Working Conditions and Exposure to Work Related Injuries and 
Accidents at Kokompe-Accra Ghana 
 
Samson Obed Appiah 
 
 
Abstract 
The occupational environment in which artisans work may expose them to work-related injuries, 
chronic illness, stress and, disability. In order to understand the issue of workplace safety among 
artisans in the informal small-scale enterprises, there is the need to explore their general level of 
safety. Consequently, it will be possible to suggest possible ways of improving their health 
conditions and safety in the work place. This paper examined the general level of safety of 
automobile artisans at the Kokompe Artisanal Centre in Accra as well as assessing their level of 
awareness about occupational accidents and injuries they are exposed to and the preventive 
measures in place. The qualitative in-depth interview and observational methods were used to 
examine incidences of work-related injuries and accidents among the artisans. In all 58 artisans 
including auto-mechanics, auto-electricians, auto-welders, auto sprayers and auto-spare parts 
dealers were selected through convenience and snowballing sampling techniques. The working 
conditions of the artisans were poor due to haphazard siting of temporary workshops by squatter 
artisans resulting in multiple exposures to different hazards: physical, psychosocial and 
ergonomic hazards leading various forms of work-related physical injuries well as 
musculoskeletal disorders (MSDs) and work-related illnesses. The contributing factors of 
accidents and injuries were: human, environmental and mechanical factors. The physical 
environment and the nature of work are both hazardous since the work entails improper sitting 
posture, lifting of heavy objects and generally working without any safety measures. The artisans 
were mostly aware of the many dangers associated their work which is largely unregulated. For 
policy implication, city authorities must consider a re-engineering of the entire workplace of the 
artisans by planning and demarcating the structure in accordance with standard practice to enable 
work to be done in a safe and healthy environment. 
 
Keywords: Working conditions, Exposure to Work-related Accidents, Injuries, and Kokompe. 
Department of Sociology, University of Ghana, Legon  soappiah@ug.edu.gh   
 
Ghana Journal of Geography Vol. 11(2), 2019 pages 52-76 
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Ghana Journal of Geography Vol. 11(2), 2019 pages 52-76 
Introduction 
Exposure to occupational hazards, with the resultant injuries, disease and death, has profound 
effects both on work productivity as well as on the socio-economic well-being of workers and their 
families. These hazards are the most common in the informal sector, which is inadequately 
supervised and lacks occupational health services. Because of inadequate financing and difficulties 
in obtaining credit facilities, small-scale industries use poor, outdated machinery and equipment, 
limiting their productivity and increasing exposure to hazards (Okuga, Mayega and Bazeyo, 2012). 
The work processes of informal small scale workers present the risk of physical injuries – such as 
cuts and burns as well as hearing impairment resulting from loud noises, and eye injuries due to 
excessive UV-radiation and respiratory dysfunctions caused by noxious metal fumes inhaled 
(Sabitu, IIiyasu and Dauda, 2009). There is also a risk of psychosocial hazards such as stress at 
work and exhaustion, in addition to the ergonomic hazards that mainly involve musculoskeletal 
injuries such as sprains, muscle pain, dislocations and fractures (Aguma-Acon, 2012; Theuri, 
2012; Mbulingwe, 2014). From the above examples of the nature and types of hazards and injuries 
informal small-scale workers are exposed to, the working environment and conditions are the main 
determinants.  
Hazards relating to inadequate safety and health standards are particularly evident in the informal 
sector. Informal workers do not have the necessary awareness, technical means and resources to 
implement health and safety measures (Okuga et al. 2012).  A poor work environment, including 
inadequate premises and often very unsatisfactory welfare facilities causes large human and 
material losses (Theuri, 2012). Workers in the informal small-scale enterprises have been shown 
to be more prone to work related hazards and injuries as they work in an unhealthy and unsafe 
work environment. These groups of workers however have been reported not to know much about 
such hazards and to have little or no training on workplace safety (Johnson and Motilewa, 2016). 
For most informal sector operators, their homes and workplaces are one and the same place as 
vulnerability to diseases and poor health results from a combination of undesirable living and 
working conditions. The conditions under which most informal workers operate are precarious and 
unsafe as many live in ramshackle structures, lack sanitary facilities or portable water, and have 
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Working Conditions and Exposure to Work Related Injuries and Accidents at Kokompe 
poor waste disposal. The interaction between occupational hazards and poor living conditions can 
exacerbate the health and safety problems of informal sector workers, since micro-enterprises in 
the informal sector, poor working practices and poor working conditions are interrelated (Theuri, 
2012). 
