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

Corrigendum to "Epidemiology of Subway-Related Fatalities in New York City, 1990-2003" [Journal of Safety Research 39 (2008) 583-588] (DOI:10.1016/j.jsr.2008.10.004)

Gershon, R., Pearson, J. M., Nandi, V., Vlahov, D., Bucciarelli-Prann, A., Tracy, M., Tardiff, K., & Galea, S. (n.d.).

Publication year

2009

Journal title

Journal of Safety Research

Volume

40

Issue

1

Page(s)

75

10.1016/j.jsr.2009.01.001

Abstract

Abstract

~

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

Gershon, 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., Pearson, J. M., & Westra, L. J. (n.d.).

Publication year

2009

Journal title

Infection Control and Hospital Epidemiology

Volume

30

Issue

7

Page(s)

716-718

10.1086/600290

Abstract

Abstract

~

Mental, physical, and behavioral outcomes associated with perceived work stress in police officers

Gershon, R., Barocas, B., Canton, A. N., Xianbin Li, L., & Vlahov, D. (n.d.).

Publication year

2009

Journal title

Criminal Justice and Behavior

Volume

36

Issue

3

Page(s)

275-289

10.1177/0093854808330015

Abstract

Abstract

This study estimates the effects of perceived work stress in police officers and determines the impact of coping on both perceived work stress and health. Officers from a large, urban police department (N = 1,072) completed detailed questionnaires. Exposure to critical incidents, workplace discrimination, lack of cooperation among coworkers, and job dissatisfaction correlated significantly with perceived work stress. Work stress was significantly associated with adverse outcomes, including depression and intimate partner abuse. Officers who relied on negative or avoidant coping mechanisms reported both higher levels of perceived work stress and adverse health outcomes. Results have implications for improving stress-reducing efforts among police officers. Interventions that address modifiable stressors and promote effective coping and resiliency will probably be most beneficial in minimizing police stress and associated outcomes.

Noise levels associated with New York City's mass transit systems

Neitzel, R., Gershon, R., Zeltser, M., Canton, A., & Akram, M. (n.d.).

Publication year

2009

Journal title

American journal of public health

Volume

99

Issue

8

Page(s)

1393-1399

10.2105/AJPH.2008.138297

Abstract

Abstract

Objectives. We measured noise levels associated with various forms of mass transit and compared them to exposure guidelines designed to protect against noise-induced hearing loss. Methods. We used noise dosimetry to measure time-integrated noise levels in a representative sample of New York City mass transit systems (subways, buses, ferries, tramway, and commuter railways) aboard transit vehicles and at vehicle boarding platforms or terminals during June and July 2007. Results. Of the transit types evaluated, subway cars and platforms had the highest associated equivalent continuous average (Leq) and maximum noise levels. All transit types had Leq levels appreciably above 70 A-weighted decibels, the threshold at which noise-induced hearing loss is considered possible. Conclusions. Mass transit noise exposure has the potential to exceed limits recommended by the World Health Organization and the US Environmental Protection Agency and thus cause noise-induced hearing loss among riders of all forms of mass transit given sufficient exposure durations. Environmental noise-control efforts in mass transit and, in cases in which controls are infeasible, the use of personal hearing protection would benefit the ridership's hearing health.

Nurse work environments and occupational safety in intensive care units

Stone, P. W., & Gershon, R. (n.d.).

Publication year

2009

Journal title

Journal of Nursing Administration

Volume

39

Issue

7-8 SUPPL.

Page(s)

S27-S34

10.1097/NNA.0b013e3181aeb49e

Abstract

Abstract

Using data collected from 39 intensive care units (ICUs) in 23 hospitals across the United States, the purpose of this study was to examine hospital structural characteristics, nurse characteristics, and nurses' working conditions' impact on occupational safety outcomes. ICU with more positive organizational climates had lower rates of occupational injuries and blood and body fluid exposures (p < .05). Similarly, ICUs in hospitals that had attained magnet accreditation had lower rates of negative occupational health incidents (p < .05).Hospital profitability was inversely related to rates of blood and body fluid exposure (p < .05). Monitoring nurses' working conditions and improving the organizational climate of hospitals is likely to improve the safety of the employee and the profitability of the hospital through improved system outcomes (such as lower turnover of the employees) as well as improve the quality of patient care delivered.

