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Emergency Preparedness Safety Climate and Other Factors Associated With Mental Health Outcomes Among World Trade Center Disaster Evacuees

Published online by Cambridge University Press:  04 November 2016

Martin F. Sherman
Affiliation:
Department of Psychology, Loyola University Maryland, Baltimore, Maryland
Robyn R. Gershon*
Affiliation:
Philip R. Lee Institute for Health Policy Studies, School of Medicine, University of California, San Francisco, California Department of Epidemiology and Biostatistics, School of Medicine, University of California, San Francisco, California
Halley E. M. Riley
Affiliation:
Rollins School of Public Health, Emory University, Atlanta, Georgia
Qi Zhi
Affiliation:
Philip R. Lee Institute for Health Policy Studies, School of Medicine, University of California, San Francisco, California
Lori A. Magda
Affiliation:
School of Psychology, Fairleigh Dickinson University, Teaneck, New Jersey.
Mark Peyrot
Affiliation:
Department of Psychology, Loyola University Maryland, Baltimore, Maryland
*
Correspondence and reprint requests to Robyn R. Gershon, 3333 California Street, Suite 280, San Francisco, CA 94118 (E-mail: [email protected]).

Abstract

Objective

We examined psychological outcomes in a sample of participants who evacuated from the World Trade Center towers on September 11, 2011. This study aimed to identify risk factors for psychological injury that might be amenable to change, thereby reducing adverse impacts associated with emergency high-rise evacuation.

Methods

We used data from a cross-sectional survey conducted 2 years after the attacks to classify 789 evacuees into 3 self-reported psychological outcome categories: long-term psychological disorder diagnosed by a physician, short-term psychological disorder and/or memory problems, and no known psychological disorder.

Results

After nonmodifiable risk factors were controlled for, diagnosed psychological disorder was more likely for evacuees who reported lower “emergency preparedness safety climate” scores, more evacuation challenges (during exit from the towers), and evacuation-related physical injuries. Other variables associated with increased risk of psychological disorder outcome included gender (female), lower levels of education, preexisting physical disability, preexisting psychological disorder, greater distance to final exit, and more information sources during egress.

Conclusions

Improving the “emergency preparedness safety climate” of high-rise business occupancies and reducing the number of egress challenges are potential strategies for reducing the risk of adverse psychological outcomes of high-rise evacuations. Focused safety training for individuals with physical disabilities is also warranted. (Disaster Med Public Health Preparedness. 2017;11:326–336)

Type
Original Research
Copyright
Copyright © Society for Disaster Medicine and Public Health, Inc. 2016 