The automobile service industry has a large group of workers many of which are in the unorganized 
informal small-scale sector. The numerous activities they are involved in expose them to many 
physical and chemical agents that can be hazardous to their health. These workers are also proned 
to workplace accidents and injuries, many of which are preventable (Johnson and Motilewa, 2016). 
In Ghana, the relevance of the informal small-scale enterprises like Kokompe, Abossey Okai and 
Suame Magazine artisanal spare part retail and repairs center cannot be ignored in the face of 
shrinking public sector employment. These artisans provide important services to the large 
Ghanaian lower and middle class vehicle-owner population, many of who own and use home-used 
or second-hand vehicles. In spite of their valuable contributions, these artisans operate in 
precarious and hazardous environment exposing them to all kinds of preventable injuries and 
accidents. These artisanal centres are urban slum community concentrated with high population of 
urban youths making a living out of artisanal works and with very few social amenities, poor 
infrastructural planning and exposure to occupational hazards, risks and accidents. As a result, 
they fall within a high risk group with low education, income, social status and minimal support 
from state regulatory and inspection agencies. It is therefore important to examine the general 
safety and working conditions of the artisans, their awareness of occupational hazards and risks, 
the predisposing factors and nature of workplace accidents they experience. Against this 
background, this paper argues that, any attempt to reduce workplace accidents would fail unless 
the working environment and conditions of artisans and their knowledge of the hazards and risks 
they are exposed to is known. This is because an understanding of their working environment and 
conditions and exposure to incidences of hazards, injuries and accidents would help in reducing 
workplace accidents. 
  
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Ghana Journal of Geography Vol. 11(2), 2019 pages 52-76 
Existing Literature and Theoretical Framework 
A number of researchers have studied the special nature and culture of informal small-scale 
enterprises (Eakin, 1992; Hasle, 2000; Walters, 2001; and Robin, 2003). Some of these do not put 
special emphasis on occupational health and safety but rather they make important contribution to 
the understanding of the reaction, motivation and resources of informal small-scale enterprises 
(Hasle and Limborg, 2006). In most of the studies on the nature and operations of informal small 
scale enterprises, the owner is emphasised as the dominant actor in relation to any changes made 
in them (Hasle and Limborg, 2006). Other studies document how the personal values and priorities 
of the owner are determinants of the culture, social relations and the attitude of the enterprise 
(Hasle, 2000; Walters, 2001; Eakin, 1992). 
Based on the above references, one main characteristic feature of informal small-scale enterprises 
is the owner-manager/sole proprietor. In many cases he/she is the key person and his or her 
opinions and values constitute the approach of the enterprise to occupational health and safety 
(Hasle, 2000; Antonsson et. al, 2002 and Walters, 2001). Many of these owners consider health 
and safety to be the responsibility of the employees and thereby blame them for accidents and 
injuries (Eakin, 1992).  The effect of this is to avoid questioning the firm’s owner/manager and 
organization of work. Many Small and Medium Enterprises’ (SME) owners/managers are isolated, 
overworked, do not use services offered by the Occupational Health and Safety (OHS) sector 
associations and generally do not belong to business groups (Hasle, 2000). They also appear to be 
poorly informed and do not realize the extent of their health and safety problems (Walters, 2001). 
At the same time, many owners consider regulation and demands to improve health and safety 
standards as financial burden which is too heavy and not realistic for a small enterprise. In 
combination with the fact that accidents are a rare experience within the individual workplace, this 
attitude forms an ad hoc approach to health and safety as problems to be solved (Hasle, 2000). 
Consequently, most informal small-scale enterprises can be described as organizations which have 
to fight for survival with the owners as the responsible persons who, like an octopus, has to handle 
many different issues at the same time, and consequently, health and safety issues are not always 
high on the agenda. It is this position as both owner, manager and in some cases worker, held by 
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Working Conditions and Exposure to Work Related Injuries and Accidents at Kokompe 
one person who has to handle all management issues including safety, which is the key to the 
understanding the nature of many small enterprises. The owner-manager gets a large part of his or 
her identity from the enterprise and his or her own beliefs and cultural values are the guidelines 
for the development of the business. His/her management is often a patriarchal one, which may be 
ego-centric and action-oriented, but which also means that he/she assumes a certain responsibility 
for the employees (Hasle and Limborg, 2006). 
Clark (2012) buttressed these problem scenarios by indicating that poor OHS infrastructure and 
funding, insufficient number of qualified occupational health and safety practitioners and the 
general lack of adequate information are among the main drawbacks to effective OHS practices. 
Kheni, Dainty, and Gibb (2008) in their survey on health and safety practices among informal 
small-scale construction revealed some OHS problems. The main problems identified by Kheni et 
al. (2008) included lack of skilled human resources, inadequate government support for regulatory 
institutions and inefficient institutional frameworks responsible for health and safety standards. 