Protecting home health care workers : A challenge to pandemic influenza preparedness planning

Baron, S., McPhaul, K., Phillips, S., Gershon, R., & Lipscomb, J. (n.d.).

Publication year

2009

Journal title

American journal of public health

Volume

99

Issue

SUPPL. 2

Page(s)

S301-S307

10.2105/AJPH.2008.157339

Abstract

Abstract

The home health care sector is a critical element in a pandemic influenza emergency response. Roughly 85% of the 1.5 million workers delivering in-home care to 7.6 million clients are low-wage paraprofessionals, mostly women, and disproportionately members of racial and ethnic minorities. Home health care workers' ability and willingness to respond during a pandemic depends on appropriate communication, training, and adequate protections, including influenza vaccination and respiratory protection. Preparedness planning should also include support for child care and transportation and help home health care workers protect their income and access to health care. We summarize findings from a national stakeholder meeting, which highlighted the need to integrate home health care employers, workers, community advocates, and labor unions into the planning process.

The prevalence and risk factors for percutaneous injuries in registered nurses in the home health care sector

Gershon, R., Pearson, J. M., Sherman, M. F., Samar, S. M., Canton, A. N., & Stone, P. W. (n.d.).

Publication year

2009

Journal title

American Journal of Infection Control

Volume

37

Issue

7

Page(s)

525-533

10.1016/j.ajic.2008.10.022

Abstract

Abstract

Background: Patients continue to enter home health care (HHC) "sicker and quicker," often with complex health problems that require extensive intervention. This higher level of acuity may increase the risk of percutaneous injury (PI), yet information on the risk and risk factors for PI and other types of exposures in this setting is exceptionally sparse. To address this gap, a large cross-sectional study of self-reported exposures in HHC registered nurses (RNs) was conducted. Methods: A convenience sample of HHC RNs (N = 738) completed a survey addressing 5 major constructs: (1) worker-centered characteristics, (2) patient-related characteristics, (3) household characteristics, (4) organizational factors, and (5) prevalence of PIs and other blood and body fluid exposures. Analyses were directed at determining significant risk factors for exposure. Results: Fourteen percent of RNs reported one or more PIs in the past 3 years (7.6 per 100 person-years). Nearly half (45.8%) of all PIs were not formally reported. PIs were significantly correlated with a number of factors, including lack of compliance with Standard Precautions (odds ratio [OR], 1.72; P = .019; 95% confidence interval [CI]: 1.09-2.71); recapping of needles (OR, 1.78; P = .016; 95% CI: 1.11-2.86); exposure to household stressors (OR, 1.99; P = .005; 95% CI: 1.22-3.25); exposure to violence (OR, 3.47; P = .001; 95% CI: 1.67-7.20); mandatory overtime (OR, 2.44; P = .006; 95% CI: 1.27-4.67); and safety climate (OR, 1.88; P = .004; 95% CI: 1.21-2.91) among others. Conclusion: The prevalence of PI was substantial. Underreporting rates and risk factors for exposure were similar to those identified in other RN work populations, although factors uniquely associated with home care were also identified. Risk mitigation strategies tailored to home care are needed to reduce risk of exposure in this setting.

Violence, job satisfaction, and employment intentions among home healthcare registered nurses

Canton, A. N., Sherman, M. F., Magda, L. A., Westra, L. J., Pearson, J. M., Raveis, V. H., & Gershon, R. (n.d.).

Publication year

2009

Journal title

Home healthcare nurse

Volume

27

Issue

6

Page(s)

364-373

10.1097/01.NHH.0000356828.27090.bd

Abstract

Abstract

Workplace violence, defined as violent acts directed toward workers, includes physical assault, threat of assault, and verbal abuse (Occupational Safety and Health Administration [OSHA], 2004) and is widely recognized as a threat to workers' health and safety. Healthcare workers, especially nurses, are known to be at high risk (Duhart, 2001). As employees who work alone, have access to drugs, provide care to people in distress, and/or have frequent close contact with clients, they face a greater likelihood of exposure to violence (Chappell & Di Martino, 2000). Nurses' risk has been correlated with degree of patient contact; the odds of physical violence are 7.2 and 9.0 times greater for healthcare workers with moderate and high patient contact, respectively, compared with those with little or no contact (Findorff et al., 2004).

Web-based training on weapons of mass destruction response for emergency medical services personnel.

Gershon, R., Canton, A. N., Magda, L. A., DiMaggio, C., Gonzalez, D., & Dul, M. W. (n.d.).

