University of Ghana http://ugspace.ug.edu.gh SCHOOL OF PUBLIC HEALTH COLLEGE OF HEALTH SCIENCES UNIVERSITY OF GHANA, LEGON EVALUATION OF OCCUPATIONAL HEALTH AND SAFETY STANDARDS COMPLIANCE AMONG WORKERS OF SELECTED FOOD INDUSTRIES IN THE GREATER ACCRA REGION OF GHANA BY SOLOMON ABAKAH (10346061) THIS THESIS/DISSERTATION IS SUBMITTED TO THE UNIVERSITY OF GHANA, LEGON IN PARTIAL FULFILLMENT OF THE REQUIREMENT FOR THE AWARD OF MASTER OF PUBLIC HEALTH (MPH) DEGREE JULY, 2018 University of Ghana http://ugspace.ug.edu.gh DECLARATION I, Solomon Abakah do hereby declare that except for the other investigations which have been duly acknowledged, this dissertation is mine and that it has not been presented for a degree in this university or another university elsewhere. …………………………… ……………………………… Solomon Abakah Date (Student ……………………………. ………..……………………. Dr. Uri Selorm Markakpo Date (Supervisor) 2 University of Ghana http://ugspace.ug.edu.gh ABSTRACT Introduction Poor Occupational Health, and reduced working capacity of workers may cause economic loss to a country. In countries like Ghana with a high rate of unemployment coupled with a growing informal sector, workers focus mainly on job security, neglecting the need for quality work life. It is argued that poor countries and companies cannot afford safety and health measures. However, there is no evidence that any country or company in the long run benefits from poor safety and health. There are Occupational Health and Safety Standards in Ghana. Lack of enforcement of Occupational Health and Safety policy and inadequate information are some of the factors that militate against compliance with OHS regulations among workers. Aims and objectives The study therefore sought to evaluate the Occupational Health and Safety Standards compliance among workers of selected industries in Accra. It also sought to evaluate the prevalence of injuries among workers in the selected food industries and to assess the level of awareness of Occupational Health and Safety Standard measures available in the facilities. Methods This study was cross-sectional in design and employed quantitative techniques, using a structured questionnaire for collection of data, addressing questions related to the research objectives. A total of 408 workers from the selected industries were interviewed using the structured questionnaire and a systematic sampling technique. Descriptive statistics such as means ± SD, cross-tabulations, tables, frequency and percentages were used to describe demographic characteristics of the study population and other factors that influence compliance with occupational health and safety standards among the workers. Bivariate analysis using Chi-square was conducted to determine the i University of Ghana http://ugspace.ug.edu.gh association between the independent variables and dependent variable and factors found to be statistically significant were subsequently analyzed by Multivariate logistic regression. Odds Ratio (OR) was determined for each of the independent variables and statistical significance of 5% probability level (p ≤0.05). Results The findings of the study indicated that the prevalence rate of injuries in the selected industries was (7.3%). The most occurring injury among workers of the selected industries was cuts/puncture which was mainly due to nonuse or inappropriate use of PPEs. Factors which were associated with workers’ compliance with occupational health and safety standards include sex, work duty or job description, use of PPE and workers’ satisfaction with health and safety policies in the industries. CONCLUSION The main objective of this study was to evaluate the Occupational Health and Safety Standards compliance among workers of selected industries in Accra. This study therefore identified the relevant factors that are significantly associated with noncompliance with OHSS among industrial workers in Ghana so that effective measures can be put in place to augment the findings. ii University of Ghana http://ugspace.ug.edu.gh DEDICATION This work is dedicated firstly to the Almighty God, by whose grace and love I’ve come this far, Reverend Andrew Pappoe Jnr for his constant prayers, my late mother Mrs. Florence Abakah and Chief Superintendent (Ghana Police) Leonard Kwesi Abakah (Brother) for their relentless financial support. Last but not the least, Dr. Uri Markakpo (Supervisor) for his patience. iii University of Ghana http://ugspace.ug.edu.gh TABLE OF CONTENT DECLARATION........................................................................................................................... 2 ABSTRACT .................................................................................................................................... i DEDICATION.............................................................................................................................. iii TABLE OF CONTENT ............................................................................................................... iv LIST OF TABLES ..................................................................................................................... viii LIST OF FIGURES ..................................................................................................................... ix LIST OF ACRONYMS ................................................................................................................ x CHAPTER ONE ......................................................................................................................... 11 1.0. INTRODUCTION................................................................................................................ 11 1.1 Background ....................................................................................................................................... 11 1.2 Statement of problem ....................................................................................................................... 12 1.3 Justification ....................................................................................................................................... 13 1.4 Explanation of conceptual framework .............................................................................................. 14 1.4.1 Conceptual framework .............................................................................................................. 15 1.5 Research questions ........................................................................................................................... 16 1.6 General objectives ............................................................................................................................ 16 1.7 Specific objectives ............................................................................................................................. 16 CHAPTER TWO ........................................................................................................................ 17 2.0. LITERATURE REVIEW ................................................................................................... 17 2.1 Introduction ................................................................................................................................ 17 2.2 What is occupational health and safety? .................................................................................... 17 2.3 Workplace safety and health issues in Ghana .................................................................................. 18 2.4 Training and supervision to the workers on matters of occupational health and safety ................. 20 2.5 Use of personal protective equipment (PPEs) in food industries ..................................................... 21 2.5.1 Factors influencing the use of PPEs in food industries .............................................................. 22 2.6 Knowledge and awareness of occupational health and safety among industrial workers .............. 23 2.6.1 Knowledge and awareness of occupational health and safety among industrial workers in Ghana .................................................................................................................................................. 24 iv University of Ghana http://ugspace.ug.edu.gh 2.7 Impact of OHS on worker productivity in industries ........................................................................ 25 CHAPTER THREE .................................................................................................................... 27 3.0. METHODS ........................................................................................................................... 27 3.1 Study design ...................................................................................................................................... 27 3.2 Study area ......................................................................................................................................... 27 3.3. VARIABLES ........................................................................................................................................ 30 3.3.1 Outcome variables ..................................................................................................................... 30 3.3.2 Independent variables ............................................................................................................... 30 3.4 Study population ............................................................................................................................... 30 3.4.1 Inclusion criteria ......................................................................................................................... 30 3.5 Sample size determination ............................................................................................................... 30 3.5.1 Sampling method ....................................................................................................................... 31 3.6 Data collection technique/ methods and tools ................................................................................ 31 3.7 Quality control .................................................................................................................................. 31 3.8 Data processing and analysis ............................................................................................................ 32 3.9 Ethical considerations/ issues ........................................................................................................... 32 3.9.1 Access and approval of study area ............................................................................................ 33 3.9.2 Privacy and confidentiality ......................................................................................................... 33 3.9.3 Compensation ............................................................................................................................ 33 3.9.4 Risks and Benefits ...................................................................................................................... 33 3.9.5 Voluntary withdrawal ................................................................................................................ 34 3.9.6 Informed Consent and Consenting process ............................................................................... 34 3.9.7 Data storage and usage.............................................................................................................. 34 3.9.8 Declaration of conflict of interest .............................................................................................. 34 3.9.9 Funding of the study .................................................................................................................. 35 CHAPTER FOUR ....................................................................................................................... 36 RESULTS .................................................................................................................................... 36 4.0 Introduction ................................................................................................................................ 36 4.1 Socio- demographic characteristics of workers in the selected food processing industries. ..... 36 4.2 Work- related characteristics and occupational safety practices of respondents. .................... 39 4.3 Prevalence of occupational injuries ............................................................................................ 41 4.4 Distribution of occupational injuries among workers of the selected food industries .............. 44 v University of Ghana http://ugspace.ug.edu.gh 4.5 Prevalence of occupational injuries in relation to occupational safety practices among participants ............................................................................................................................................. 45 4.6 Level of awareness among study participants ............................................................................ 46 4.7 Univariate Analysis of the socio- demographic characteristics of workers’ compliance with health and safety standards. ................................................................................................................... 46 4.8 Multiple Logistic Regression Analysis of the socio- demographic characteristics of workers’ compliance with health and safety standards ........................................................................................ 49 4.9 Univariate Analysis of the relationship between work- related characteristics and compliance with occupational health and safety standard practices among participants ........................................ 