Dwomoh, Owusu and Addo (2013), studied OHS in Ghana’s timber industry and showed that 
occupational hazards, injuries and accidents exist among lumber and logs workers. Their findings 
concluded that enterprises in the timber industry need to pay much attention to their health and 
safety needs. A study by Kwankye (2012) on woodworkers in the Kumasi Metropolis indicated 
that unavailability and low usage of personal protective equipment (PPE) increase the risk of 
getting involved in accidents. Monney et al. (2014) studied occupational health and safety practices 
among vehicle mechanics in Mampong Municipal area in the Ashanti Region of Ghana. The result 
of their study indicated that 78% of the artisans lacked training in fire safety and besides 
firefighting equipment were non-existent in the workshops visited. In addition, 64% of the artisans 
had sustained various work-related physical injuries. Due to the physical exertion required by their 
work, most artisans experienced musculoskeletal disorders. Use of PPE was as low (27%) and the 
main reasons for non-use of PPE were attributed to discomfort, PPE are not important for their 
jobs as well as the cost of procuring them.  
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Ghana Journal of Geography Vol. 11(2), 2019 pages 52-76 
Bittel’s 3Es of Accident Prevention Framework 
In understanding the attitude and behavior of artisans towards occupation health and safety in their 
workshop and measures they put in place for accident reduction and prevention, Bittle’s (1985) 
framework for accident prevention was used. According to Bittel (1985), accident reduction and 
prevention depend on the three E’s– Engineering, Education and Enforcement. In other words, 
jobs should be engineered for safety; employees should be educated in safe procedures and safety 
rules should be enforced. 
Firstly, engineering a job for safety is very crucial in ensuring safety and health at the workplace. 
This is because when the work and its environment are not well structured, the chances are that, 
accidents and injuries are more likely to occur. In many workplaces, a major occupational health 
and safety concerns the way in which the work environment and conditions are structured and 
organized. In many instances, the manner in which the job and its environment and conditions are 
engineered and organized among workers in the informal sector is a leading cause of the numerous 
preventable occupational injuries and accidents.  
As note in the three E’s proposal, education is another key element in occupational health and 
safety promotions and accident reduction at the workplace. A job or workplace well engineered 
for safety and health is a necessary but not a sufficient condition for ensuring safety and health at 
the workplace. In many instances, workers in both the formal and informal small-scale sector are 
not well educated on the need to use personal protective equipment as well as follow established 
and laid down procedures for work. Educating workers on safety mechanisms and procedures is 
the responsibility of the entire social partners at the workplace namely employers, workers and 
their unions and state agencies. Artisans’ knowledge on safety mechanisms and procedures is not 
only low but also such preventive measures do not exist at the first place.  
Finally, enforcement is another key aspect of accident prevention and reduction in Bittel’s 
framework since safety rules and mechanisms should be enforced to ensure workplace safety. 
Enforcement of safety rules and regulation is the responsibility of workers, 
employers/management and state regulatory and inspection agencies.  
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Working Conditions and Exposure to Work Related Injuries and Accidents at Kokompe 
In effect, the 3Es-Engineering, Education and Enforcement are mutually interrelated to bring 
about workplace safety or otherwise. This is because; a well-engineered workplace must have 
mechanisms of educating workers in safe procedures of work as well as enforcing safety rules. 
Materials and Methods 
The data used for analysis in this article was taken was collected at Kokompe Artisanal Centre in 
Accra between June, 2013 to July 2014 and supplemented with further data in August, 2018. The 
qualitative in-depth interview and observational methods were used to interrogate the working 
conditions and exposure to hazards and accidents among the artisans at Kokompe in Accra. The 
interview process was often conversational and situational with occasional interruptions from 
customers and other artisans seeking some explanations from the interviewee. The semi-structured 
interview guide was supplemented with direct observations of the artisans at work by the 
researcher in order to confirm or deny any claim they made. It was anticipated that due to the 
sensitive nature of artisans’ health and safety under investigation, adequate data may not be 
generated using in-depth interviews alone. This was due to the fact that, there were instances the 
artisans were not forthcoming with their responses on questions posed by the researcher. The 
researcher also observed the artisans in their work activity with the working conditions and 
environment they operated in. 