Publication year

2009

Journal title

American journal of disaster medicine

Volume

4

Issue

3

Page(s)

153-161

10.5055/ajdm.2009.0024

Abstract

Abstract

OBJECTIVE: To develop, implement, and assess a web-based simulation training program for emergency medical services (EMS) personnel on recognition and treatment of ocular injuries resulting from weapons of mass destruction (WMD) attacks. DESIGN: The training program consisted of six modules: WMD knowledge and event detection, ocular anatomy, ocular first aid (ie, flushing, cupping, and patching), and three WMD simulations (ie, sarin gas release, anthrax release, and radioactive dispersal device). Pretest, post-test, and 1-month follow-up test and a program evaluation were used to measure knowledge gain and retention and to assess the effectiveness of the program. SETTING: New York State EMS. PARTICIPANTS: Four hundred and sixty-four individuals participated in the training program and all waves of the testing (86 percent retention rate). MAIN OUTCOME VARIABLES: The effectiveness of the training intervention was measured using pretest and post-test questionnaires and analyzed using dependent t-tests. RESULTS: Assessment scores for overall knowledge increased from the pretest (mean = 15.7, standard deviation [SD] = 2.1) to the post-test (mean = 17.8, SD = 1.3), p < 0.001, and from pretest (mean = 15.7, SD = 2.1) to 1-month follow-up test (mean = 16.6, SD = 2.0), p < 0.001. Ninety-two percent of respondents indicated that the program reinforced understanding of WMDs. CONCLUSIONS: This training method provides an effective and low-cost approach to educate and evaluate EMS personnel on emergency treatment of eye trauma associated with the use of WMD. Online training should also be supplemented with hands-on practice and refresher trainings.

Epidemiology of subway-related fatalities in New York City, 1990-2003

Gershon, R., Pearson, J. M., Nandi, V., Vlahov, D., Bucciarelli-Prann, A., Tracy, M., Tardiff, K., & Galea, S. (n.d.).

Publication year

2008

Journal title

Journal of Safety Research

Volume

39

Issue

6

Page(s)

583-588

10.1016/j.jsr.2008.10.004

Abstract

Abstract

Problem: Subway transit is a relatively safe mode of transportation, yet compared to all other forms of mass transit in the United States (U.S.), subways have the highest fatality rate. The aim of this paper is to characterize subway-related fatalities in order to identify opportunities for risk reduction. Method: Medical examiner records for all New York City (NYC) subway-related deaths (1990-2003) were reviewed. Data were abstracted on decedents' demographics and autopsy findings, including laboratory findings. Results: There were 668 subway-related fatalities, of these, 10 (1.5%) were homicides, 343 (51.3%) were determined to be suicides, and 315 (47.2%) were accidental. Although decedent characteristics varied between fatality categories, they were not particularly informative with regard to prevention. Conclusion: Prevention strategies that focus on structural controls are likely to be most efficacious in improving the overall safety of the NYC subway systems. Impact on industry: These findings suggest that structural rather than individual-level interventions would be most successful in preventing subway fatalities.

Factors that influence Medical Reserve Corps recruitment.

Qureshi, K., Gershon, R., & Conde, F. (n.d.).

Publication year

2008

Journal title

Prehospital and disaster medicine : the official journal of the National Association of EMS Physicians and the World Association for Emergency and Disaster Medicine in association with the Acute Care Foundation

Volume

23

Issue

3

Page(s)

s27-34

10.1017/s1049023x00024067

Abstract

Abstract

The Medical Reserve Corps (MRC) is a key strategy used in the United States to assure an adequate surge capacity healthcare workforce for response to disasters. A survey of Hawaiian healthcare providers (n = 1,057) was conducted to identify factors that influence interest, ability, and willingness to join the MRC; 468 (44.3%) healthcare providers responded. Overall, females were more likely to demonstrate an interest in joining the MRC, while physicians and dentists reported lower levels of ability and willingness, in addition to a lower level of interest in joining the MRC than the other professional groups. The most important motivating factor in joining the MRC was altruism and the ability to help one's own community. Respondents reported a number of factors that would influence their decision to join or remain a MRC member. These included: (1) time commitment required; (2) MRC organization and management; (3) provision of MRC-sponsored training or education sessions and continuing education credits; (4) concerns regarding the safety of family members during a disaster; (5) professional liability protection for work performed during MRC operations; and (6) competing personal obligations. Strategies targeting these factors probably will be most effective in recruitment and retention of MRC volunteers as well as members of other public health surge capacity volunteer groups.

