

Page(s)

51-61

Abstract

Abstract

The application of new genetic technologies in the workplace not only holds the promise of improving worker health and safety but also raises significant ethical, legal, and social issues which could have serious adverse effects on workers, including effects on their employability and insurability. In the workplace, one appropriate target for study and intervention concerning the use of genetic technologies and information is the occupational health care professional, particularly the occupational medicine physician. Occupational medicine physicians frequently are directly involved in the development and implementation of employer policies regarding medical testing in the employment setting as well as in the control, interpretation and application of the resulting information. Therefore, a study was undertaken to determine the extent of involvement of occupational medicine physicians in the U.S. in genetic testing in the workplace and their level of knowledge and concern about the ethical, legal, and social issues of such testing. A questionnaire survey of members of the American College of Occupational and Environmental Medicine (ACOEM) was performed with distribution by email and in-person at the organization's annual national meeting. Among respondents, 7.7% reported being currently engaged in genetic testing in the workplace, primarily to protect workers from workplace hazards. Overall, 40% of respondents felt that workplace genetic testing should be used in decisions about job placement, but 17% felt that workplace genetic testing was never appropriate. Most respondents (57%) did not feel competent dealing with genetic testing issues, and the vast majority (75%) reported feeling ethically conflicted about workplace genetic testing. For guidance in the resolution of ethical conflicts, respondents reported relying primarily on professional codes of ethics and guidelines, but their level of familiarity with ACOEM's position on genetic testing in the workplace was generally low. These results suggest that occupational medicine physicians do not feel prepared to deal with the ethical, legal, and social issues of genetic testing in the workplace and that professional organizations should consider increasing their educational efforts in these areas.

Mass fatality preparedness in the death care sector

Gershon, R. R., Magda, L. A., Riley, H. E., & Merrill, J. A. (n.d.).

Publication year

2011

Journal title

Journal of Occupational and Environmental Medicine

Volume

53

Issue

10

Page(s)

1179-1186

10.1097/JOM.0b013e31822cfe76

Abstract

Abstract

Objective: To characterize mass fatality preparedness of the death care sector (ie, funeral industry organizations) and to determine the workforce's ability and willingness to report to duty during a hypothetical high fatality pandemic event. Methods: Anonymous, Web-based, cross-sectional survey of a national funeral industry sample. Preparedness was characterized using descriptive statistics. Factors significantly associated with ability and willingness were identified using chi-squared bivariate analysis. Results: Respondents (N = 492) generally rated their organizational preparedness planning as suboptimal; only six of thirteen preparedness checklist items were typically in place. In contrast, response intentions were uniformly high; more than 80% of the respondents were willing to report to work, although high prevalence of secondary obligations might hinder this. Conclusions: Preparedness strategies that address interorganizational, surge capacity, and personal emergency planning are likely to be most efficacious. STATEMENT OF CLINICAL SIGNIFICANCE: Occupational medicine plays an important role in emergency preparedness and response. Funeral industry organizations could benefit from skills and resources of occupational medicine, including training, fit testing, development of plans, and coordination and hosting of planning exercises.

Modeling pre-evacuation delay by evacuees in World Trade Center Towers 1 and 2 on September 11, 2001: A revisit using regression analysis

Sherman, M. F., Peyrot, M., Magda, L. A., & Gershon, R. R. (n.d.).

Publication year

2011

Journal title

Fire Safety Journal

Volume

46

Issue

7

Page(s)

414-424

10.1016/j.firesaf.2011.07.001

Abstract

Abstract

We have tested a linear regression model to identify significant predictors of pre-evacuation delay in a sample of evacuees enrolled in the World Trade Center Evacuation Study. We have found that pre-evacuation delay was greater when there were more environmental cues, more seeking out of information, and more pre-evacuation actions. Additionally, higher perceived risk was predictive of shorter pre-evacuation delay times. These findings are compared and contrasted with an analysis of participants in the National Institute of Standards and Technology investigation of the World Trade Center disaster, recently reported by Kuligowski and Mileti (2009). Both studies reported factors associated with pre-evacuation delay that were similar to those associated with community evacuation. Additionally, we found that greater knowledge and greater emergency preparedness were associated with greater perception of risk. Greater emergency preparedness was negatively related to pre-evacuation delay within World Trade Center Tower I, but within World Trade Center Tower II, the relation between emergency preparedness and pre-evacuation delay was positive. These findings have implications for training of occupants of high-rise buildings.

The differing perspectives of workers and occupational medicine physicians on the ethical, legal and social issues of genetic testing in the workplace

Brandt-Rauf, S. I., Brandt-Rauf, E., Gershon, R., & Brandt-Rauf, P. W. (n.d.).

Publication year

2011

Journal title

New Solutions

Volume

21

Issue

1

Page(s)

89-102

10.2190/NS.21.1.j

Abstract

Abstract

Genetic testing in the workplace holds the promise of improving worker health but also raises ethical, legal, and social issues. In considering such testing, it is critical to understand the perspectives of workers, who are most directly affected by it, and occupational health professionals, who are often directly involved in its implementation. Therefore, a series of focus groups of unionized workers (n=25) and occupational medicine physicians (n=23) was conducted. The results demonstrated strikingly different perspectives of workers and physicians in several key areas, including the goals and appropriateness of genetic testing, and methods to minimize its risks. In general, workers were guided by a profound mistrust of the employer, physician, and government, while physicians were guided primarily by scientific and medical concerns, and, in many cases, by the business concerns distrusted by the workers.

Disaster mental health training programmes in New York City following September 11, 2001

Gill, K. B., & Gershon, R. R. (n.d.).