In selecting the study area as well as the various artisans, purposive and convenient sampling 
methods were employed. In all, 58 auto artisans comprising 15 mechanics, 12 welders, 15 sprayers, 
10 spare part dealers and six electricians were selected and interviewed. Direct observation was 
utilized in addition to the in-depth interviews as the researcher observed the artisans at their work 
activity to ascertain the use or otherwise of Personal Protective Equipment (PPEs). To do this, the 
study area was first divided or mapped into two main clusters: namely the zone occupied by the 
spare part dealers and the zone for the other four groups of artisans (sprayers, welders, mechanics 
and electricians) on the other hand. In selecting the individual artisans from the four artisanal 
workshops, at least a master/owner, a senior apprentice, a worker and apprentices were selected. 
This was done to ensure that in each zone all the categories of artisans (masters/owners, senior 
apprentice, worker and apprentice) were covered. This ensured equal representation of the views 
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Ghana Journal of Geography Vol. 11(2), 2019 pages 52-76 
of all the categories. In each case, those who were willing to be part of the study were selected and 
interviewed. The convenient sampling technique was used because of the unwillingness of the 
artisans to take part in the interviews as a result of their perception that the research was for the 
purpose of tax collection by the city authorities. The perception was fueled by rumors that went 
round the study area that the Accra Metropolitan Assembly (AMA) had sent a team to investigate 
the income levels of artisans to increase the level of taxes to impose on them.  
Data from the field were in the form of notes, sound bites on recorders and pictures and videos on 
camera. While the notes were carefully read through to confirm information provided by the 
respondents, the interviews captured on recorder were played and transcribed and coding was then 
carried out. This involved organization of raw data into categorized themes or concepts. Further, 
data was re-categorized into subsections under the various themes which were represented in the 
interview question. Finally, the data was sorted into comparative themes and concepts based on 
the research question of the paper. Data so treated was then analyzed. In doing so, the researcher 
looked for patterns in the data such as recurrent behavior under the various categorizations among 
the artisans. The analyses of the data under the various themes were done using the terminologies 
and concepts of the people studied. Below is the map showing the location of Kokompe. 
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Working Conditions and Exposure to Work Related Injuries and Accidents at Kokompe 
 
Figure 1: Map showing the Location of Kokompe 
Results and Discussion 
The findings of the paper were grouped under the following themes;  
General level of safety and working condition among artisans 
Automobile service industry has a large group of workers many of which are in the unorganized 
informal small-scale sector. The numerous activities they are involved in expose them to many 
physical and chemical agents that can be hazardous to their health (Johnson and Motilewa, 2016). 
The conditions under which the workers at Kokompe operate were precarious and unsafe. A study 
by Theuri (2012) in Kenya found similar conditions under which many of the informal small-scale 
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Ghana Journal of Geography Vol. 11(2), 2019 pages 52-76 
workers operate. These small-scale enterprises operated in makeshift structures, lack sanitary 
facilities or potable water and have poor waste disposal systems.  
The structures at Kokompe are mainly constructed of temporal materials using wooden boards and 
iron sheets. The poor infrastructure is compounded by the wooden structures which have no well-
laid down pattern, resulting in overcrowding. There is also lack of access road to the area since 
abandoned vehicles, metal scraps and metal chips have taken over the entire area close to the main 
road. Some of the abandoned vehicles serve as “houses” for some of the mechanics and other 
artisans. Worsening the potential health and safety of these artisans is the scorching sun under 
which they work and particularly, the mechanics, welders and electricians in particular work. Price 
(2004) argues that exposure to extreme heat may result in heat stroke and heat exhaustion which 
may also increase the possibility of acute cardiovascular diseases. Exposure to heat during work 
has also been reported to cause reduced sperm count in men and to cause non-melanoma skin 
cancer (Fartasch, Diepgen, Schmitt and Drexler, 2012; Machida, 2013).  
The enclosed structures like those used by the spare part dealers-and sprayers were not designed 
to be used as workplaces and so do not have adequate ventilation. They lack sanitary facilities, 
potable water and adequate refuse disposal facility. Waste disposal has become a problem as many 
workshops in the area dispose of hazardous waste improperly which has an adverse impact on the 
work environment. Problems with sanitation are very visible at Kokompe: empty plastic water 
sachets, oil from vehicles, disused pieces of spare parts and other waste products choke the open 
drains which run through the area. These choked drains become the breeding ground for 
mosquitoes besides the offensive smell emanating from them. A mechanic who works along a 
large and particularly choked gutter complained thus:  
The gutter is always choked with ‘pure water’ rubbers (small plastic bags and 
others. So, anytime we come here and eat, we get sick… and we often get 
malaria…Since January this year (2014) the rubbish in the gutter has not been 
cleared. 
The smell from the gutter was so offensive that a female artisan had to spray a disinfectant around 
her stall to reduce the smell in order to attract customers to her store. 