Home health care registered nurses and the risk of percutaneous injuries : A pilot study

Gershon, R., Pogorzelska, M., Qureshi, K. A., & Sherman, M. (n.d.).

Publication year

2008

Journal title

American Journal of Infection Control

Volume

36

Issue

3

Page(s)

165-172

10.1016/j.ajic.2007.04.278

Abstract

Abstract

Background: Home health care is the fastest-growing sector in the health care industry, expected to grow 66% over the next 10 years. Yet data on occupational health hazards, including the potential risk of exposure to blood and body fluids, associated with the home care setting remain very limited. As part of a larger study of bloodborne pathogen risk in non-hospital-based registered nurses (RNs), data from 72 home health care nurses were separately analyzed to identify risk of blood/body fluid exposure. Methods: A 152-item self-administered mailed risk assessment questionnaire was completed by RNs employed in home health care agencies in New York State. Results: Nine (13%) of the home health care nurses experienced 10 needlesticks in the 12-month period before the study. Only 4 of the needlesticks were formally reported to the nurse's employer. The devices most frequently associated with needlesticks were hollow-bore and phlebotomy needles, and included 3 needles with safety features. Exposure was most commonly attributed to patient actions, followed by disposal-related activities. Conclusions: These data suggest that home health care nurses may be at potential occupational risk for bloodborne pathogen exposure. Risk management strategies tailored to the home health care setting may be most effective in reducing this risk.

Household-related hazardous conditions with implications for patient safety in the home health care sector

Gershon, R., Canton, A. N., Raveis, V. H., Silver, A., Chen, C. C., Qureshi, K. A., Sherman, M. F., & Stone, P. W. (n.d.).

Publication year

2008

Journal title

Journal of Patient Safety

Volume

4

Issue

4

Page(s)

227-234

10.1097/PTS.0b013e31818936e3

Abstract

Abstract

OBJECTIVES: The home health care (HHC) setting is unique because it is both a household and a care-giving environment. As such, it may present a risk for adverse events that could affect the health and safety of HHC patients. This study assessed and characterized unsafe household conditions with implications for patient safety in the HHC setting. METHODS:: A convenience sample of HHC registered nurses (RNs) from New York State completed a self-administered survey, which addressed the type and frequency of hazardous conditions in the households of their current patients. These nurses were asked to report on potential hazards (biological, chemical, environmental and physical, and violence) observed in patients' households. RESULTS:: A total of 738 RNs completed the survey. Hazardous household conditions were frequently reported including animal hair (n = 543, 74%), cigarette smoke (n = 534, 72%), excessive dust (n = 428, 58%), vermin (n = 328, 44%), and unsanitary conditions (n = 317, 43%). The threat of violence was also frequently reported. Hazardous conditions were significantly associated with a number of patient-related factors. CONCLUSIONS:: Hazardous conditions identified in the households of HHC patients present a well-documented risk of injury/illness in the community setting and may also present occupational risk to caregivers. Many of these hazards are readily modifiable, although others may be less amenable to intervention. Additional studies are warranted in order to further assess and characterize the prevalence and risk factors for hazardous household conditions and to determine the relationship between these conditions and adverse patient safety events in the home care setting.

Participatory action research methodology in disaster research : Results from the world trade center evacuation study

Gershon, R., Rubin, M. S., Qureshi, K. A., Canton, A. N., & Matzner, F. J. (n.d.).

Publication year

2008

Journal title

Disaster medicine and public health preparedness

Volume

2

Issue

3

Page(s)

142-149

10.1097/DMP.0b013e318184b48f

Abstract

Abstract

Objective: Participatory action research (PAR) methodology is an effective tool in identifying and implementing risk-reduction interventions. It has been used extensively in occupational health research, but not, to our knowledge, in disaster research. A PAR framework was incorporated into the World Trade Center evacuation study, which was designed to identify the individual, organizational, and structural (environmental) factors that affected evacuation from the World Trade Center Towers 1 and 2 on September 11, 2001. PAR teams-comprising World Trade Center evacuees, study investigators, and expert consultants-worked collaboratively to develop a set of recommendations designed to facilitate evacuation from high-rise office buildings and reduce risk of injury among evacuees. Methods: Two PAR teams worked first separately and then collectively to identify data-driven strategies for improvement of high-rise building evacuation. Results: The teams identified interventions targeting individual, organizational, and structural (environmental) barriers to safe and rapid evacuation. Conclusions: PAR teams were effective in identifying numerous feasible and cost-effective strategies for improvement of high-rise emergency preparedness and evacuation. This approach may have utility in other workplace disaster prevention planning and response programs. (Disaster Med Public Health Preparedness. 2008;2:142-149)

Safety factors predictive of job satisfaction and job retention among home healthcare aides

Sherman, M. F., Gershon, R., Samar, S. M., Pearson, J. M., Canton, A. N., & Damsky, M. R. (n.d.).