50 4.10 Multiple Logistic Regression Analysis of the relationship between work- related characteristics and compliance with occupational health and safety standard practices among participants ............. 51 CHAPTER FIVE ........................................................................................................................ 53 DISCUSSION .............................................................................................................................. 53 5.0 Introduction ...................................................................................................................................... 53 5.1 Socio-demographic Characteristics ................................................................................................... 53 5.2 Prevalence of occupational injuries among workers ........................................................................ 54 5.3 Level of awareness among industrial workers .................................................................................. 56 5.4 Compliance with health and safety standards .................................................................................. 56 CHAPTER SIX ........................................................................................................................... 59 SUMMARY, CONCLUSION AND RECOMMENDATIONS .............................................. 59 6.0 Introduction ...................................................................................................................................... 59 6.1 Summary ........................................................................................................................................... 59 6.2 Conclusion ......................................................................................................................................... 59 6.3 Limitations ......................................................................................................................................... 60 6.4 Recommendations ............................................................................................................................ 60 6.4.1 Recommendations to management .................................................................................. 60 2. For effective participation, training programs must be made compulsory for all workers when they are organized. There should be intense training on health and safety procedures as part of the orientation programs of newly recruited staff and interns. ................................................................. 61 6.4.2 Recommendations to the workers ............................................................................................ 61 6.4.3 Recommendations for academic purposes ............................................................................... 61 REFERENCES ............................................................................................................................ 62 APPENDICES ............................................................................................................................. 68 vi University of Ghana http://ugspace.ug.edu.gh APPENDIX I: PARTICIPANTS’ INFORMATION SHEET ................................................................................ 68 APPENDIX II: PARTICIPANTS’ CONSENT FORM/ CERTIFICATE OF CONSENT ........................................... 71 APPENDIX IV: STUDY QUESTIONNAIRE ................................................................................................... 73 vii University of Ghana http://ugspace.ug.edu.gh LIST OF TABLES Table 4.1: Socio-demographic characteristics of workers the selected food processing industries, Fan Milk Ltd- Ghana and Promasidor Ghana Ltd in the Okaikoi South Municipality, Accra, 2018……………………………………………………………………………………………..37 Table 4.2: Work-related and behavioral characteristics of workers the selected food processing industries, Fan Milk Ltd- Ghana and Promasidor Ghana Ltd in the Okaikoi South Municipality, Accra, 2018……………………………………………………………………………………...39 Table 4.3: Prevalence of Occupational Injuries among workers the selected food processing industries, Fan Milk Ltd- Ghana and Promasidor Ghana Ltd in the Okaikoi South Municipality……………………………………………………………………………………................41 Table 4.4: Prevalence of occupational injuries by Sociodemographic factors among workers of the selected food industries……………………………………………………………………………………………………43 Table 4.5: Prevalence of occupational injuries by working and behavioral factors among workers of the selected food industries…………………………………………………………………..44 Table 4.6: Level of awareness among workers of the selected food industries………………...45 Table 4.7: Univariate Analysis of the workers’ socio- demographic characteristics and compliance with health and safety standards…………………………………………………………………………………………47 Table 4.8: Multiple Logistic Regression Analysis of the socio- demographic characteristics of workers’ compliance with health and safety standards…………………………………………………………………………………...…….48 Table 4.9: Univariate Analysis of working and behavioral factors among workers of the selected food industries…………………………………………………………………………………...50 Table 4.10: Multiple Logistic Regression Analysis of working and behavioral factors among workers of the selected food industries………………………………………………………….51 viii University of Ghana http://ugspace.ug.edu.gh LIST OF FIGURES Figure 1.1: Conceptual Framework of Study ............................................................................... 15 Figure 3.1: Map Showing Location of Promasidor Ghana .......................................................... 28 Figure 3.2: Map Showing Location of Fan Milk Limited ........................................................... 29 Figure 4.1: Types of occupational injuries among workers of the selected food processing industries…………………………………………………………………………………………42 ix University of Ghana http://ugspace.ug.edu.gh LIST OF ACRONYMS ILO International Labour Organization OHS Occupational Health and Safety OHSS Occupational Health and Safety Standards WHO World Health Organization OSHA Occupational Health and Safety Administration PPE Personal Protective Equipment NIHL Noise- Induced Hearing Loss DALYs Disability- Adjusted Life Years LI Legislative Instrument x University of Ghana http://ugspace.ug.edu.gh CHAPTER ONE 1.0. INTRODUCTION 1.1 Background The idea of occupational health and safety (OHS) in industries was understood in Ghana before the Factories, Offices, and Shops Act 1970 was introduced. Industrialization in Ghana since then has been on the rise by the maintenance of systems and standards put in place to make health and safety practices better so as to reduce accidents, injuries and diseases at the work place (Annan, Addai, & Tulashie, 2015).The process of increasing industrialization has resulted to an enormous percentage of the workforce being exposed to occupational hazards. Though in recent years, there have been breakthroughs in occupational health and safety, many factors associated with workplace health and safety challenges still linger in most African countries, especially in Ghana (Puplampu, Lg, & Africa, 2012). According to WHO (1995), occupational health engulfs the actions for occupational medicine, occupational psychology, occupational hygiene, physiotherapy, ergonomics, safety, rehabilitation, etc. Safety on the contrary involves the protection of workers from physical injury (Hughes et al, 2008). Legal measures have been pioneered in various sectors to ensure safety of workers from work- related injuries and illnesses as well as prevent accidents in the industry (Kheni, Gibb, & Dainty, 2006). They include but not limited to the Mining and Minerals Regulations 1970 LI 665, the Workman’s Compensation Law 1987, the Radiation Protection Instrument LI 1559 of 1993 and the Ghana Labor Act 2003 (Act 651). 11 University of Ghana http://ugspace.ug.edu.gh Although there are bits of OHS legal requirements under jurisdictions of different agencies in Ghana, there is no national policy and body charged with monitoring and ensuring that these requirements and guidelines are implemented (Annan et al., 2015). There is therefore the need to conduct studies to evaluate compliance with OHSS among staff of industries in Ghana and also assess how noncompliance contributes to occupational injuries and illnesses. 1.2 Statement of problem According to the International Labor Organization (ILO), about 2.3 million people die each year due to work-related accidents or illnesses. 350,000 of these deaths are as a result of occupational accidents. In addition, the ILO estimates that there are 264,000 non-fatal accidents each year that result in work-related illnesses, leading to approximately 3 days of absence from work (Melorose, Perroy, & Careas, 2015). In Ghana, 14.5% of a total of 9,269,889 persons in employment have had a work place accident before. About 6.3% of all employed persons have had an accident in the last 12 months, leading to a reduction in productivity and economic loss (Ghana Statistical Service, 2016). A study conducted by Piavi et al, (2008) reveals that about 1,852 fatalities at the work place were recorded in 1998 due to poor health and safety practices in Ghana and this significantly rose to 9,661 cases in 2005. The rate of fatal injuries was 20.6 (per 100,000 workers) in 1998 and this went up to 23.6 (per 100,000 workers) in 2003. These rates of occupational injuries and fatalities were reported to have resulted in about 1.4 million days of absenteeism 1998, and about 2.3 million days in 2003. These levels of absenteeism have serious repercussions on productivity of the workers and the companies involved as well as the economy of the nation as whole (Adjotor, 1022). 12 University of Ghana http://ugspace.ug.edu.gh Furthermore, Mock et al (2005), indicated that the unsafe and unhealthy work environment, especially for industrial workers have become burdensome on Ghanaian workers and aggravated by the inadequacy of salaries of workers. Various studies have reported that there is significant association between increased accident rates and noncompliance with safety precautionary measures (Gyekye, 2006). This study therefore sought to evaluate OHS compliance among workers of selected industries in the Greater Accra Region of Ghana. 1.3 Justification Despite improvements in work design, prevalence of work related hazards, accidents and diseases are still high in our work places. Occupational Health and Safety Standards compliance is essential in prevention of the occurrence of accidents, injuries and diseases at the workplace. Therefore, evaluation of Occupational Health and Safety Standards compliance among workers in industries would generate evidence based data needed to formulate policies to reduce the rate of accidents and injuries in our work places. Also, conduct of this study among industrial workers would help create the awareness necessary to improve on the importance of the Occupational Health and Safety Standard adherence as a tool for minimizing the rate of accidents, injuries, diseases and death in the course of work. 13 University of Ghana http://ugspace.ug.edu.gh 1.4 Explanation of conceptual framework Figure 1. Illustrates the conceptual framework for the evaluation of Occupational Health and Safety Standards compliance among workers of selected food industries in the Greater Accra region of Ghana. It contains factors that influence compliance with Occupational Health and Safety Standards among workers of selected industries. These factors are grouped under demography, knowledge on OHSS and facility support. Reviews have shown that the income of a worker is a determinant of the level of compliance with OHS. A good monthly income and allowances, which increases with higher educational status and work experience, is motivation for workers to strictly adhere to OHSS. The Ministry of Health Report (2007) has identified that OHS concerns in Ghana which include a weak OHS infrastructures, untrained and inadequate OHS professionals, and lack of proper monitoring and surveillances for occupational health and safety diseases and injuries, inappropriate use of work equipment, and the general lack of adequate information are among the main drawbacks to an effective OHS compliance among industrial workers (Puplampu, Lg, & Africa, 2012). The health impact of injuries in Africa, measured in terms of deaths, morbidity and disability, is immense (Forjuoh, Zwi, & Mock, 1998). Despite the global acknowledgement of injury as a major public health problem, there is limited knowledge on OHS in Africa. Insufficient OHS education has been indicated as one of the factors contributing to noncompliance with occupational health and safety practice in Ghana. Thus adequate knowledge of occupational health and safety standards extremely influences workers’ compliance with health and safety standards. 14 University of Ghana http://ugspace.ug.edu.gh 1.4.1 Conceptual framework 1.4 CONCEPTUAL FRAMEWORK DEMO GRAPHIC CHARACTERISTICS 1. AGE 2. E DUCATIONAL LEVEL OF WORKERS 3. P ROFESSIONAL CATEGORY 4. IN COME LEVEL 5. WORKERS’ EXPERIENCE COMPLIANCE WITH KNOWLEDGE OF OHSS OCCUPATIONAL HEALTH AND SAFETY STANDARD PRACTICES FACILIT Y SUPPORT 1. TRAINING AND LOW RATE OF ACCIDENTS, RETRAING OF INJURIES AND DISEASES STAFF 2. PROVISION OF PROTECTIVE EQUIPMENT 3. STRICT ADHERANCE TO SAFETY RULES 4. APPROPRIATE USE OF WORK EQUIPMENT 5. AVAILABILTY OF STANDARD PROTOCOLS/ GUIDELINES 6. PROPER MONITORING AND SURVEILLANCE FOR OHS Figure1.1: Conceptual Framework of Study 15 University of Ghana http://ugspace.ug.edu.gh 1.5 Research questions 1. Do industries have health and safety standards in place to prevent or minimize occupational accidents and injuries? 2. Are workers of the selected industries aware of the health and safety issues in their work environment? 3. Are the OHS standards complied with in food industries in Ghana? 