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Working Conditions and Exposure to Work Related Injuries and Accidents at Kokompe 
Throughout Kokompe, there was no firefighting appliances as water hydrants are not visible. Fire 
hazards from naked paraffin lamps; LPG (for cooking and welding) and unsafe electrical 
connections make Kokompe a potential disaster zone. This situation explains why in recent times 
two major fire outbreaks have occurred with grave consequences for human life and property. For 
example, in October 2011, Kokompe artisanal center was gutted by fire which was estimated to 
have destroyed over 400 market stalls, as well as a significant amount of goods and cash. Many 
market stalls are constructed from wood which make them highly flammable. In addition, naked 
electrical wires traversing the area and flammable chemicals used, underscore the importance of 
fire safety equipment. The Ghana Fire Service also complains that access routes to market are 
often blocked by stalls and goods which mean that fire engines are obstructed in cases of fire 
outbreaks.  
The lack of basic first-aid items and personnel with elementary first-aid skills at the workplaces 
are a challenge to the general safety, health and welfare of the artisans. This, added to the lack of 
a medical outfit within the immediate confines of the workshop is likely to result in loss of lives 
in the case of a major accident. The importance of first-aid equipment and supplies and availability 
of personnel with basic skills in first aid administration at the workplace, has been emphasized by 
some authors (Erickson, 1996; Alli, 2008). The general environment safety conditions of artisans 
at Kokompe is poor made up of improper infrastructure, bad roads, poorly planned area putting 
the artisans in danger of being exposed to all kinds’ hazards and accidents. 
 
Awareness of Occupational Hazards and Accidents 
It is important to access the artisans’ levels of awareness of occupational hazards and accidents 
associated with their daily operations. This is because, workers’ level of awareness of accidents 
and hazards associated with their work is crucial to accident reduction, prevention as well as 
ensuring a safe and healthy workplace. According to Okuga et al. (2012), awareness of 
occupational accidents and hazards is the first step in promoting workplace safety.  
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Ghana Journal of Geography Vol. 11(2), 2019 pages 52-76 
The paper notes that, though most of the artisans knew of the risks and hazards associated with 
their work while a few of them had no idea. Awareness of occupational hazards was independently 
matched with the category of artisan. The findings indicated that all the sprayers (15), mechanics 
(15), welders (12) and electricians (6) are aware of the hazards associated with their respective 
jobs. For the spare part dealers (ten), four of them had some idea about the hazards associated with 
their jobs whiles the remaining six had no idea. The artisans were aware of the hazards associated 
with their respective jobs namely physical, psychosocial and ergonomic hazards. The work 
processes undertaken by these artisans present the risk of physical hazards such as cuts, burns, 
hearing impairment resulting from loud noises and eye injuries due to excessive UV-radiation. 
There is also the possibility of injuries associated with respiratory dysfunctions due to the noxious 
metal and spraying paint fumes inhaled. There was also a risk of exposure to psychosocial hazards 
such as stress at work and exhaustion. In addition, there were ergonomic hazards that mainly 
results in musculoskeletal injuries such as muscle pain, dislocation and fractures. 
The welders indicated they were aware their work exposes them to physical hazards such as 
welding sparks, inhaling welding arc and fumes, handling of hot metals and extreme weather 
conditions among others. For the mechanics, electricians and spare part dealers, the hazards and 
risks they were exposed to included poor lifting methods, and carjacking practices resulting in 
dislocations and fractures among others.  
 
 
A 35-year-old apprentice mechanic narrated his experience six months earlier when a car he was 
working on had an apprentice electrician trapped underneath. According to him: 
It was only a miracle that happened that day if not we would have been dead now. 
On that fateful day, I had removed the tyres of a car and jacked it with two big 
concrete blocks and I went under it to work. My other colleague, the apprentice 
electrician, joined me under the car to check an electrical problem. After some time, 
I decided to get out from under the car to pick a tool while the apprentice was called 
by a customer to check something on his car. Minutes after the car came down. You 
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Working Conditions and Exposure to Work Related Injuries and Accidents at Kokompe 
can imagine what would have happened to us if we were still under that car (35-
year-old apprentice mechanic). 
The above incident is just one of the near misses of occupational hazards and risks that artisans 
are exposed to in their daily operations. It was found that artisans have a high level of awareness 
of occupational hazards and risks associated with their respective jobs. It is however important to 
note that, despite the artisans’ awareness of the occupational hazards and dangers, they continue 
to work in such environment since for them that was the only way they could make their daily 
living and provide their livelihood. For instance, an apprentice welder who was seen working on 
a vehicle without an eye goggle, protective cloth and boot indicated that he knew it was hazardous 
but felt it was just normal to work without the PPEs. In his words: 
 I know the naked fire can expose my eyes to injuries, but you see, we always work 
like that and everything is fine. Even though we sustain some injuries and accidents, 
it is part of our everyday job and just as the farmer will by all means experience 
cutlass wound in the farm, you expect us also to suffer burns from fire and cuts 
from the metals as we work (36-year-old apprentice welder).     