Publication year

2010

Journal title

Disasters

Volume

34

Issue

3

Page(s)

608-618

10.1111/j.1467-7717.2010.01159.x

Abstract

Abstract

The need for mental health resources to provide care to the community following large-scale disasters is well documented. In the aftermath of the World Trade Center (WTC) disaster on September 11, 2001, many local agencies and organizations responded by providing informal mental health services, including disaster mental health training for practitioners. The quality of these programmes has not been assessed, however. The National Center for Disaster Preparedness at Columbia University's School of Public Health reviewed disaster mental health training programmes administered by community-based organizations, professional associations, hospitals, and government agencies after September 11. Results indicate that the quality and the effectiveness of programmes are difficult to assess. A wide range of curricula and a widespread lack of recordkeeping and credentialing of trainers were noted. Most of the training programmes provided are no longer available. Recommendations for improving the quality of disaster mental health training programmes are provided.

Factors associated with the ability and willingness of essential workers to report To duty during a pandemic

Gershon, R. R., Magda, L. A., Qureshi, K. A., Riley, H. E., Scanlon, E., Carney, M. T., Richards, R. J., & Sherman, M. F. (n.d.).

Publication year

2010

Journal title

Journal of Occupational and Environmental Medicine

Volume

52

Issue

10

Page(s)

995-1003

10.1097/JOM.0b013e3181f43872

Abstract

Abstract

Objective: To determine essential workers' ability and willingness to report to duty during a serious pandemic outbreak and to identify modifiable risk factors. Methods: Workers (N = 1103) from six essential workgroups completed an anonymous, cross-sectional survey. Results: Although a substantial proportion of participants reported that they would be able (80%), fewer would be willing (65%) to report to duty. Only 49% of participants would be both able and willing. Factors significantly associated with ability/willingness included individual-level (eg, intentions to adhere to respiratory protection and pandemic vaccination recommendations) and organizational-level factors (eg, preparedness planning for respiratory protection and worker vaccination programs). Conclusions: During a serious pandemic event, non-illness-related shortfalls among essential workers could be substantial. Organizational preparedness efforts should focus on worker protection programs and the development of policies that would facilitate the attendance of healthy workers.

Pandemic-related ability and willingness in home healthcare workers.

Gershon, R. R., Magda, L. A., Canton, A. N., Riley, H. E., Wiggins, F., Young, W., & Sherman, M. F. (n.d.).

Publication year

2010

Journal title

American journal of disaster medicine

Volume

5

Issue

1

Page(s)

15-26

10.5055/ajdm.2010.0002

Abstract

Abstract

OBJECTIVE: To assess pandemic-related attitudes and behavioral intentions of home healthcare workers (HHCWs). DESIGN: Cross-sectional survey. SETTING: New York City. PARTICIPANTS: A convenience sample of 384 HHCWs. MAIN OUTCOME VARIABLES: Ability and willingness to report to work during a pandemic influenza outbreak. RESULTS: A large proportion of HHCWs reported that they would be either unable or unwilling (or both) to provide care to their current (83 percent) or new (91 percent) patients during a pandemic. Ability was significantly associated with not having children living at home, having alternatives to mass transportation, not having a spouse/partner employed as a first responder or healthcare worker, and having longer tenure (ie, six or more years) in homecare. During an outbreak, 43 percent of HHCWs said they would be willing to take care of current patients and only 27 percent were willing to take care of new patients. Willingness to care for both current and new patients was inversely associated with fear for personal safety (p < 0.01). Provision of key elements of a respiratory protection program was associated with decreased fear (p < 0.05). Most participants (86 percent) had not received any work-based, pandemic-related training, and only 5 percent reported that their employer had an influenza pandemic plan. CONCLUSIONS: Given that a large majority of the participating HHCWs would either be unable or unwilling to report to duty during a pandemic, potential shortfalls in this workforce may occur. To counter this, organizations should focus on strategies targeting intervenable barriers to ability and to willingness (ie, the provision of a vaccine and respiratory protection programs).

Evaluation of a pandemic preparedness training intervention for emergency medical services personnel

Gershon, R. R., Vandelinde, N., Magda, L. A., Pearson, J. M., Werner, A., & Prezant, D. (n.d.).

Publication year

2009

Journal title

Prehospital and Disaster Medicine

Volume

24

Issue

6

Page(s)

508-511

10.1017/S1049023X00007421

Abstract

Abstract

Introduction: Emergency medical services (EMS) personnel play an integral role during the national response to a pandemic event. To help ensure their health and safety, especially during the early stages of an outbreak, knowledge and adherence with personal protective equipment (PPE) and infection control strategies will be essential.Objectives: The objective of this study was to assess the effectiveness of a multi-method, pandemic preparedness training intervention using a pre-/post-test design.Methods: A convenience sample of 129 EMS personnel participated in a training program on pandemic preparedness. Training consisted of an educational intervention with a focus on the routes of transmission of the influenza virus, proper use of respiratory PPE, agency policies regarding infection control practices, and seasonal influenza vaccination. This was followed by a skill-based drill on respirator fit-checking and proper respirator donning and doffing procedures.Results: Pre-/post-test results indicate a significant increase in knowledge and behavioral intentions with respect to respirator use, vaccination with seasonal influenza vaccine, and willingness to report to duty during a pandemic.Conclusions: This method was effective in increasing knowledge and compliance intentions in EMS healthcare personnel. Further research should focus on whether training results in behavior modification.

Evaluation tool for the assessment of personal protective respiratory equipment

Gershon, R. R., Pearson, J. M., & Westra, L. J. (n.d.). In Infection Control and Hospital Epidemiology (1–).

Publication year

2009

Volume

30

Issue

7

Page(s)

716-718

10.1086/600290