1.6 General objectives The main objective of this study is to evaluate the Occupational Health and Safety Standards compliance among workers of selected industries in Accra, Ghana. 1.7 Specific objectives 1. To determine the prevalence of occupational injuries among workers of the selected food processing industries in Accra, Ghana. 2. To assess the level of awareness of occupational health and safety standard practices that are available in the selected facilities. 3. To determine the level of OHSS compliance among workers of selected industries in Accra, Ghana. 16 University of Ghana http://ugspace.ug.edu.gh CHAPTER TWO 2.0. LITERATURE REVIEW 2.1 Introduction This chapter reviews literature limited to the Occupational Safety and Health among industrial workers. The literature is reviewed categorically by defining occupational safety, types of hazards into the following: biological, physical and ergonomic, distribution, causes, effect. Finally, knowledge, practices and barriers among workers on occupational safety is incorporated in all the aforementioned. 2.2 What is occupational health and safety? In the world today, many employees spend most of their time at the workplace. Work ensures that people earn income to provide social, psychological and economic experiences that promote the mental wellbeing of individuals. By reason of this, the work environment as much as possible should be free of hazardous exposures which could be harmful to the health and safety of the worker. However, several accidents, injuries, illnesses and damages occur at different workplaces. (Awan, 2007). There is therefore the urgent need for measures and guidelines to help manage and improve safety and health at the workplace. (Melorose, Perroy, & Careas, 2015). The (WHO, 1995) defines occupational health as “The promotion and maintenance of the highest degree of physical, mental social well- being of workers in all occupations”. Occupational health is known to be an interdisciplinary activity which focuses on the protection and promotion of the health of workers. This ensures that workers are safe from work related accidents and diseases through the prevention and control of circumstances and conditions that are considered harmful to 17 University of Ghana http://ugspace.ug.edu.gh health and safety at the workplace. (Tadesse, 2006). Furthermore, occupational health encompasses development of a healthy work environment, improving the physical, mental and social well-being of workers and strengthening the development and maintenance of the working capacity of all workers so as to empower them to live socially and economically productive lives for sustainable development (Dijk, Varekamp, Radon, & Version, 2011). IAPA (2007) also defines occupational safety as “the maintenance of a work environment that is relatively free from actual or potential hazards that can injure employees”. It aims at the improvement of working conditions and environment. Members of many different professions (e.g. Engineers, physicians, hygienists, psychologists, nurses) contribute to “occupational safety, occupational health, occupational hygiene, well-being at work and improvement of the working environment” (Djik et al, 2011). The ILO (2009) on the other hand defines Occupational health and safety as “the science of anticipation, recognition, evaluation and control of hazards arising in or from the workplace that could impair the health and well-being of workers, taking into account the possible impact on the surrounding communities and the general environment”. 2.3 Workplace safety and health issues in Ghana Industrialization in Ghana is gradually on the ascendency and this development is exposing an enormous proportion of the workforce to diverse health and safety hazards at the workplace. (Melorose et al., 2015). According to reports by the International Labour Organization (ILO), 160 million workers are affected with occupational diseases, over 270 million are subjected to damages and pains as a result of occupational injuries and about 2 million workers perish prematurely every year from work- related illnesses such as skin infections, respiratory diseases, noise induced 18 University of Ghana http://ugspace.ug.edu.gh hearing loss (NIHL), cancers, poisoning, silicosis and musculoskeletal injuries (Awan, 2007). In the year 2000, the Labour Department of Ghana recorded figures of 8,692 occupational injuries in its annual report, while the 1999 record stood at 4,088. This is a representation of figures which were recorded only for reported injuries which occurred in the formal sector (Melorose et al., 2015). The primary concerns of the International Labour Organization (ILO) suggests that workers must be protected against diseases and injuries resulting from employment and it is a basic part of social justice. Occupational health and safety is a human right (WHO, 2010). There are many essential OHS issues which continues to thrive in Ghana’s economy. One of the paramount challenges of occupational health and safety practice is that, the nation (Ghana) does not have an exhaustive national OHS policy. (Puplampu et al., 2012). Nonetheless there are fragments of legal requirements under jurisdictions of different agencies in Ghana. (Annan et al., 2015) that take care of issues related to occupational health and safety. Most employees are incessantly exposed to hazards at the workplace. This is one key occupational health and safety issue which researchers have reported (Puplampu et al., 2012). Hazards refer to “those features, either physical or psychosocial or a combination of both, at the workplace that have the potential to lead to harm or unwanted consequences. It is an inherent property of a substance, agent, source of energy or situation having the potential of causing considerable consequences for example, chemicals, slippery floor, working while standing, and working while standing on a ladder” (Ghana Ministry of Health-MOH, 2010). When work is associated with health hazards, it may cause occupational disease, damages or at worst death. The Kumasi Central Market which is Ghana’s biggest market was caught up in a fire outbreak, destroying and estimate of more than 400 markets stalls, a significant amount of goods and cash (Ghana News Agency, 2009). In the year 2000, the construction industry recorded 902 accident 19 University of Ghana http://ugspace.ug.edu.gh cases, of which 56 were fatal accidents and 846 were nonfatal accidents. As reported by the National Disaster Management Organization, a staggering figure of about 11,000 Ghanaian workers were affected by fire and explosion and the cost of damage was estimated to be approximately 7 million dollars (Annan, Addai, & Tulashie, 2015). 2.4 Training and supervision to the workers on matters of occupational health and safety According to Boella, 1992, the rate of industrialization is increasing rapidly worldwide. It has therefore become necessary for both employers and employees to improve the level of their skills to adjust to the changing demands of the manufacturing industry. Undoubtedly, any training and education acquired at the start of ones working life, will become redundant or obsolete during the same working lifetime and hence the need to obtain new skills or improve on knowledge and attitude of the worker (Mourtzis & Chryssolouris, 2013). The Man Power Service Commission defines training as “a planned process to modify attitude, knowledge or skill behavior through learning experience to achieve effective performance in an activity or range of activities”.(Mourtzis & Chryssolouris, 2013) The approaches to health and safety training varies from information-based, computer-based to hands-on demonstrations. One method which is employed in health and safety training is lectures; which is normally used to present health and safety related information. The use of videos, pamphlets and other documented materials are also frequently used (Burke et al., 2006). Schemes for hazard control and prevention are generally to ensure that every worker is assured of a nontoxic and advantageous working environment. The Occupational Safety and Health Administration (OSHA) has propounded more than a hundred occupational health and safety standards necessary for protecting the worker in the work environment (Newman, 1998). 20 University of Ghana http://ugspace.ug.edu.gh Some practices used to reduce work behaviours that expose workers to occupational accidents and injuries include the introduction of sterner regulations which are implemented by supervisors, appropriate punishments meted out for non-conformance to workplace policies and procedures, and intensification of daily supervision at the workplace (Pettinger, n,d). According to the handbook on occupational health and safety by the Government of Alberta (2011), three control measures are considered to tackle workplace hazards that cannot be eliminated. These are engineering, administrative (enforcement of policies), and the use of appropriate PPEs Engineering Controls: It involves maintenance of the facilities and work machines which contribute to reducing hazard. (Melorose et al., 2015). Administrative Controls: Administrative controls emphasizes on ensuring that the suitable steps are taken to prevent hazards such as documentation of policies and procedures that create level of expectations in worker performances, codes of practice, occupational health and safety programs, required orientation and training and work schedules (Melorose et al., 2015). 2.5 Use of personal protective equipment (PPEs) in food industries The food industry is a broad spectrum which includes a compound of activities pertaining to the production, supply, and consumption of food products and services worldwide. There are several numbers of both the skilled and unskilled labour which are employed in the food industry. Consequentially, the food industry records high incidences and accident rates (Chinda, 2014). The least but effective measure to prevent work place accidents, injuries and illnesses on the hierarchy of control is the use of Personal Protective Equipment. 21 University of Ghana http://ugspace.ug.edu.gh Personal protective equipment, or “PPE" as is popularly known, is any protective kit which is worn by the worker or held to reduce exposure to hazards that may cause injuries and illnesses at the workplace (Osha.gov, 2016). According to numerous studies done on health and safety, about 90% of all occupational injuries can be prevented by adopting safety measures which includes use of personal protective equipment. Further studies have also shown that, noncompliance with the use of appropriate PPE was a major contribution to workers’ exposure to workplace hazards that could cause injuries and illnesses (Wanjiku, 2017). In selecting PPEs, knowledge of the hazard and its associated health effect when a worker is exposed should be taken into consideration. PPE must fit correctly and adjusted for the workers’ comfort (Lombardi, Verma, Brennan, & Perry, 2009). While the use of personal protective equipment has been recognized as a significant hazard control measure in work environments where other strategies may be impossible to implement, there is a great concern about how the use of PPEs remains low in food industries (Lombardi et al., 2009). It is therefore important to identify factors that influence a workers’ use of personal protective equipment. 2.5.1 Factors influencing the use of PPEs in food industries Factors that influence a worker’s choice on the use of PPE are diverse and complex. Circumstances leading to nonuse of PPEs differ from one work environment to another (Graveling et al., 2009). According to various theories in health behavior research, knowledge is a key component of motivation to engage in health enhancing behavior and/or avoiding unhealthy behavior. When workers are made aware of the hazards and their effects on health and work output, they are more inclined to use PPE to protect themselves from exposure to the hazards. Conversely if workers are provided with PPE but are not told why or how to use PPE, it is likely that such PPE will not be 22 University of Ghana http://ugspace.ug.edu.gh utilized (Wanjiku, 2017). It is therefore necessary to educate and train workers on how to use PPE and thereby giving workers adequate knowledge and increasing compliance with PPE use. Knowledge on why the equipment is needed should cover when it is to be used, repaired or replaced and its limitations. Training should include elements of theory as well as practice in using the equipment, and should be carried out in accordance with any recommendations and instructions supplied by the PPE manufacturer (NFU Mutual Risk Management Service, 2017). 2.6 Knowledge and awareness of occupational health and safety among industrial workers Awareness of safety and health is generally increasing and thus, it has become a vital component in every workplace. The labour union, employers and other stakeholders engage in trainings and activities to make sure that workers comply with safety standards so as to preserve a productive and healthy work-force. However, severe injuries and illnesses are still a challenge for industries in developing countries. (Adebola, 2014). Every worker has a fundamental right to work in an environment that is safe and healthy. Irrespective of this, the International Labour Organisation has reported that there are more than 160 million workers who report ill owing to hazard exposure at the workplace, whereas more than a million workers have perished due to accidents and diseases at the workplace. The prevalence of occupational accidents and diseases differ hugely among countries, especially among developing and developed countries (Lugah et al., 2010). In developing countries, employers and stakeholders turn a blind eye on the relevance of occupational health and safety practices at the workplace. This is as a result of low level of knowledge on occupational health and safety matters in Africa. In Sub-Saharan Africa, issues of HIV/ AIDS, malaria, child mortality and water quality which are of public health concern have eclipsed occupational health problems (“Occupational Risks and Hazards Exposure , Knowledge 23 University of Ghana http://ugspace.ug.edu.gh of Occupational Health and Safety Practice and Safety Measures among Workers of Sheba Leather Plc , Wukro ,” 2016). When workers do not have the appropriate knowledge, attitude and approach towards safety measures, efforts to make the work environment free from accidents and injuries become futile. Research works conducted in industrial countries shows that the causes of about 90% of workplace accidents is due to human errors, while 10% of the accidents is as a result of unsuitable workplace and equipment (Sanaei Nasab, Ghofranipour, Kazemnejad, Khavanin, & Tavakoli, 2009). 