The above assertion of the apprentice welder is a clear indication that he is aware of the 
consequences of adopting improper safety procedures, but felt that it was normal to experience 
some form of injuries while working. This was the attitude, behaviour and assumption of most of 
the artisans interviewed. Some of the sprayers interviewed and observed considered spray-painting 
to be dangerous due to the fumes they inhale but were reluctant to wear protective nose masks. 
Due to their belief that accidents and injuries are normal parts of their daily work, they continue 
to work in these hazardous environment with the explanations of meeting their daily need.  
 
For instance, according to a 45-year-old married mechanic: 
My whole life depends on this job.... so you can imagine the case of an accident or 
injuries during work. Absence from work for just a day means that I would not have 
any income or money and my brother you know the effect of that. At times you come 
to work and customers do not come regularly, so just imagine you did not come at 
all due to injuries (45-year-old married mechanic). 
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 It is therefore clear that for the artisans, the financial benefits of their work are more important 
than the hazards and dangers associated with their work and present in their working environment 
Nature and Types of Work-related Injuries and Accidents  
In order to know the nature and type of accidents and injuries, the artisans were asked to report 
and narrate accidents and injuries they have ever experienced especially those they have 
experienced in the last six months prior to the study. The nature of injuries and accidents varied 
from minor to severe ones. In other words, the nature of accidents and injuries could be classified 
into serious incidents, non-recordable and near-misses.  
The most common type of injuries experienced was cuts and burns and the least common were 
fractures. Other injuries included backaches, chest pains, eye injuries and hearing problems. For 
the welders, the common injuries and accident they experienced in the line of work included cuts 
and burns on various parts of their bodies as a result of the handling of hot metals during welding. 
However, other welders, experienced eye injuries due to exposure to naked fire. A 35-year-old 
apprentice welder narrated an injury he had about three months ago while working on a car. 
According to him: 
I was working on a car when I realized that the fire from the welding machine was 
poor. I, therefore, decided to increase the oxygen outflow by pouring water on the 
carbonated stones. All that I saw was that my cloth has been lit with fire and 
burning my hand. It took the timely intervention of my master and others to save 
me. You can now see my arms with the healed scars (35 year old apprentice 
welder). 
The mechanics and spare parts dealers reported the incidences of cuts, dislocations and fractures 
on various parts of the body, especially the shoulders and arms. For most of the cuts, dislocations 
and fractures – they were caused by manual handling of heavy car parts and engines they work 
with as well as awkward postures, lifting, and twisting, bending and repetitive working 
movements. The electricians experienced accidents in the form of electric shocks and cuts on the 
hand.  It was realized that most electricians who had never experienced any form of injury were 
new apprentices who had just come into the job.  
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Working Conditions and Exposure to Work Related Injuries and Accidents at Kokompe 
Work-related Illness and Diseases 
Apart from physical injuries identified, there were other non-physical work-related injuries at 
Kokompe. For example, as a result of excessive noise levels and prolong inhalation of 
contaminated air (isocyanates in spray paints and dust), there were complaints of hearing and 
respiratory problems. According to existing literature, excessive noise levels and prolong 
inhalation of contaminated air could lead to reduced hearing acuity and work–related asthma 
(Williams, Jones and Cocker, 1999 and Pronkand Skarping, 2006, as cited in Monney et al., 2014). 
In addition, due to the physical exertion one expects high prevalence of musculoskeletal disorders 
(shoulder pains, backaches, numbness of hands and feet and rheumatism/arthritis)   among the 
artisans. Consistent with these findings, other studies such as Okuga et al., (2012); Theuri, (2012) 
and Katula, (2013) who have all established high-incidence of musculoskeletal disorders among 
workers whose work involves physical exertion. These include musculoskeletal disorders 
(shoulder pains, backaches, numbness of hands and feet and rheumatism/arthritis); eye strain and 
injury, skin irritation and respiratory disorders. Price, (2008); Spies, (2008) and Fartasch et al., 
(2012) have also reported that persistent coughing is among the early symptoms of exposure to 
isocyantes in spray paints, which after long-term exposure could result in lung infections and  even 
deaths. 