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References

REFERENCES

1. US Fire Administration. The World Trade Center Bombing: Report and Analysis. New York, NY: US: Department of Homeland Security; 1993:132.Google Scholar
2. Gershon, RRM, Magda, LA, Riley, HEM, Sherman, MF. The World Trade Center evacuation study: factors associated with initiation and length of time for evacuation. Fire Mater. 2012;36(5-6):481-500. http://dx.doi.org/10.1002/fam.1080.Google Scholar
3. Sherman, MF, Peyrot, M, Magda, LA, et al. Modeling pre-evacuation delay by evacuees in World Trade Center Towers 1 and 2 on September 11, 2001: A revisit using regression analysis. Fire Saf J. 2011;46(7):414-424. http://dx.doi.org/10.1016/j.firesaf.2011.07.001.Google Scholar
4. Groeger, JL, Stellman, SD, Kravitt, A, et al. Evacuating damaged and destroyed buildings on 9/11: behavioral and structural barriers. Prehosp Disaster Med. 2013;28(6):556-566. http://dx.doi.org/10.1017/S1049023X13008996.Google Scholar
5. Neria, Y, Nandi, A, Galea, S. Post-traumatic stress disorder following disasters: a systematic review. Psychol Med. 2008;38(4):467-480. http://dx.doi.org/10.1017/S0033291707001353.Google Scholar
6. Liu, B, Tarigan, LH, Bromet, EJ, et al. World Trade Center disaster exposure-related probable posttraumatic stress disorder among responders and civilians: a meta-analysis. PLoS One. 2014;9(7):e101491. http://dx.doi.org/10.1371/journal.pone.0101491.Google Scholar
7. Brackbill, RM, Thorpe, LE, DiGrande, L, et al. Surveillance for World Trade Center disaster health effects among survivors of collapsed and damaged buildings. Morb Mortal Wkly Rep Surveill Summ. 2006;55(2):1-18.Google Scholar
8. Farfel, M, DiGrande, L, Brackbill, R, et al. An overview of 9/11 experiences and respiratory and mental health conditions among World Trade Center Health Registry enrollees. J Urban Health. 2008;85(6):880-909.Google Scholar
9. DiGrande, L, Neria, Y, Brackbill, RM, et al. Long-term posttraumatic stress symptoms among 3,271 civilian survivors of the September 11, 2001, terrorist attacks on the World Trade Center. Am J Epidemiol. 2011;173(3):271-281. http://dx.doi.org/10.1093/aje/kwq372.Google Scholar
10. Galea, S, Vlahov, D, Tracy, M, et al. Hispanic ethnicity and post-traumatic stress disorder after a disaster: evidence from a general population survey after September 11, 2001. Ann Epidemiol. 2004;14(8):520-531. http://dx.doi.org/10.1016/j.annepidem.2004.01.006.Google Scholar
11. Dohrenwend, BS. Social status and stressful life events. J Pers Soc Psychol. 1973;28(2):225-235. http://dx.doi.org/10.1037/h0035718.Google Scholar
12. Neria, Y, Gross, R, Olfson, M, et al. Posttraumatic stress disorder in primary care one year after the 9/11 attacks. Gen Hosp Psychiatry. 2006;28(3):213-222. http://dx.doi.org/10.1016/j.genhosppsych.2006.02.002.Google Scholar
13. Shyam-Sunder, S. Federal Building and Fire Safety Investigation of the World Trade Center Disaster: Final Report of the National Construction Safety Team on the Collapses of the World Trade Center Towers. http://www.nist.gov/manuscript-publication-search.cfm?pub_id=909017. Published December 1, 2005. Accessed August 29, 2014.Google Scholar
14. Qureshi, KA, Gershon, RR, Smailes, E, et al. Roadmap for the protection of disaster research participants: findings from the World Trade Center Evacuation Study. Prehosp Disaster Med. 2007;22(6):486-493. http://dx.doi.org/10.1017/S1049023X00005306.Google Scholar
15. Gershon, RR, Qureshi, KA, Rubin, MS, et al. Factors associated with high-rise evacuation: qualitative results from the World Trade Center Evacuation Study. Prehosp Disaster Med. 2007;22(3):165-173. http://dx.doi.org/10.1017/S1049023X0000460X.Google Scholar
16. DeJoy, DM. Theoretical models of health behavior and workplace self-protective behavior. J Safety Res. 1996;27(2):61-72. http://dx.doi.org/10.1016/0022-4375(96)00007-2.Google Scholar
17. Gershon, RRM. World Trade Center Attack on September 11, 2001. In: Landesman LY, Weisfuse IB, eds. Case Studies in Public Health Preparedness and Responses to Disasters. Burlington, MA: Jones & Barlett Learning; 2014.Google Scholar
18. IBM SPSS Statistics for Windows, Version 22.0. [computer program]. Armonk, NY: IBM Corp.; 2013.Google Scholar
19. DeLisi, LE, Maurizio, A, Yost, M, et al. A survey of New Yorkers after the Sept. 11, 2001, terrorist attacks. Am J Psychiatry. 2003;160(4):780-783. http://dx.doi.org/10.1176/appi.ajp.160.4.780.Google Scholar
20. Gershon, RRM, Qureshi, KA, Barocas, B, et al. Worksite emergency preparedness: lessons from the World Trade Center Evacuation Study. In: Cooper CL, ed. International Terrorism and Threats to Security: Managerial and Organizational Challenges. Northampton, MA: Edward Elgar Publishing Inc; 2008:36. http://dx.doi.org/10.4337/9781848443815.00020.Google Scholar
21. Bandura, A. Organisational applications of social cognitive theory. Aust J Manag. 1988;13(2):275-302. http://dx.doi.org/10.1177/031289628801300210.Google Scholar
22. Benight, CC, Bandura, A. Social cognitive theory of posttraumatic recovery: the role of perceived self-efficacy. Behav Res Ther. 2004;42(10):1129-1148. http://dx.doi.org/10.1016/j.brat.2003.08.008.Google Scholar
23. Richardson, KM. Meaning reconstruction in the face of terror: an examination of recovery and posttraumatic growth among victims of the 9/11 World Trade Center attacks. J Emerg Manag. 2015;13(3):239-246. http://dx.doi.org/10.5055/jem.2015.0237.CrossRefGoogle ScholarPubMed
24. Gargano, LM, Caramanica, K, Sisco, S, et al. Exposure to the World Trade Center disaster and 9/11-related post-traumatic stress disorder and household disaster preparedness. Disaster Med Public Health Prep. 2015;9(6):625-633. http://dx.doi.org/10.1017/dmp.2015.71.Google Scholar
25. Brackbill, RM, Hadler, JL, DiGrande, L, et al. Asthma and posttraumatic stress symptoms 5 to 6 years following exposure to the World Trade Center terrorist attack. JAMA. 2009;302(5):502-516. http://dx.doi.org/10.1001/jama.2009.1121.Google Scholar
26. Brackbill, RM, Cone, JE, Farfel, MR, et al. Chronic physical health consequences of being injured during the terrorist attacks on World Trade Center on September 11, 2001. Am J Epidemiol. 2014;179(9):1076-1085. http://dx.doi.org/10.1093/aje/kwu022.Google Scholar
27. Gershon, RR, Rubin, MS, Qureshi, KA, et al. Participatory action research methodology in disaster research: results from the World Trade Center evacuation study. Disaster Med Public Health Prep. 2008;2(3):142-149. http://dx.doi.org/10.1097/DMP.0b013e318184b48f.Google Scholar
28. McKnight, PE, McKnight, KM, Sidani, S, et al. Missing Data: A Gentle Introduction. New York, NY: Guilford Press; 2007.Google Scholar
29. Sterne, JAC, White, IR, Carlin, JB, et al. Multiple imputation for missing data in epidemiological and clinical research: potential and pitfalls. BMJ. 2009;338:b2393. http://dx.doi.org/10.1136/bmj.b2393.Google Scholar
30. Gershon, RR, Karkashian, CD, Grosch, JW, et al. Hospital safety climate and its relationship with safe work practices and workplace exposure incidents. Am J Infect Control. 2000;28(3):211-221. http://dx.doi.org/10.1067/mic.2000.105288.Google Scholar
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