2.6.1 Knowledge and awareness of occupational health and safety among industrial workers in Ghana Ghana, like many Sub- Saharan countries have low knowledge of occupational health and safety which can be attributed to low levels of education generally. A 2008 report of the Ghana Living Standards Survey Five (GLSS5) on educational fulfilment indicated that about 31% of Ghanaians who are 15 years old and above had no formal education. About 55.7% of Ghanaians had elementary education and 13.6% had secondary level of education or higher. In summary, 86.7% of the Ghanaians do not have educational levels below secondary education or higher (Nana-otoo, 2016). This explains why the level of knowledge of occupational health and safety is low. Policy procedures are considered one of the challenging issues in Africa in that policies do not work. According to Clark (2005), majority of Ghana’s legal provisions on OHS is narrow in that many work sectors are vaguely covered. Nevertheless, there are few laws that inform the implementation of occupational health and safety. These regulations include but not exclusive to Factories, Offices and Shops Act 1970, Act 328 and the Mining Regulations 1970 LI 665 which have facilitated the implementation of OHS in the manufacturing, shipping and mining sectors. Other acts related to 24 University of Ghana http://ugspace.ug.edu.gh OHS are the Environmental Protection Agency Act 490, 1994, Workmen‘s Compensation Law 1987, and the Ghana Health Service and Teaching Hospitals Act 526, 1999 but these legal frameworks need modification to meet international standards (Puplampu et al., 2012). A study conducted by Dwumfour- Asare et al., 2013 informs that, on the average, there are about 60% of industrial workers who do not have knowledge of any existing laws or regulations on workplace safety and health. Although a significant proportion of workers have no idea about laws on OHS, the magnitude of students who were also unaware of OHS regulations and will soon be added into the job market is devastating. The law on OHS which was commonly known by the 40% of respondents who claimed to have knowledge of laws on OHS, was the Labour Act (Dwumfour-Asare & Asiedu, 2013). These findings show evidence that there is low level of knowledge and awareness of OHS among industrial workers in Ghana. 2.7 Impact of OHS on worker productivity in industries The objective of most industries is to reach maximum productivity from their workforce and equipment (Katsuro, Gadzirayi, Taruwona, & Mupararano, 2010). Productivity is “an expression of how efficiently and effectively goods and services (i.e. goods and services which are demanded by users) are produced. Thus, its key characteristics are that it is expressed in physical or economic units - in quantities or values (money) - based on measurements which are made at different levels: on the level of the economy overall, that of a sector or branch of the economy, that of the enterprise and its individual plants/units and that of individuals” (EANPC, 2005). According to the World Health Organization (WHO) poor occupational health and reduced working capacity of workers may cause economic loss up to 10-20% of the Gross National Product of a country (Aditya et al., 2016). It is also estimated that about 270 million workers suffer from 25 University of Ghana http://ugspace.ug.edu.gh occupational accidents and 160 million occupational diseases each year (ILO, 2005). This is perhaps just the tip of the iceberg, as data for estimating nonfatal illness and injury are not available in most developing countries. Occupational injuries alone account for more than 10 million Disability-Adjusted Life Years (DALYs) lost, or healthy years of life lost whether to disability or premature death, and 8% of unintentional injuries worldwide (DCPP, 2007). Universally, there is an increase in cost of occupational health and safety diseases. Global financial losses owing to workstation injuries and illnesses go beyond $1,250 billion (ILO, 2003). According to (Takala, 2002) global occupational deaths, diseases, and illnesses cost an estimated loss of 4% of the Gross Domestic Product. Domestic statistics which have been reported in Ghana reveals that occupational health and safety related accidents, diseases and hazards accounts for about 7% of her GDP (Adei & Kunfaa, 2004). With more efforts made, incidents of workplace accidents, diseases and hazards, which are very preventable can be minimized significantly. It can be said that productivity in Ghana is not being optimized. Therefore making occupational health and safety issues a priority in Ghana is necessary to promote sustainability in the economy (Amponsah-Tawiah, 2013). 26 University of Ghana http://ugspace.ug.edu.gh CHAPTER THREE 3.0. METHODS 3.1 Study design This study was cross-sectional in design and employed quantitative techniques to address questions on specific objectives. 3.2 Study area The study was conducted in two (2) selected food processing industries, namely Promasidor Ghana and Fan Milk Limited- Ghana, both situated at Kaneshie in the North Industrial Area, within the Okaikoi South Municipality of Ghana. North Industrial Area is located approximately 4.3 Km/2.7mi away from the capital of Ghana, Accra. Promasidor Ghana is a food and beverage producing company. It commenced operations in Ghana in 1999. Cowbell, a fat- filled milk powder, is the leading brand of products produced by this company. The company has grown to include a number of extensions to its line of products, namely; Cowbell Coffee, Choco-Malt, Sweet Milk, Coconut, Strawberry, Mocha and Miksi. It is located on the 43 Dadeban Road, North Industrial Area 27 University of Ghana http://ugspace.ug.edu.gh Figure 3.1: Map Showing Location of Promasidor Ghana (Downloaded from “(www.promasidor.com.gh)” on 25th February, 2018) The other industry surveyed was Fan Milk Limited. It was founded by Erik Emborg, who was a Dutch entrepreneur, in 1960. The company has a mission to produce high quality products for consumers. Fan Milk Limited has a range of products in different brands and sizes. These include FanYogo and Fan Maxx which are yoghurts, FanIce which is vanilla ice cream and FanChoco which is a blend of milk and cocoa powder. It is located on the No. 1 Dadeban Road in North Industrial Area. 28 University of Ghana http://ugspace.ug.edu.gh Figure 3.2: Map Showing Location of Fan Milk Limited (Downloaded from “(www.fanmilk-gh.com)” on 25th February, 2018) 29 University of Ghana http://ugspace.ug.edu.gh 3.3. VARIABLES 3.3.1 Outcome variables Compliance with Occupational Health and safety standards by staff of selected industries. 3.3.2 Independent variables The independent factors that influence compliance with occupational health and safety standards among industrial workers include demographic characteristics (age, educational status, professional category, income level, educational level of workers), workers’ knowledge (work experience, knowledge of OHS standards), organizational factors (availability of training schedule on occupational health hazards and safety, availability of occupational health hazards and safety policy), attitude of workers and safety measures for preventing occupational injuries and illnesses. 3.4 Study population The study population comprises workers from two food processing industries. 3.4.1 Inclusion criteria Workers at the manufacturing and production units of the selected companies 3.5 Sample size determination A minimum sample size of 384 was obtained using the Cochran's formula 𝑍 2𝛼/2 𝑃 (1−𝑃) n = 2 𝑑 Where 𝑍𝛼/2 = 1.96 30 University of Ghana http://ugspace.ug.edu.gh P= 50% d=5% With 10% non-response rate of 38, making a total sample size of 422 3.5.1 Sampling method Every week, an average of 150 industrial workers was sampled. A total of 3-4 weeks was used to get the sample size of exposed workers within the inclusion criteria. A skip interval was determined by dividing the sampling frame by the sample size which was used to systematically select the participants. Where a participant did not give consent, the next available person was selected. This technique was used to select 408 participants over four weeks to constitute the desired sample size. 3.6 Data collection technique/ methods and tools A face-to-face interview with participants using a structured questionnaire was employed to collect data. Demographic information such as age, sex, educational level and income level was also taken. Data were also collected on prevalence of occupational injuries, awareness of health and safety standards at the work place and the level of compliance with the standards. 3.7 Quality control Quality assurance procedures and precautions were taken to ensure the reliability and validity of the data. Research assistants with public health background were recruited and given adequate training. The training included; the purpose and objectives of the study, data collection techniques and tools used, data collection and ethical guidelines. The principal investigator was part of the team during the interviews to ensure that relevant information in line with the objectives of the study was collected. The questionnaire was checked for mistakes and completeness before final 31 University of Ghana http://ugspace.ug.edu.gh entry into appropriate software for statistical analysis. Errors and omissions detected were discussed with the respective assistants and corrected. The reliability of the questionnaire was tested using Cronbach’s alpha and a value more than 0.7 was accepted as good. 3.8 Data processing and analysis Raw data collected were cleaned and entered into Microsoft excel spreadsheet in windows 10 and imported to STATA software version 15 for statistical analysis. Descriptive statistics such as cross- tabulations, tables, frequency and percentages were used to describe demographic characteristics of the study population. Chi-square was used to determine association between demographic characteristics and factors that influence compliance with occupational health and safety standards. Bivariate analysis using the chi-Square was conducted to examine other factors that significantly influence workers’ compliance with health and safety standards and factors found to be significantly associated at the bivariate level were subsequently entered into multivariate logistic regression to establish the factors that are strongly associated. Adjusted and crude Odds Ratio (OR) were determined for each of the independent variables and statistical significance was determined at a 5 % probability level (p≤0.05). 3.9 Ethical considerations/ issues Ethical clearance was obtained from the Ghana Health Service Ethnical Review Committe. Permission was also sought from the management of Promasidor and Fan Milk Gh Ltd and informed consent was also sought from each participant before the study was carried out. 32 University of Ghana http://ugspace.ug.edu.gh 3.9.1 Access and approval of study area The principal investigator visited the study area personally to notify the management of the selected food processing industries about the intention to conduct the study. In addition, permission was obtained before commencement of the study. 3.9.2 Privacy and confidentiality To ensure privacy and confidentiality, the questionnaire was coded and names of respondents were not required in filling out the questionnaire. The interview was conducted in an isolated area with individual respondents so as to guarantee their privacy. Participants’ names were also not mentioned in the report of the study and information gathered on participants were kept strictly confidential between the principal investigator and the study participants. 3.9.3 Compensation The study participants were not offered any compensation for participating in the study. This was made known to them before they chose to take part in the study. However, participants were given refreshment or snacks after answering the questionnaires. 3.9.4 Risks and Benefits Apart from the time that was lost by study subjects in answering the questionnaires and personal questions that participants were a bit uncomfortable in answering, there was no risk or cost associated in participating in the study. Participants did not gain any direct benefits. However, the results of the study would contribute to knowledge of safety standards at the work-place to decrease the rate of occupational accidents and diseases. This is beneficial to both the study participants and staff of industries in Ghana as a whole. 33 University of Ghana http://ugspace.ug.edu.gh 3.9.5 Voluntary withdrawal Participation in the study was entirely voluntary and participants could chose not to answer any individual question or all the questions. Participants were also at liberty to withdraw from the study at any point in time. However, they were admonished and encouraged to fully participate to ensure that findings from the study were a true reflection of the factors being investigated in the study area. In the event of withdrawal by any participant, all data gathered on the individual were deleted and destroyed. 