Predisposing Factors of Accident and Injuries 
The predisposing factors of accidents and injuries identified by the artisans could be classified into 
three categories namely, human, environmental and mechanical factors. The main contributing 
factor to accidents and injuries was human such as failure to follow established safe-working 
procedure, lack of attention, unsafe personal acts, improper posture, carelessness at work, fatigue 
caused by overworking and lack of skills and non-use of PPEs. Reasons cited for irregular and 
non-use of PPEs were that, PPEs were uncomfortable while working, they were also expensive 
making access difficult. For others, PPEs have been given to a colleague to use, forgetfulness and 
lack of knowledge on the requirement for use of PPEs for even ‘simple’ tasks. One remarkable 
character of the artisans’ work was the absence of personal protective equipment (PPEs). It was 
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observed that in many cases, the artisans lacked gloves, eye goggles, safety boots and protective 
clothes. For example, a sprayer was observed using a surgical mask ostensibly to protect his face 
from exposure to volatile organic chemical compounds. In another case, some welders were seen 
using ordinary sunglasses to protect their eyes from the gas flames. In effect, it was observed that 
in many cases, the appropriate PPE was not used.  The welder who was using the ordinary sunglass 
rationalized his action in the quote below: 
I am aware of the dangers of working without protecting my face and this is why I 
am using this sunshade. For me whether it is a sunglass or a goggle does not matter, 
but what is important for me is that it provides protection (45-year-old welder). 
The above sentiment was a reflection of the views of many other artisans who were observed using 
inappropriate PPE. For many of these artisans it was better to use the inappropriate PPE rather than 
not using any at all. This finding on the low and non-use of PPEs by auto artisans is consistent 
with studies by (Johnson and Motilewa, 2016); who also reported the low usage of PPEs among 
auto technicians in Nigeria. 
The environmental factors identified included slippery and muddy floors due to rain, hazardous 
chemicals, poor illumination and source of electricity. The working environment was such that, 
welding, spraying, vehicle repairing and other related activities were all carried out at the same 
place and at the same time. This has resulted in multiple exposures to different hazards including 
excessive noise apparently beyond the recommended maximum noise levels of 85 dB (A) for an 
eight–hour working day (ILO/WHO, 2013). The high level of noise is a concern raised by most of 
the artisans interviewed.  
  
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Working Conditions and Exposure to Work Related Injuries and Accidents at Kokompe 
They complained that it was a major problem, but that there was nothing they could do about it 
since exposure to noise was one of their occupational hazards. According to a 45 year old 
mechanic:  
The noise level here is too high for us and at times it is even difficult to hear your 
colleagues when they call you. Some of us have started developing hearing 
problems as a result. But there is nothing we can do about it since we do not have 
ear plugs. 
The above views of the spare part dealers and mechanics were expressed by several others during 
the interview with the researcher. 
The mechanical factors identified include unsafe tools, heavy tools and rapidly moving parts. The 
researcher also observed that, the small workshops suffer from poor housekeeping. Tools and 
materials are usually out of reach and working postures which can lead to the development of 
strain are common. In many cases, artisans work in awkward positions as a result of limited 
working space. Artisans especially spare part dealers lift engines and other heavy parts and 
sometimes over a long distance. In several instances, no proper ergonomic chairs were available 
and artisans were observed sitting on makeshift ‘seats’ such as concrete stools, drums, crates, 
buckets and other non-ergonomically designed chair. As a result of using these makeshift ‘seats’, 
some of the artisans, especially the spare parts dealers, mechanics and welders claimed they have 
developed waist problems. A 43-year-old welder, whose views were shared by others observed:  
We have to make our own seats out of concrete, stones, drums and so on. This is 
the only way we can sit while working; some of us are experiencing pains in our 
waist. Now I find it difficult to bend down when I am working. 
These finding confirms other studies such as Okuga et al. (2012) who observed that in Uganda the 
most common ergonomic hazards result in poor working posture, long hours of working, handling 
of heavy loads and uncomfortable seating. In Namibia, Amweelo (2000) reported that most 
occupational accidents were due to falling, flying or moving objects.  
It was also observed that sprayers were exposed to a range of hazardous chemical substance (HCS). 
A strong smell of paint vapours, paint removers and paint thinners were encountered during the 
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Ghana Journal of Geography Vol. 11(2), 2019 pages 52-76 
field study in the paint mixing and spraying processes. Spies (2008) has observed that sprayers 
and painters are often exposed to high concentration of isocyanates.   
However, it was interesting to indicate that apart from the above factors (human, environmental 
and mechanical), some of the artisans attributed accidents to unforeseeable forces or bad luck.  One 
example which illustrates this case occurred to a welder. The apprentice welder was welding a part 
of a car of which the master had instructed him on what to do. While engaged in the task, he was 
at the same time talking to two other colleagues. The apprentice welder was apparently so 
preoccupied with the conversation with his friends that suddenly his forefinger was caught by the 
fire. He however attributed the cause of the accident to unforeseeable forces.  