Publication year

2008

Journal title

Journal of Occupational and Environmental Medicine

Volume

50

Issue

12

Page(s)

1430-1441

10.1097/JOM.0b013e31818a388e

Abstract

Abstract

OBJECTIVES: Although many of the well known work characteristics associated with job satisfaction in home health care have been documented, a unique aspect of the home health care aides' (HHA) work environment that might also affect job satisfaction is the fact that their workplace is a household. To obtain a better understanding of the potential impact of the risks/exposures/hazards within the household environment on job satisfaction and job retention in home care, we recently conducted a risk assessment study. METHODS: Survey data from a convenience sample of 823 New York City HHAs were obtained and analyzed. RESULTS: Household/job-related risks, environmental exposures, transportation issues, threats/verbal and physical abuse, and potential for violence were significantly correlated with HHA job satisfaction and job retention. CONCLUSIONS: Addressing the modifiable risk factors in the home health care household may improve job satisfaction and reduce job turnover in this work population.

Worksite emergency preparedness : Lessons from the world trade center evacuation study

Gershon, R., Qureshi, K. A., Barocas, B., Pearson, J., & Dopson, S. A. (n.d.).

Publication year

2008

Page(s)

232-266

10.4337/9781848443815.00020

Abstract

Abstract

~

Factors associated with high-rise evacuation : Qualitative results from the world trade center evacuation study

Gershon, R., Qureshi, K. A., Rubin, M. S., & Raveis, V. H. (n.d.).

Publication year

2007

Journal title

Prehospital and Disaster Medicine

Volume

22

Issue

3

Page(s)

165-173

10.1017/S1049023X0000460X

Abstract

Abstract

Introduction: Due to the fact that most high-rise structures (i.e., >75 feet high, or eight to ten stories) are constructed with extensive and redundant fire safety features, current fire safety procedures typically only involve limited evacuation during minor to moderate fire emergencies. Therefore, full-scale evacuation of high-rise buildings is highly unusual and consequently, little is known about how readily and rapidly high-rise structures can be evacuated fully. Factors that either facilitate or inhibit the evacuation process remain under-studied.Objective: This paper presents results from the qualitative phase of the World Trade Center Evacuation Study, a three-year, five-phase study designed to improve our understanding of the individual, organizational, and environmental factors that helped or hindered evacuation from the World Trade Center (WTC) Towers 1 and 2, on 11 September 2001.Methods: Qualitative data from semi-structured, in-depth interviews and focus groups involving WTC evacuees were collected and analyzed.Results: On the individual level, factors that affected evacuation included perception of risk (formed largely by sensory cues), preparedness training, degree of familiarity with the building, physical condition, health status, and footwear. Individual behavior also was affected by group behavior and leadership. At the organizational level, evacuation was affected by worksite preparedness planning, including the training and education of building occupants, and risk communication. The environmental conditions affecting evacuation included smoke, flames, debris, general condition and degree of crowdedness on staircases, and communication infrastructure systems (e.g., public address, landline, cellular and fire warden's telephones).Conclusions: Various factors at the individual, organizational, and environmental levels were identified that affected evacuation. Interventions that address the barriers to evacuation may improve the full-scale evacuation of other high-rise buildings under extreme conditions. Further studies should focus on the development and evaluation of targeted interventions, including model emergency preparedness planning for high-rise occupancies.

Home health care challenges and avian influenza

Gershon, R., Qureshi, K. A., Stone, P. W., Pogorzelska, M., Silver, A., Damsky, M. R., Burdette, C., Gebbie, K. M., & Raveis, V. H. (n.d.).