3.9.6 Informed Consent and Consenting process Informed consent was obtained from participants before commencement of the study. Respondents in the study were approached individually to explain the objectives of the study to them and their consent sought. The decision to take part in the study was absolutely voluntary and refusal to take part did not affect the relationship between the participant(s) and the principal investigator or his assistant. In addition, respondents were made to sign a written consent form after a detailed explanation to them before they participated in the study. 3.9.7 Data storage and usage Data collected in this study were strictly for research purposes. They were stored with passwords on electronic media and in safely locked boxes. Anonymity was ensured in dissemination of findings from this study since participants were not identified by their names. 3.9.8 Declaration of conflict of interest The researcher as the principal investigator hereby affirms that there is no conflict of interest in this study. 34 University of Ghana http://ugspace.ug.edu.gh 3.9.9 Funding of the study There was no funding from any external source and all estimated costs of the study was borne solely by the principal investigator. 35 University of Ghana http://ugspace.ug.edu.gh CHAPTER FOUR RESULTS 4.0 Introduction This chapter presents the results of the study where figures and tables are used to illustrate the findings. It shows the socio- demographic data of the respondents, the level of compliance with health and safety standards, the level of awareness and the prevalence of injuries to the respondents. This chapter also presents the associations that exist between the dependent and independent variables. 4.1 Socio- demographic characteristics of workers in the selected food processing industries. Table 4.1 shows the socio- demographic characteristics of workers in the selected food processing industries. In all, 422 questionnaires were distributed but only 408 of the participants responded from both Fan Milk Ltd, GH and Promasidor GH Ltd. This represented a response rate of 96.7% (408/422). The age range of the respondents was between 18-57 years. Majority of the respondents were aged between 28-37years which represents 49.26% (201/408), followed by those within the age range of 38-47years who comprised 30.88% (126/408) of the respondents. Respondents aged between 48-57years represented the minority age group with 0.98% (4/408). The males accounted for a greater percentage of the respondents 83.09% (339/408) Table 4.1 also shows that majority of the respondents reside in urban areas, representing 99.51% (406/408) and only 0.49% (2/408) reside in peri-urban areas. 36 University of Ghana http://ugspace.ug.edu.gh Furthermore, 55.88% (228/408) of the respondents were single, 42.65% (174/408) married and 1.47% (6/408) were separated. The study sites were dominated by Christians which accounted for 67.16% (274/408) of the participants and 32.84 (134/408) are Muslims. The income level of the participants ranged from less than a 1000 Ghana cedis to an amount greater than 2000 Ghana cedis. The majority of the respondents 48.53% (198/408) earned monthly salaries between 1000 to 1500 Ghana cedis. This was followed closely by 32.60% (133/408) who receive salaries between 1600 to 2000 Ghana cedis, 16.18% (66/408) receive salaries greater than 2000 Ghana cedis and only 2.70% (11/408) earn less than 1000 Ghana cedis. Finally, the results on the educational level of the respondents showed that the least percentage 0.49% (2/408) had a Junior Secondary School certificate, followed by 12.01% (49/408) who had a Senior Secondary School certificate. Finally, majority of the participants 87.50% (357/408) had obtained Tertiary level of education as at the time of data collection. 37 University of Ghana http://ugspace.ug.edu.gh Table 4.1: Socio-demographic characteristics of workers in the selected food processing industries. Variable F r e q u e n c y ( n = 4 0 8 ) P e r c e n t a g e ( % ) Age group 18-27 years 7 7 18.87 28-37 years 201 49.26 38-47 years 126 30.88 48-57 years 4 0.98 Sex Female 69 16.91 Male 339 83.09 Residence Urban 406 99.51 Peri-urban 2 0.49 Marital Status Single 228 55.88 Married 174 42.65 Separated 6 1.47 Religion Christian 274 67.16 Muslim 134 32.84 Monthly Salary in cedis <1000 11 2.70 1000-1500 198 48.53 1600-2000 133 32.60 >2000 66 16.18 Educational Level Junior High School 49 12.01 Senior High School 357 87.50 Tertiary 77 18.87 38 University of Ghana http://ugspace.ug.edu.gh 4.2 Work- related characteristics and occupational safety practices of respondents. Table 4.2 below summarizes the data on work- related characteristics and occupational safety practices among the study participants. As shown, majority of the participants 31.37% (128/408) were involved with heavy machinery, followed by those who work at the production unit representing 27.45% (112/408). About 82.84% (338/408) do not have a shift system and work within 7-9 hours each working day. 17.16% (70/408) of the respondents are on a shift schedule and work within 4-6 hours each working day. The results also show that 99.51% (406/408) of the respondents use Personal Protective Equipment (PPE) appropriate for their work duties. 95.59% (390/406) of the respondents indicated that they use the PPEs always and 4.41% (16/406) responded that they use PPEs sometimes. About 92.65% (378/408) of the participants responded they had not experienced any work related injuries. 7.35% (30) said they had suffered from work related injuries with 5.88% (24/30) getting injured by their working tools. The other injuries occurred through falls, getting burnt by hot substances or chemicals and collision, representing 0.49% (2/30) each. The table also represents how the workers of the selected industries pay their medical bills. In relation to medical bills, majority of the participants, 65.20% (266/408) said their medical bills were paid by their institutions while 21.08% (86/408) paid by means of the National Health Insurance. The workers’ satisfaction as described in the table reveals that 93.14% (380/408) were satisfied with the health and safety assurance existing at their place of work while 6.86% (28/408) are not satisfied with the health and safety at their place of work. 39 University of Ghana http://ugspace.ug.edu.gh Table 4.2: Work-related characteristics and occupational safety practices of respondents. Variable Frequency (n=408) Percentage (%) Work duties Packaging 43 10.54 Heavy Machinery 128 31.37 Mechanical 76 18.63 Laboratory 49 12.01 Production 112 27.45 Work Hours 4-6 hours 70 17.16* 7-9 338 82.84 Use of PPE at work Yes 406 99.51 No 2 0.49 How often PPEs are used (n=406) Always 390 96.06 Sometimes 16 3.94 Sources of injury No injury 378 92.65 Injured by work tool 24 5.88 Falls 2 0.49 Hot substances or chemicals 2 0.49 Collision 2 0.49 Medical Bills National Health Insurance 86 21.08 Private Health Insurance 2 0.49 Self 36 8.82 Family 18 4.41 Satisfied with OHS Policy Yes 380 93.14 No 28 6.86 Note: *= Respondents who run a shift system 40 University of Ghana http://ugspace.ug.edu.gh 4.3 Prevalence of occupational injuries Table 4.3 and Fig 4.1 below, summarizes the prevalence of occupational injuries among the participants. As shown, in all, about 7.35% (30/408) of workers reported at least one work-related injury. Among the 30 who had suffered from a work- related injuries, 93.33% (28/30) were injured once, and only 6.67% (2/30) had been injured twice or more. The frequently occurring injury among the respondents was cut/puncture, representing 80% (24/30). Next being dislocation, representing 13.33 % (4/30) and burns being the least occurring injury 6.67 % (2/30). Majority of those who had an injury, reported that they got injured by their work tools 80% (24/30) while falls, burns by hot substances or chemicals and collisions represented 6.67% (2/30) each of injuries that had occurred. Furthermore, the causes of injuries among those who had been injured were non provision of appropriate PPEs, and represented 66.67% (20/30), lack of adequate supervision was 20% (6/30) and the least being ignorance on OHS standards 13.33% (4/30). In addition, the results (Table 4.3) show that, 66.67% (20/30) of the participants who had an injury reported to management, and 33.33% (10/30) did not report to management. Among those who reported the injuries to management, 10% (2/20) responded that they were invited before a committee which probed into what caused the injuries. 90% (18/20) said that nothing was done. The types of Occupational injury, which were sustained and reported by the participants were cuts/puncture (80%), dislocation (13.33%) and burns (6.67%) as shown in (Figure 4.1). 41 University of Ghana http://ugspace.ug.edu.gh Table 4.3: Prevalence of occupational injuries among the study participants. Variable Frequency (N) Percentage (%) Occupational Injury Yes 30 7.35 No 378 92.65 Frequency of Occupational injury (n=30) Number of times injury Once 28 93.33 Two or more times 2 6.67 Type of Injury (n=30) Cut or Puncture 24 80.00 Dislocation 4 13.33 Burns 2 6.67 Source of Injury (n=30) Injured by work tool 24 80.00 Falls 2 6.67 Hot substance/ Chemical 2 6.67 Collision 2 6.67 Cause of Injury (n=30) Non provision of appropriate PPE 20 66.67 Ignorance on OHS Standards 4 13.33 Lack of supervision 6 20.00 Injuries Reported (n=30) Yes 20 66.67 No 10 33.33 Actions Taken After Reporting (n=20) Investigations were done and I was invited 2 10.00 Nothing was done 18 90.00 42 University of Ghana http://ugspace.ug.edu.gh 90 80 80 70 60 50 40 30 24 20 13.33 10 6.674 2 0 Cut/Puncture Dislocation burns Common Types of Injuries Frequency Percentage (%) Figure 4.1: Types of occupational injuries among study participants. 43 % Percentage University of Ghana http://ugspace.ug.edu.gh 4.4 Distribution of occupational injuries among workers of the selected food industries Table 4.4 below, shows the prevalence of occupational injuries in relation to socio- demographic characteristics of participants. As shown, there was a significant association between occupational injuries and sex (χ² = 6.5908, p < 0.01). There was also a significant association between age (χ² = 71.6729, p < 0.01), marital status (χ² = 7.7409, p < 0.05) and work duty (χ² = 16.6790, p < 0.01) while educational level of participants was not significantly associated with occupational injury. Table 4.4: Prevalence of occupational injuries in relation to socio- demographic characteristics of respondents O c c u p a t i o nal Injures Variable No (n=378) Y es(n=30) χ² p - v a l u e Sex Male 309 30 6.5908 0.010* Female 69 0 Age group 18-27 years 54 23 71.6729 0.000** 28-37 years 199 2 38-47 years 121 5 48-57 years 4 0 Marital Status Single 204 24 7.7409 0.021* Married 168 6 Separated 6 0 Educational Level Junior High School 2 0 0.2085 0.901 Senior High School 45 4 Tertiary 331 26 Work Duty Packaging 42 1 16.6790 0.002** Heavy Machinery 119 18 Mechanical 69 7 Laboratory 49 0 Notes. *—significant, p < 0.05 **—significant, p < 0.01, N =408 44 University of Ghana http://ugspace.ug.edu.gh 4.5 Prevalence of occupational injuries in relation to occupational safety practices among participants As shown (Table 4.5), there were significant associations between occupational injuries and work hours (p<0.05), use of PPEs (p<0.01), the training programs attended by the respondents (p<0.01) and how satisfied the respondents were concerning OHS standards (p<0.01). However, how often the respondents use PPE was not significantly associated with occupational injuries (Table 4.5) Table 4.5: Prevalence of occupational injuries by working and behavioral factors among workers of the selected food industries. O c c u p a t i o n al Injures Variable No (n=378) Y e s(n=30) χ² p - v a l u e Work Hours 4-6 hours 70 0 6.7061 0.010* 7-9 hours 308 30 Use of PPE Yes 378 28 25.3421 0.000** No 0 2 Frequency of PPE use Always 360 30 1.4945 0.222 Sometimes 18 0 Medical Bills National health insurance 86 0 239.7943 0.000** Private health insurance 2 0 Self 36 0 Family 0 18 The Institution 254 12 Satisfaction with HS Yes 368 12 143.0430 0.000** No 10 18 Training Programs Organized Quarterly 58 18 39.0230 0.000** Biannually 75 0 Notes. *—significant, p < 0.05 **—significant, p < 0.01, N =408 45 University of Ghana http://ugspace.ug.edu.gh 4.6 Level of awareness among study participants Table 4.6 summerizes the data on the level of awareness of occupational safety standard measures among study participants. As shown, 99.02% (404/408) of the respondents were aware of the safety labels around their work departments, 99.51% (406/408) understood health and safety, while 81.13% (331/408) had exposed wires in their work space. In addition, 86.27% (352/408) of the respondents were trained to use fire extinguishers while 13.73% (56/408) have had no training on how to use fire extinguishers. Table 4.6: Level of awareness among workers of the selected food industries. Awareness (n=408) Variable Yes No N (%) N (%) Safety Labels 404(99.02) 4(0.98) Understanding Health and Safety 406(99.51) 2(0.49) Exposed Cables 331(81.13) 77(18.87) Trained to use fire extinguisher 352(86.27) 56(13.73) 4.7 Univariate Analysis of the socio- demographic characteristics of workers’ compliance with health and safety standards. Table 4.7 below summarizes data on univariate analysis of the socio- demographic characteristics of workers’ compliance with occupational health and safety standards. As shown, sex of the workers was significantly associated with compliance with health and safety standards with (p<0.01). The odds of a male complying with health and safety standards was 3.10 (CI= 1.95, 4.93) 46 University of Ghana http://ugspace.ug.edu.gh times more than a female. There was also significant association between the workers’ religion where there was a 0.37 (CI= 0.26, 0.54) reduced odds of a Muslim complying with health and safety standards than a Christian and income level (p<0.01) (Table 4.7). 