Publication year

2007

Journal title

Home Health Care Management and Practice

Volume

20

Issue

1

Page(s)

58-69

10.1177/1084822307305908

Abstract

Abstract

Recent public health disasters, both nationally and internationally, have underscored the importance of preparedness in effectively responding to these events. Within the home health care sector, preparedness is especially critical, as home care patients may be at increased risk of disaster-related morbidity and mortality because of their age, disability, or other vulnerability. Importantly, the home health care population is growing, with an estimated 7 million patients currently receiving home health care services. Yet the degree of preparedness at all levels of the home care sector (agency, health care worker, and patient and/or family) is largely unknown. Without this knowledge, important first steps toward development and implementation designed to address barriers to preparedness cannot be taken. To help address some of these knowledge gaps, one aspect of preparedness, namely the willingness of home health care workers to respond during an avian influenza outbreak, was recently examined. Findings revealed very low levels of willingness. Preliminary recommendations designed to address this issue are presented following a general discussion of the issue.

Non-hospital based registered nurses and the risk of bloodborne pathogen exposure

Gershon, R., Qureshi, K. A., Pogorzelska, M., Rosen, J., Gebbie, K. M., Brandt-Rauf, P. W., & Sherman, M. F. (n.d.).

Publication year

2007

Journal title

Industrial Health

Volume

45

Issue

5

Page(s)

695-704

10.2486/indhealth.45.695

Abstract

Abstract

The aim of this study was to assess the risk of blood and body fluid exposure among non-hospital based registered nurses (RNs) employed in New York State. The study population was mainly unionized public sector workers, employed in state institutions. A self-administered questionnaire was completed by a random stratified sample of members of the New York State Nurses Association and registered nurse members of the New York State Public Employees Federation. Results were reviewed by participatory action research (PAR) teams to identify opportunities for improvement. Nine percent of respondents reported at least one needlestick injury in the 12-month period prior to the study. The percutaneous injury (PI) rate was 13.8 per 100 person years. Underreporting was common; 49% of all PIs were never formally reported and 70% never received any post-exposure care. Primary reasons for not reporting included: time constraints, fear, and lack of information on reporting. Significant correlates of needlestick injuries included tenure, patient load, hours worked, lack of compliance with standard precautions, handling needles and other sharps, poor safety climate, and inadequate training and availability of safety devices (p

Organizational climate and nurse health outcomes in the United States : A systematic review

Gershon, R., Stone, P. W., Zeltser, M., Faucett, J., Macdavitt, K., & Chou, S. S. (n.d.).

Publication year

2007

Journal title

Industrial Health

Volume

45

Issue

5

Page(s)

622-636

10.2486/indhealth.45.622

Abstract

Abstract

Increasing interest has been focused on understanding the role working conditions play in terms of the serious issues facing hospitals today, including quality of patient care, nurse shortages, and financial challenges. One particular working condition that has been the subject of recent research, is the impact of organizational climate on nurses' well-being, including occupational health outcomes. To examine evidence-based research on the association between organizational climate and occupational health outcomes among acute-care registered nurses, a systematic review of published studies was conducted. Studies assessing the association between organizational climate variables and three common health outcomes in nurses (blood/body fluid exposures, musculoskeletal disorders, and burnout) were reviewed. Fourteen studies met the inclusion criteria. Although most were cross-sectional in design and variability was noted across studies with respect to operational definitions and assessment measures, all noted significant associations between specific negative aspects of hospital organizational climate and adverse health impacts in registered nurses. While evidence for an association between organizational climate constructs and nurses' health was found, data were limited and some of the relationships were weak. Additional studies are warranted to clarify the nature of these complex relationships.

Organizational climate and occupational health outcomes in hospital nurses

Stone, P. W., Du, Y., & Gershon, R. (n.d.).

Publication year

2007

Journal title

Journal of Occupational and Environmental Medicine

Volume

49

Issue

1

Page(s)

50-58

10.1097/01.jom.0000251622.05429.0c

Abstract

Abstract

OBJECTIVE: The objective of this study was to determine relationships between organizational climate (OC) factors and occupational health outcomes (lost workdays, musculoskeletal injury, blood and body fluid exposures, injuries, and burnout) among hospital-based nurses. METHODS: Measures were obtained through a self-administered, anonymous survey distributed in 13 New York City hospitals. Multivariate models appropriate for clustered data were developed. These analyses controlled for nurse and employment characteristics. Independent effects of OC factors were examined. RESULTS: Surveys from 2047 predominantly registered nurses were obtained (response rate 50%). More than 75% reported lost workdays due to illness in the previous 4-month period and over one third reported experiencing some type of injury. OC factors were independently associated with injuries and measures of burnout (P ≤ 0.05). CONCLUSIONS: OC is significantly associated with the health and well-being of hospital nurses.