47 University of Ghana http://ugspace.ug.edu.gh Table 4.7: Univariate Analysis of the workers’ socio- demographic characteristics and compliance with health and safety standards. Compliance Variable Odds Ratio 95% Conf. Interval p-value Sex Female Ref Male 3.1 1.95 – 4.93 0.000** Residence Urban Ref 0.814 Peri-Urban 1.27 0.17 – 9.34 Marital Status Single Ref Married 1.04 0.73 – 1.48 0.818 Separated 0.53 0.16 – 0.78 0.308 Religion Christian Ref Muslim 0.37 0.26 – 0.54 0.008** Income Level <1000 Ref 1000-1500 6.98 2.49 – 19.52 0.000** 1600-2000 12.01 4.21 – 34.28 0.000** >2000 24.78 8.24 – 74.56 0.000** Educational Level Junior High school Ref Senior High School 0.39 0.05 – 3.03 0.368 Tertiary 12.61 0.18 – 6.36 0.886 Notes. *—significant, p < 0.05 **—significant, p < 0.01, N =408, (Ref) = Reference 48 University of Ghana http://ugspace.ug.edu.gh 4.8 Multiple Logistic Regression Analysis of the socio- demographic characteristics of workers’ compliance with health and safety standards According to the results (Table 4.8) the odds of a male worker in the food industry complying with health and safety standards is 2.81 (CI= 1.75, 4.93) times more likely than a female (p<0.01). Religion was also significantly associated with compliance (p<0.01) with Muslims having a reduced odds of compliance 0.57 (CI= 0.38, 0.86) compared to a Christian. Workers who receive monthly income between 1000-1500 Ghana cedis are 6.10 (CI= 2.14, 17.36) times more likely to comply with health and safety standards than workers who receive monthly income of less than 1000 Ghana cedis. Additionally, workers who receive monthly income ranging from 1600-2000 and above 2000 Ghana cedis are 11.88 (CI= 4.08, 34.48) and 18.05 (CI= 5.87, 55.50) more likely to comply with health and safety standards compared to workers who receive monthly income less than a 1000 Ghana cedis respectively. Table 4.8: Multiple Logistic Regression Analysis of the socio- demographic characteristics of workers’ compliance with health and safety standards Compliance Variable COR 95% CI AOR 95% CI p-value Sex Female Ref Male 3.10 1.95 – 4.93 2.81 1.75 – 4.62 0.000** Religion Christian Ref Muslim 0.37 0.26 – 0.54 0.57 0.38 – 0.86 0.008** Income Level <1000 Ref 1000-1500 6.98 2.49 – 19.52 6.10 2.14 – 17.36 0.000** 1600-2000 12.01 4.21 – 34.28 11.88 4.08 – 34.48 0.000** >2000 24.78 8.24 – 74.56 18.05 5.87 - 55.50 0.000** Notes. *—significant, p < 0.05 **—significant, p < 0.01, N =408, (Ref) = Reference 49 University of Ghana http://ugspace.ug.edu.gh 4.9 Univariate Analysis of the relationship between work- related characteristics and compliance with occupational health and safety standard practices among participants According to the results (Table 4.9), there was a significant association between compliance with health and safety standards and the work category (p<0.01). There is a 6.59 (CI: 3.47-12.54) increased odds of a heavy machinery worker complying with health and safety standards compared to a worker at packaging. There is also a 5.64 increased odds of a mechanical worker complying with safety standards as compared to a worker in packaging (CI: 2.79-11.11). Also there is a 0.38 (0.18-2.96) reduced odds of a laboratory worker complying with health and safety among compared to a worker in packaging. Additionally, the shift system type of work schedule was significantly associated with compliance with health and safety with a p<0.05 (CI: 0.87-2.14). Workers with no shift system have a 0.37 times reduced odds of compliance with health and safety than workers on a shift system. The use of PPEs was also significantly associated with compliance (p<0.01, CI: 0.02-0.11). Workers who do not always use PPE have a reduced odds of 0.04 to comply with health and safety than workers who always use PPE. Satisfaction with health and safety among participants was significantly associated with compliance (p<0.01, CI: 2.59-9.83). Workers who are not satisfied with HS at the workplace have a reduced odds of 0.05 to comply than workers who are satisfied. 50 University of Ghana http://ugspace.ug.edu.gh Table 4.9: Univariate Analysis of the relationship between work- related characteristics and compliance with occupational health and safety standard practices among participants Compliance Variable Odds Ratio 95% Conf. Interval p-value Work Duty Packaging Ref Heavy Machinery 6.59 3.47 – 12.54 0.000** Mechanical 5.64 2.79 – 11.37 0.000** Laboratory Production 0.38 0.18 – 0.79 0.000** Work Hours (Hours) 1.57 0.84 – 2.96 0.158 4-6 hours Ref 7-9 hours 0.37 0.87 – 2.14 0.056 Frequency of PPE use Always Ref Sometimes 0.04 0.02 – 0.11 0.000** Working experience (Years) <1 Ref 2-3 0.38 0.21 – 0.70 0.002** 4-5 0.85 0.46 – 1.56 0.591 6-7 1.41 0.63 – 3.14 0.402 >7 0.57 0.23 – 1.46 0.235 Satisfaction with HS Yes Ref No 0.05 2.59 – 9.83 0.000** Notes. *—significant, p < 0.05 **—significant, p < 0.01, N =408, (Ref) = Reference 4.10 Multiple Logistic Regression Analysis of the relationship between work- related characteristics and compliance with occupational health and safety standard practices among participants The odds of a worker at the heavy machinery is 5.27 times (CI: 2.78-10.02) likely to comply with health and safety standards than workers at packaging. There is also a 5.11 odds of complying with safety standards among mechanical workers than packaging (CI: 2.52-10.35) and a reduced odds 51 University of Ghana http://ugspace.ug.edu.gh of 0.32 (0.15-0.67) of complying with health and safety among laboratory workers than those at packaging department. The use of PPEs was also significantly associated with compliance with occupational health and safety standard practices (p<0.01, CI: 0.01-0.2.61). Workers who do not always use PPE have a reduced odds of 0.04 to comply with health and safety standard practices than workers who always use PPE. Satisfaction with health and safety at the workplaces was significantly associated with compliance (p<0.01, CI: 1.45-5.56). Workers who were not satisfied with HS at the workplace have a reduced odds of 0.05 to comply than workers who are satisfied. Table 4.10: Multiple Logistic Regression Analysis of the relationship between work- related characteristics and compliance with occupational health and safety standard practices among participants. Crude Odds with 95% Adjusted odds with 95% Compliance CI CI p-value Work Duty Packaging (R) Heavy Machinery 6.59(3.47,12.54) 5.27(2.78,10.02) 0.000** Mechanical 5.64(2.79,11.37) 5.11(2.52,10.35) 0.000** Laboratory 0.38(0.18,0.79) 0.32(0.15,0.67) 0.003** Production 1.57(0.84,2.96) 1.39(0.74,2.61) 0.305 How often PPE is used Always (R) Sometimes 0.04(0.02,0.11) 0.04(0.01,2.61) 0.000** Satisfaction with HS policy Yes (R) No 0.05(2.59,9.83) 2.84(1.45,5.56) 0.002** Notes. *—significant, p < 0.05 **—significant, p < 0.01, N =408, (R) = Reference 52 University of Ghana http://ugspace.ug.edu.gh CHAPTER FIVE DISCUSSION 5.0 Introduction Various studies have reported that there is significant association between increased accident rates and noncompliance with safety precautionary measures. To help resolve this problem therefore, the study was carried out to evaluate the occupational health and safety standards compliance among workers of selected food processing industries in the Greater Accra Region of Ghana. In order to execute the study, the objectives which are; the prevalence of work- related injuries among workers, the level of awareness to health and safety standard practices and the level of compliance with occupational health and safety standards were done which produced the following findings. 5.1 Socio-demographic Characteristics The study had a response rate of 96.7% (408/422). Out of this, the majority were males, representing 83.09%. This is in line with the findings of other studies which also have shown that males constitute the greater percentage of individuals who work in the industrial sector (Dwumfour-Asare & Asiedu, 2013)(Adebola, 2014). This finding could be due to the perception that the manufacturing industry sector should be dominated by males because an increase in number of workers who are females would only retard productivity (Gyan, 2013). The results of the study also showed that majority (80.14%) of the workforce were within the 28- 47 years age group. There is consistency in age distribution among respondents of this study with the findings of other studies conducted among workers of industries and the 2015 Labour Force Report (He, Messacar, & Ostrovsky, 2017) (Ghana Statistical Service, 2016). The reason for this 53 University of Ghana http://ugspace.ug.edu.gh distribution could be explained that, most manufacturing industries aim at maximizing productivity and profit and therefore require a young and active workforce in order to achieve this goal (He et al., 2017) Furthermore, about 99.51% of the respondents in the study had attained at least senior secondary level of education. This is consistent with a similar research work done on awareness and compliance with occupational health and safety in Taiwan (Hu CC; Shiao,JSC; Guo,YL, 1998) which showed that majority of the respondents had high educational level because of the minimum educational requirements which manufacturing and processing industries demand. 5.2 Prevalence of occupational injuries among workers The prevalence rate of injuries among the participants of this study was 7.35%. The rate of injuries was lower than rates in the findings of other research works in Africa (Rushton, 2003; Gizaw et al., 2014), and could probably be due to the fact that the respondents of this study had a high level of awareness of issues concerning occupational health and safety which enabled them to adopt practices that led to the reduction in the rate of injuries among them. Indeed, this assertion is supported by other results if this study which indicated high levels (81-99.5%) of awareness of various occupational health and safety issues among the participants. In addition, a research on occupational injuries in Thailand also indicated that, due to an increase in awareness of safety and health issues, there is a decline in the rates of occupational injuries since 1996 from 40 per 1000 workers to 21 per 1000 workers (Thepaksorn & Pongpanich, 2014). From the study, the frequently occurring injury among the respondents was cuts/punctures. Per the response of the respondents, this was mainly due to nonuse or inappropriate use of PPEs. As 54 University of Ghana http://ugspace.ug.edu.gh reported in other studies conducted on accidents, injuries and illnesses in food processing industries, cuts/puncture occurred more because workers under this sector are often in direct contact with objects, which may either be sharp or pointed (Bhushan, 2008) for neglecting to use PPE. A study conducted in the textile industry also reported a similar outcome for the same reasons (Serinken et al., 2012). For instance, according to (Katsuro et al., 2010), workers got injured for negligence to use of PPE. The study also revealed that 33% of the respondents who had an injury, failed to report to management and 90% of those who reported injuries to management said that nothing was done about the situation. These findings corroborate those of other studies including (JT, 2013) which reported similar attitudes towards injuries sustained by workers. The explanations given to these occurrences was that some employers consider the reporting of injuries by workers as a means to filing for compensation claims and therefore adopt such intimidating attitude which include outright dismissal of the workers to discourage them from reporting injuries. This could therefore have accounted for why some of the workers failed to report their injuries (CEL_Committee on Education and Labor, 2008). Furthermore, determination of the association between injury occurrence and work schedule showed that injuries occurred most among industrial workers who worked during normal working hours and did not go on any shift work. Even though this finding agrees with that reported by (Salminen, 2016), several other studies especially those conducted among healthcare workers (Caruso, 2015; Salminen, 2009) (Ryu et al., 2017) have also argued that shift work rather caused lack of effective sleep among workers leading to a higher risk of occupational injuries among individuals who work on shift compared to those who work during normal diurnal working hours. Furthermore, the observation of higher rate of occupational injury among female industrial 55 University of Ghana http://ugspace.ug.edu.gh workers in this study compared to the male counterparts, confirms the report by (Ryu et al., 2017), which explained that female workers find it difficult to balance domestic chores with their work and therefore are more prone to errors leading to occupational injuries than the male counterparts. 5.3 Level of awareness among industrial workers The results of this study showed that 99.0% of the respondents had knowledge of safety label in their work environment. 99.5% also had understanding to what health and safety is. 81.1% had no exposed cables in their work environment while 86.3% have been trained to use fire extinguishers. These results indicate that the general level of awareness of Occupational Health and Safety is high among workers in the selected food processing industries and could be as a result of various trainings on health and safety measures being organized by the institutions in which they work. The high educational status of most of the workers could also be an explanation to the increased level of Occupational Health and Safety awareness. This assertion is similar to what (Hu CC; Shiao,JSC; Guo,YL, 1998) reported in their findings. 