Prevalence and risk factors for bloodborne exposure and infection in correctional healthcare workers

Gershon, R., Sherman, M., Mitchell, C., Vlahov, D., Erwin, M. J., Lears, M. K., Felknor, S., Lubelczyk, R. A., & Alter, M. J. (n.d.).

Publication year

2007

Journal title

Infection Control and Hospital Epidemiology

Volume

28

Issue

1

Page(s)

24-30

10.1086/510813

Abstract

Abstract

OBJECTIVE. To determine the prevalence and risk factors for bloodborne exposure and infection in correctional healthcare workers (CHCWs). DESIGN. Cross-sectional risk assessment study with a confidential questionnaire and serological testing performed during 1999-2000. SETTING. Correctional systems in 3 states. RESULTS. Among 310 participating CHCWs, the rate of percutaneous injury (PI) was 32 PIs per 100 person-years overall and 42 PIs per 100 person-years for CHCWs with clinical job duties. Underreporting was common, with only 25 (49%) of 51 PIs formally reported to the administration. Independent risk factors for experiencing PI included being age 45 or older (adjusted odds ratio [aOR], 2.41 [95% confidence interval (CI), 1.31-4.46]) and having job duties that involved needle contact (aOR, 3.70 [95% CI, 1.28-10.63]) or blood contact (aOR, 5.05 [95% CI, 1.45-17.54]). Overall, 222 CHCWs (72%) reported having received a primary hepatitis B vaccination series; of these, 150 (68%) tested positive for anti-hepatitis B surface antigen, with negative results significantly associated with receipt of last dose more than 5 years previously. Serologic markers of hepatitis B virus infection were identified in 31 individuals (10%), and the prevalence of hepatitis C virus infection was 2% (n = 7). The high hepatitis B vaccination rate limited the ability to identify risk factors for infection, but hepatitis C virus infection correlated with community risk factors only. CONCLUSION. Although the wide coverage with hepatitis B vaccination and the decreasing rate of hepatitis C virus infection in the general population are encouraging, the high rate of exposure in CHCWs and the lack of exposure documentation are concerns. Continued efforts to develop interventions to reduce exposures and encourage reporting should be implemented and evaluated in correctional healthcare settings. These interventions should address infection control barriers unique to the correctional setting.

Roadmap for the protection of disaster research participants : Findings from the world trade center evacuation study

Qureshi, K. A., Gershon, R., Smailes, E., Raveis, V. H., Murphy, B., Matzner, F., & Fleischman, A. R. (n.d.).

Publication year

2007

Journal title

Prehospital and Disaster Medicine

Volume

22

Issue

6

Page(s)

486-493

10.1017/S1049023X00005306

Abstract

Abstract

Introduction: This report addresses the development, implementation, and evaluation of a protocol designed to protect participants from inadvertent emotional harm or further emotional trauma due to their participation in the World Trade Center Evacuation (WTCE) Study research project. This project was designed to identify the individual, organizational, and structural (environmental) factors associated with evacuation from the World Trade Center Towers 1 and 2 on 11 September 2001.Methods: Following published recommended practices for protecting potentially vulnerable disaster research participants, protective strategies and quality assurance processes were implemented and evaluated, including an assessment of the impact of participation on study subjects enrolled in the qualitative phase of the WTCE Study.Results: The implementation of a protocol designed to protect disaster study participants from further emotional trauma was feasible and effective in minimizing risk and monitoring for psychological injury associated with study participation. Conclusions: Details about this successful strategy provide a roadmap that can be applied in other post-disaster research investigations.

Nurse work environments and occupational safety in intensive care units

Stone, P. W., & Gershon, R. (n.d.).

Publication year

2006

Journal title

Policy, Politics, and Nursing Practice

Volume

7

Issue

4

Page(s)

240-247

10.1177/1527154406297896

Abstract

Abstract

Using data collected from 39 intensive care units (ICUs) in 23 hospitals across the United States, the purpose of this study was to examine hospital structural characteristics, nurse characteristics, and nurses' working conditions' impact on occupational safety outcomes. ICU with more positive organizational climates had lower rates of occupational injuries and blood and body fluid exposures (p