5.4 Compliance with health and safety standards The study showed that males are more likely to comply with health and safety standard practices than females in industries. Other studies (Salminen, 2016)(Ryu et al., 2017) on compliance with health and safety standards reported similar findings, which were attributed to the fact that females undergo variations in their mood due to hormonal influences associated with their biological nature. Those factors therefore, increase their tendency towards noncompliance with safety rules (Nana-otoo, 2016). In view of this, it was suggested that females are more likely to fit into the 56 University of Ghana http://ugspace.ug.edu.gh clerical careers than work in the factories (Gyan, 2013). Studies by (Trades Union Congress, 2017)(Kane, Giles, Dennerstein, & Organization, 1999) and (Serinken et al., 2012), on the contrary, reported that men are much more careless and hasty leading to flouting of safety rules and thereby getting more exposed to injuries and death than women. The findings of the study again showed that a worker’s duty at the workplace is significantly associated with chances of complying with health and safety standards. According to (Jones, 2013), this finding is because a worker’s job description determines the safety procedures to adopt and how careful he or she must be in order to avoid occupational accidents, injuries, diseases and death. In consonance with this therefore, findings of this study showed that workers in the laboratory were least likely to comply with safety standards as compared with workers of heavy machinery, mechanical, production and packaging (Lazim, 2013). However, the findings indicated that, where there is more supervision, workers were likely to comply with safety regulations than where there was little supervision. Furthermore, 95.59% of the respondents stated that they use PPEs. 96.06% of the respondents who use PPE reported that they use the PPEs always while 3.94% said they use PPE sometimes. The negligence to use PPE by this minority group was attributed to ignorance of OHS standards (Bogale, kumie, & Tefera, 2014) and lack of supervision. In view of this, regular training on the job and active supervision would increase the tendency of workers to comply with OHS standards. Apart from this, most of the participants also complained of discomfort when using PPEs as reported by (Hu CC; Shiao,JSC; Guo,YL, 1998). Regarding satisfaction with the health and safety policy, those who were satisfied with the policy had a better chance of complying with health and safety standards. Dissatisfaction among some of the workers however could be as a result of poor working relationships with supervisors or policies 57 University of Ghana http://ugspace.ug.edu.gh that are too strict (Chinda, 2014). Improvement in working relationship with employers therefore would help resolve this situation. 58 University of Ghana http://ugspace.ug.edu.gh CHAPTER SIX SUMMARY, CONCLUSION AND RECOMMENDATIONS 6.0 Introduction This chapter discusses the conclusions from the study and makes recommendations for improving the safety of workers through compliance with occupational health and safety standards in the selected food processing industries and other industries in Ghana as a whole. 6.1 Summary The study fundamentally evaluates Occupational Health and Safety Standards compliance among workers of selected food industries in the Greater Accra region of Ghana. The prevalence of occupational injuries, knowledge and awareness of workers’ health and safety and level of compliance with health and safety was assessed. The study was quantitative and data was collected using questionnaires. 6.2 Conclusion In conclusion, the study shows that, the odds of a food industrial worker complying with health and safety standards was significantly associated with the workers’ knowledge and awareness to health and safety procedures. The study also revealed that there was a significant association between occupational injuries and sex, age and the work category of the respondents. Although there is a significant association between injuries and educational level according to literature the study revealed no significance between occupational injuries and educational level which was probably because 99.51% of the respondents in the study had attained at least senior secondary 59 University of Ghana http://ugspace.ug.edu.gh level of education and thereby increasing the odds of compliance with health and safety standards, leading to reduced rates of work related injuries, accidents and illnesses. The most common injury among the workers was cut/puncture, which could be drastically minimized by the use of appropriate personal protective equipment. 6.3 Limitations Sampling bias: The study involved workers of industries where there was a shift system and hence not all of the workers were given equal chance to participate. Due to the sample size, purposive sampling was used to select the industries and study area. Due to this, only workers in urban and peri urban areas had the chance to participate. Recall bias: The recall period in the study was upheld at the number of years a worker had been at the industry. This was a sufficiently long period to be affected by recall bias Study design: The cross-sectional study design could not allow cause effect relationship of the variables to be made clearly. 6.4 Recommendations This section presents recommendations based on the results from the study. The recommendations are presented in two parts. 6.4.1 Recommendations to management 1. Management should create an environment where workers can confidently report occurrences of accidents in their work place. Data on accidents and injuries should be 60 University of Ghana http://ugspace.ug.edu.gh documented electronically, followed up, and remedial measures should be implemented in order to prevent recurrence of similar issues. 2. For effective participation, training programs must be made compulsory for all workers when they are organized. There should be intense training on health and safety procedures as part of the orientation programs of newly recruited staff and interns. 6.4.2 Recommendations to the workers 1. All workers should use the appropriate PPEs at all times to reduce the chances of hazard exposure. 2. All cases of accidents and injuries should be duly reported by all workers for proper documentation and remedial actions. 6.4.3 Recommendations for academic purposes 1. Further research should be conducted in all other industries across the nation to compare the level of compliance among them in order to identify sectors where OHS issues need to be addressed. 61 University of Ghana http://ugspace.ug.edu.gh REFERENCES Adebola, J. O. (2014). Knowledge, Attitude and Compliance with Occupational Health and Safety Practices among Pipeline Products and Marketing Company (PPMC) Staff in Lagos. Merit Research Journal of Medicine and Medical Sciences, 2(8), 2354–3238. Retrieved from http://www.meritresearchjournals.org/mms/index.htm Adjotor, F. N. (1022). the Effects of Occupational Safety and Health on Labour Productivity: a Case Study of Some Selected Firms in the Greater Accra Region of Ghana. Legon in Partial Fulfillment of the Requirement for the Award of Mphil Economics Degree, (July). Retrieved from http://ugspace.ug.edu.gh Amponsah-Tawiah, K. (2013). Occupational Health and Safety and Sustainable Development in Ghana. International Journal of Business Administration, 4(74), 1923–4007. https://doi.org/10.5430/ijba.v4n2p74 Annan, J., Addai, E. K., & Tulashie, S. K. (2015). Short Communication A Call for Action to Improve Occupational Health and Safety in Ghana and a Critical Look at the Existing Legal Requirement and Legislation. Safety and Health at Work, 6(2), 146–150. https://doi.org/10.1016/j.shaw.2014.12.002 Awan, T. (2007). Occupational health and safety in Pakistan, (December), 3277–3280. Retrieved from http://www.amrc.org.hk/alu_article/occupational_health_and_safety/occupational_health_a nd_safety_in_pakistan Bhushan, N. L. (2008). Injuries, Illnesses, and Fatalities in Food Manufacturing, 2008. Monthly Labor Review, 1–8. Retrieved from http://www.jstor.org/stable/monthlylaborrev. 62 University of Ghana http://ugspace.ug.edu.gh 2011.01.075%0Ahttp://about.jstor.org/terms Bogale, D., kumie, A., & Tefera, W. (2014). Assessment of occupational injuries among Addis Ababa city municipal solid waste collectors: a cross-sectional study. BMC Public Health, 14(1), 169. https://doi.org/10.1186/1471-2458-14-169 Burke, M. J., Sarpy, S. A., Smith-crowe, K., Chan-serafin, S., Salvador, R. O., & Islam, G. (2006). Relative Effectiveness of Worker Safety and Health Training Methods, 96(2), 315–324. https://doi.org/10.2105/AJPH.2004.059840 CEL_Committee on Education and Labor, U. S. H. of R. (2008). Hidden Tragedy: Underreporting of workplace injuries and illnesses, (June), 1–55. Retrieved from http://edlabor.house.gov/publications/20080619WorkplaceInjuriesReport.pdf Chinda, T. (2014). Organizational factors affecting safety implementation in food companies in Thailand. International Journal of Occupational Safety and Ergonomics, 20(2), 213–225. https://doi.org/10.1080/10803548.2014.11077050 Dijk, F. Van, Varekamp, I., Radon, K., & Version, M. P. (2011). Glossary for Basic Occupational Safety and Health, 1993(page 11), 1–20. Dwumfour-Asare, B., & Asiedu, S. R. (2013). Awareness of the Factories , Offices and Shops Act 1970 ( Act 328 ) at KNUST , Ghana. Developing Country Studies, 3(10), 1–11. Retrieved from www.iiste.org Forjuoh, S. N., Zwi, A. B., & Mock, C. N. (1998). Injury control in africa: Getting governments to do more. Tropical Medicine and International Health, 3(5), 349–356. https://doi.org/10.1046/j.1365-3156.1998.00240.x 63 University of Ghana http://ugspace.ug.edu.gh Ghana Statistical Service. (2016). 2015 Labour Force Report, 50–65. Retrieved from http://www.statsghana.gov.gh/docfiles/publications/Labour_Force/LFS REPORT_fianl_21- 3-17.pdf Gizaw, Z., Gebrehiwot, M., Teka, Z., & Molla, M. (2014). Assessment of occupational injury and associated factors among municipal solid waste management workers in Gondar town and Bahir Dar City , northwest. Journal of Medicine and Medical Sciences, 5(September), 181– 192. https://doi.org/10.14303/jmms.2014.103 Gyan, C. (2013). the Role of Women in the Oil Industry. Journal of Social Sciences, 994100(33), 94–100. https://doi.org/10.3844/jsssp.2013.94.100 He, J., Messacar, D., & Ostrovsky, Y. (2017). Analytical Studies : Methods and References The Relationship between Firm Size and Age of Workforce : A Cross-industry Analysis for Canada, (11). Hu CC; Shiao,JSC; Guo,YL, S. L. (1998). Employer’s awarenessand compliance with occupational health and safety regulations in Taiwan. Occup.Med, 48(1), 17–22. Jones, M. (2013). JOB DESCRIPTION JOB TITLE : Manager , Transportation Safety. JT, M. (2013). Construction Workers Explain Why Workplace Injuries Go Unreported. International Journal of Occupational Safety and Ergonomics, 9762. Retrieved from http://edlabor.house.gov/publications/20080619WorkplaceInjuriesReport.pdf Kane, P., Giles, P., Dennerstein, L., & Organization, W. H. (1999). Women and occupational health : issues and policy paper for the Global Commission on Women’s Health. Katsuro, P., Gadzirayi, C. T., Taruwona, M., & Mupararano, S. (2010). Impact of occupational 64 University of Ghana http://ugspace.ug.edu.gh health and safety on worker productivity : A case of Zimbabwe food industry. Journal of Business, 4(13), 2644–2651. Lazim, C. S. F. M. S. M. L. M. Z. H. M. (2013). Influence of workplace behaviour on compliance wuth safety practices, 1–17. Lombardi, D. A., Verma, S. K., Brennan, M. J., & Perry, M. J. (2009). Factors influencing worker use of personal protective eyewear. Accident Analysis and Prevention, 41(4), 755–762. https://doi.org/10.1016/j.aap.2009.03.017 Lugah, V., Ganesh, B., Darus, a, Retneswari, M., Rosnawati, M. R., & Sujatha, D. (2010). Training of occupational safety and health: knowledge among healthcare professionals in Malaysia. Singapore Medical Journal, 51(7), 586–592. Melorose, J., Perroy, R., & Careas, S. (2015). 13 No Title No Title. Statewide Agricultural Land Use Baseline 2015, 1(9), 50–55. https://doi.org/10.1017/CBO9781107415324.004 Mourtzis, D. M. N. P. D., & Chryssolouris, G. (2013). On industrial learning and training for the factories of the future : a conceptual , cognitive and technology framework, 473–474. https://doi.org/10.1007/s10845-011-0590-9 Nana-otoo, A. (2016). Occupational Health and Safety issues in the Informal Manufacturing sector of Cape Coast Metropolis. Newman, J. (1998). Assessing Occupational Safety and Health Training, (June). NFU Mutual Risk Management Service. (2017). HEALTH AND SAFETY GUIDANCE NOTE PERSONAL PROTECTIVE EQUIPTMENT. Occupational Risks and Hazards Exposure , Knowledge of Occupational Health and Safety 65 University of Ghana http://ugspace.ug.edu.gh Practice and Safety Measures among Workers of Sheba Leather Plc , Wukro ,. (2016), 4(2). https://doi.org/10.15406/mojph.2016.04.00074 Puplampu, B. B., Lg, P. O. B., & Africa, W. (2012). Key Issues on Occupational Health and Safety Practices in Ghana : A Review. International Journal of Business and Social Science, 3(19), 151–156. Rushton, L. (2003). Health hazards and waste management. British Medical Bulletin, 68(September), 183–197. https://doi.org/10.1093/bmb/ldg034 Ryu, J., Jung-Choi, K., Choi, K. H., Kwon, H. J., Kang, C., & Kim, H. (2017). Associations of shift work and its duration with work-related injury among electronics factory workers in South Korea. International Journal of Environmental Research and Public Health, 14(11). https://doi.org/10.3390/ijerph14111429 Salminen, S. (2016). Long Working Hours and Shift Work as Risk Factors for Occupational Injury. The Ergonomics Open Journal, 9(1), 15–26. https://doi.org/10.2174/1875934301609010015 Sanaei Nasab, H., Ghofranipour, F., Kazemnejad, A., Khavanin, A., & Tavakoli, R. (2009). Evaluation of Knowledge, Attitude and Behavior of Workers towards Occupational Health and Safety. Iranian J Publ Health, 38(2), 125–129. Serinken, M., Turkcuer, I., Dagli, B., Karcioglu, O., Zencir, M., & Uyanik, E. (2012). Work- related injuries in textile industry workers in Turkey. Turkish Journal of Trauma and Emergency Surgery, 18(1), 31–36. https://doi.org/10.5505/tjtes.2012.54376 Tadesse, T. (2006). For Environmental and Occupational Health Students Occupational Health and Safety, (August). 66 University of Ghana http://ugspace.ug.edu.gh Thepaksorn, P., & Pongpanich, S. (2014). Occupational injuries and illnesses and associated costs in Thailand. Safety and Health at Work, 5(2), 66–72. https://doi.org/10.1016/j.shaw.2014.04.001 Trades Union Congress. (2017). Gender in occupational safety and health. Retrieved from https://www.tuc.org.uk/sites/default/files/GenderHS2017.pdf Wanjiku, M. F. (2017). Factors Influencing Use of Personal Protective Equipment ( Ppe ’ S ) By Motor Vehicle Repair Workers in Kigandaini , Thika Munyua Flaciah Wanjiku a Research Project Paper Submitted in Partial Fulfillment of the Requirements for the Award of Master of Arts. Retrieved from http://erepository. uonbi.ac.ke/bitstream/handle/11295/102695/ FLACIAH WANJIKU MUNYUA FINAL PROJECT.pdf?sequence=1&isAllowed=y 67 University of Ghana http://ugspace.ug.edu.gh APPENDICES APPENDIX I: PARTICIPANTS’ INFORMATION SHEET Research Title: “Evaluation of Occupational Health and Safety Standards Compliance among Workers of Selected Industries in the Greater Accra Region of Ghana.” Name of Researcher: Mr. Solomon Abakah Research Supervisor: Dr Uri Markakpo, Senior Lecturer, University of Ghana School of Public Health, Legon Introduction: Solomon Abakah is my name. I am a postgraduate Student of the University of Ghana (UG) reading Masters in Public Health (MPH). I am carrying out a research on “Evaluation of Occupational Health and Safety Standards Compliance among Workers of Selected Industries in the Greater Accra Region of Ghana” in partial fulfillment for the award of my MPH. degree and will like to invite you to participate though you do not need to decide immediately to participate. I will explain the details of this consent form to you so you understand what the study entails. Purpose and Nature of the Study: It has been indicated that the unsafe and unhealthy work environments, especially for industrial workers have become burdensome on Ghanaian workers increasing accident rates and sometimes due to noncompliance with safety precautionary measures This study therefore seeks to evaluate Occupational Hygiene Safety compliance among workers of selected industries in the Greater Accra Region of Ghana. As part of the study, you will be required to answer a few questions about yourself, your occupation, and health and safety history. The information you will provide will help to prevent 68 University of Ghana http://ugspace.ug.edu.gh the occurrence of accidents, injuries and diseases at the workplace. This study will also provide you with some helpful job-related health and safety information that will help you to maintain good health and stay safe at the workplace Potential Risks and Discomforts: In participating in this study, I will be asking you to share some personal views and experiences concerning yourself, your occupation, and health and safety history; and you may feel uncomfortable talking about some of the topics. You do not have to answer every question or take part in the research if you don't wish to do so. Voluntary Participation: Participation in this survey is completely voluntary and you are free to withdraw your participation anytime without giving any reason for doing so. I will give you an opportunity at the end of the interview to review your responses, and you can ask to change any responses that you want. Additional Costs and Compensation: You will not have to spend money in partaking in this study and you will not be compensated for participating. If you agree to participate in the study, I will visit you at home or any place that you think is comfortable for you to complete this. You will only have to spare 15-30 minutes of your time to answer the questions I will ask. Confidentiality: No information shared with me will be disclosed to any of your community members or to anyone who is not part of the study team. The information that I will collect from this study will be used only for academic purposes. 69 University of Ghana http://ugspace.ug.edu.gh Contacts for Additional Information: If you have any questions, you can ask them now or later. If you wish to ask questions later, you may contact me Solomon Abakah, School of Public Health, Legon on the following number 0243632448or via email: abakahsolomon@gmail.com or contact my supervisor, Dr. Uri Mackakpo, Department of Biological, Environmental and Occupational Health (BEOH), School of Public Health, Legon. You can also contact the Ghana Health Service-Ethical Review Committee Administrator, Madam Hannah Frimpong on 0507041223 for any clarifications on this research. 70 University of Ghana http://ugspace.ug.edu.gh APPENDIX II: PARTICIPANTS’ CONSENT FORM/ CERTIFICATE OF CONSENT I have been invited to participate in a research on “Evaluation of Occupational Health and Safety Standards Compliance among Workers of Selected Industries in the Greater Accra Region of Ghana”. The document describing the nature and purpose as well as risks and benefits of the study has been read and explained to me. I have been given an opportunity to have any questions about the study answered to my satisfaction. I agree voluntarily to participate in this study. _______________________ _________________ __________ Full name of participant Signature or Thumb print Date DECLARATION BY WITNESS (IF PARTICIPANT CANNOT READ BY HIM/HERSELF) I was present while the benefits, risks and nature and purpose of the study were read to the participant. All questions were answered and the participant has agreed voluntarily to take part in the study. _______________________ _________________ __________ Full name of participant Signature or Thumb print Date 71 University of Ghana http://ugspace.ug.edu.gh RESEARCHERS SIGNATURE COLUMN I certify that the nature and purpose, the potential benefits, and possible risks associated with participating in this study have been explained to the above individual to the best of my ability. I confirm that the participant was given an opportunity to ask questions about the study, and all the questions asked by the participant have been answered correctly and to the best of my ability. I confirm that the consent has been given freely and voluntarily. _______________________ __________________________ ____________________ Name of researcher Signature Date 72 University of Ghana http://ugspace.ug.edu.gh APPENDIX IV: STUDY QUESTIONNAIRE RESEARCH ON THE EVALUATION OF OCCUPATIONAL HEALTH AND SAFETY STANDARDS COMPLIANCE AMONG WORKERS OF SELECTED INDUSTRIES IN THE GREATER ACCRA REGION OF GHANA. Questionnaire Dear Participant, I would be very grateful if you would corporate in helping me carry out an important study in your institution. This study will provide you with some helpful job-related health and safety information that will help you to maintain good health and stay safe at the workplace. Could you please help to complete this questionnaire by answering a few questions about yourself, your occupation, and health and safety history? Your participation is vital to the success of this research project. Confidentiality of information that will be obtained is fully assured. Questionnaire number ………………. Date of interview DD/MM/YY …………/……../………… Name of Industry …………………………… Interviewer………………….. Signature of interviewer ………………………….. Part A- Demographic Data (Please tick as appropriate) 1. Age group 18-27 years …………………….. 1[ ] 28-37 years …………………….. 2[ ] 38-47 years …………………….. 3[ ] 48-57 years …………………….. 4[ ] Above 57 years ……………….... 5[ ] 2. Sex Female ………………..1[ ] Male ………………….2[ ] 73 University of Ghana http://ugspace.ug.edu.gh 3. Residence Urban ……………….. 1[ ] Rural ………………………. 2[ ] 4. Marital status (Please tick as appropriate) Single ………………1 [ ] Widowed…………………… 4[ ] Married ..............…...2 [ ] Separated ………………….. 5[ ] Divorced …………...3 [ ] 5. Religion Christian ………………..1 [ ] Muslim ………………. 2 [ ] Traditionalist …………...3 [ ] Other ………………….4 [ ] 6. How much do you earn per month <1000cedis…………1 [ ] 1000-1500cedis………………..2 [ ] 1600-2000cedis…….3 [ ] >Above 2000cedis……………4 [ ] 7. What is your highest educational level? No school …………………………..1 [ ] Primary …………………………….2 [ ] Junior High School ………………...3 [ ] Senior High School ………………...4 [ ] Tertiary ……………………………..5 [ ] 8. How do you pay for your medical bills? National health insurance ……………….. 1[ ] Private Health insurance ………… 2[ ] Self ……………………………………….3[ ] Family …………………………….4[ ] The Institution…………………………….5[ ] Other……………………………….6[ ] 9. How long have you been with the Institution? 0-1 year ……………………… 1[ ] 2-3 years ……………………… 2 [ ] 4-5 years …………………….. 3[ ] 6-7 years ……………………….4 [ ] >7……………………………...5 [ ] Part B (Work Environment) 10. Are health screening programs organized for the staff in the institution? Yes ………………….. 1[ ] No ……………………………… 2 [ ] 74 University of Ghana http://ugspace.ug.edu.gh 11. If yes, how often are these programs organized? Never ……………………. 1 [ ] Once a year ……………………... 2 [ ] Twice a year ……………….3 [ ] More than three times a year ……. 4[ ] 12. What do you do in the institution? Packaging ……………….. 1 [ ] Heavy Machinery ………. 2 [ ] Shredding …………….…. 3 [ ] Mechanical ……….……... 4 [ ] Laboratory…………….…. 5 [ ] Part C Please tick in the boxes the correct response(s) 13. What do you understand by occupational health and safety? Welfare of the employee at the workplace …………………………………........ 1[ ] Welfare of the employer at the workplace ……………………………………….2 [ ] Welfare of both the employer and employee at the workplace………………….. 3 [ ] Others, please specify……………………………………………………………..4 [ ] 14. Is there a fire extinguisher at your area of work? Yes ……………….. 1 [ ] No ………………… 2 [ ] 15. Have you been trained to use it.? Yes ……………….. 1 [ ] No ………………… 2 [ ] 16. Are the electric cables in your work environment exposed? Yes ……………….. 1 [ ] No ………………… 2 [ ] 17. Are safety labels or warning signs found around the working environment? Yes ……………….. 1 [ ] No ………………… 2 [ ] 18. Staff are required to put on protective clothing in the performance of their duties at all times, where/when necessary. True …………1 [ ] False ………….. 2 [ ] 19. If True in (18), how often? Always …………. 1[ ] Sometimes ………………………. 2 [ ] Never …………… 3[ ] 75 University of Ghana http://ugspace.ug.edu.gh 20. Do you run a shift system in your department? Yes ……………….. 1 [ ] No ………………… 2 [ ] 21. If yes, how many hours do you run in your shift? 4-6hours………………….1 [ ] 7-9hours……………………………2 [ ] 10-12hours……………….3 [ ] 13-15hours………………………….4 [ ] Choose the appropriate response(s) in the questions 22. Have you suffered any accident or injury in your workplace since you were employed? Yes…………………………………1 [ ] No ………………………….. 2 [ ] 23. If yes in (22), how many times have you sustained an injury(s)? Once ……………………………1[ ] Two or more times …………...2[ ] 24. If Yes in (22), Which of the following injury(s) did you suffer? (Please tick as appropriate). Cut/ puncture ………………………1[ ] Abrasion …………………………. 2[ ] Dislocation ………….……………. 3[ ] Fracture ……………………….…. 4[ ] Eye injury ………………………… 5[ ] Ear injury………………………….6[ ] Burn………………………………...7[ ] Others ……………………………...8[ ] 25. What was the source of the injury? Hit by falling object(s) ……………1[ ] Injured by work tool …………………2[ ] Falls………………………………3[ ] Lifting heavy object ………………....4[ ] Hot substance or chemical………..5[ ] Collision ……………………………. 6[ ] Other ……………………………..7 [ ] 26. What were the causes of the accident? Lack of adequate training on health and safety ……………………… 1 [ ] Non provision of adequate protective clothing and equipment ………. 2 [ ] Ignorance on health and safety matters ……………………………….. 3 [ ] Lack of supervision…………………………………………………….. 4 [ ] Others, please state ………………………………………………………5 [ ] 27. Did you report the accident to the appropriate authorities? Yes ………………………… 1 [ ] No …………………….. 2 [ ] 76 University of Ghana http://ugspace.ug.edu.gh 28. If yes, what actions were taken to prevent the occurrence of the same accident or injury in the future? The case was referred to a committee……………………………1 [ ] Investigation was instituted and I was invited …………………..2 [ ] Report issued, causes identified and report formed part of subsequent safety training meeting ……………………………………………………………….3 [ ] Nothing was done ……………………………………………….4 [ ] Other, please specify……………………………………………..5 [ ] 29. Does your institution have a health and safety committee? Yes ……………………………… 1 [ ] No…………………………… 2 [ ] Not sure ………………………… 3 [ ] 30. How regular is training organized for staff on occupational health and safety? Quarterly ……………. 1 [ ] Biannually …………………………………….… 2 [ ] Annually …………….. 3 [ ] No definite time fixed for training ………………. 4 [ ] Never …………………5 [ ] 31. Are you satisfied with what management is doing currently to improve upon occupational health and safety in your workplace? Yes …………………….. 1 [ ] No ………………………….. 2 [ ] 32. Do you or your department or unit have a written copy of occupational health and safety policy of the industry? Yes……………………………. 1 [ ] No …………………..……… 2 [ ] 33. Do you experience any of the following symptoms? Eye irritation ……………………………………. 1 [ ] Ear, nose, throat pain …………………………… 2 [ ] Skin irritation …………………………………… 3 [ ] Lower back pain ………………………………... 4 [ ] Headaches ……………………………………… 5 [ ] Shortness of breath …………………………….. 6 [ ] Humming in your ears after work ……………… 7 [ ] Do you have to shout at arm length for you to be heard by a coworker at work ………………………………………………….. 8 [ ] Whole or part body vibration …………………….9 [ ] 77 University of Ghana http://ugspace.ug.edu.gh 78