Similarly, some of the masters ended up as in the case above, attributing the accidents to 
unforeseeable circumstances and in some cases in combination with workers’/apprentices’ 
indiscretion. In many cases, the masters attributed the cause of accidents solely to the injured 
person, and in only few cases did they partly attribute - the causes to themselves. In other cases 
the injured workers had their attribution patterns reflecting those of the owners/masters. An 
instance of a master welder’ attribution, in which he resorted to unforeseeable circumstances/bad 
luck, was in the following narrative:  
This particular accident can’t be prevented...it was simply bad luck. He (the injured 
apprentice) wasn’t thinking properly. He handled the welding machine 
improperly... it wasn’t a matter of whether or not he used the machine... it was 
simply bad luck (45-year-old master welder). 
In spite of the fact that both masters and workers/apprentices provided detailed explanations of the 
causes of accidents, most of them ended up attributing the accidents to unforeseeable 
circumstances- in other words, bad luck. This is in spite of the point that the artisans at Kokompe 
identified many different factors that contributed to accident at their workplaces. Workers differ 
in respect of the number of accidents they are involved in. 
Furthermore, in some cases, artisans gave spiritual explanations for the accidents they experienced 
as witchcraft was used as the underlying cause of the accidents by some of them. Few of the 
artisans accused their colleague artisans of bewitching them and in the process resulting in the 
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Working Conditions and Exposure to Work Related Injuries and Accidents at Kokompe 
accidents. Evans-Pritchard (1937 cited in Nukunya, 2003) indicates that witchcraft accusations are 
function of social relations which are likely to result from jealousy, hatred, envy and fear. The 
relations may be that of kinship, neighbours, friends, colleagues or co-workers. This explanation 
could be considered to be the case among the artisans since the witchcraft accusations come from 
someone the supposed victim must have some relationship with. 
Consequences of Workplace Accidents and Injury 
When accidents occur, various things result from it: damage to property, injuries to people and 
loss of time, reduced production, etc.  Workplace injuries and diseases are of concern because they 
impose costs not only on injured workers and their employers, but also on society.  The causes of 
injuries prompted the researcher to further examine the socio-economic consequences. The 
artisans indicated that injuries and accidents they sustain affect their performance at work as well 
as financial and other social consequences. Most of these workers were married and were 
breadwinners; others who were not married had dependants and in many cases these accidents had 
implications for their dependants.  According to Nagash (2002:174), “One of the most obvious 
indirect costs is the human suffering caused to workers' families, which cannot be compensated 
with money.” 
The artisans indicated that they faced direct serious financial problems as a result of the accidents 
and injuries they sustain during work. This was because their jobs were not salaried, they were not 
compensated in any form if these injuries made it impossible for them to be at work. This meant 
the loss of day’s wages or income and this implied that there would be no income to take home. 
This impact or perceived cost of accidents or injuries experienced by the artisans depended on the 
degree or severity of the injuries. For many of these apprentices and workers, apart from the 
indirect loss of income, the loss of their jobs due to these injuries also result in loss of customers, 
since they could no longer meet their (customers) orders and requirements.  In any case, whether 
the loss of income as a result of one’s injury is through a direct or indirect means, the implications 
for victims appear similar. Overwhelmingly, the artisans complained that they face difficulties 
meeting the basic necessities of life such as providing food, shelter, clothing and paying children’s 
school fees and utility bills. However, even in this instance, some differences in the responses 
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Ghana Journal of Geography Vol. 11(2), 2019 pages 52-76 
could be gleaned: those who felt bitter about their plight were the married ones who had more 
responsibilities and financial obligations than the unmarried workers. For instance according to a 
45 year old married mechanic: 
My whole life depends on this job.... so you can imagine the case of an accident or 
injuries during work. Absence from work for just a day means that I would not have 
any income or money and my brother you know the effect of that. At times you come 
to work and customers do not come regularly, so just imagine you did not come at 
all due to injuries (45 year old married mechanic). 
 
Prevention and Reduction of Work-Related Accidents by Artisans 
The need to know the measures put in place by the artisans to reduce or prevent accidents and 
injuries in the course of their work is crucial to this paper. This is because workers in informal 
small-scale enterprises can only be assured of their daily wages and incomes when they work in a 
safe and healthy workplace. As a result, it was important to know their coping mechanisms with 
accidents they experience at their workplaces as well as measures they had put in place to reduce 
and prevent accidents and injuries from occurring. A safe and healthy workplace also means that 
accidents, injuries and hazards were reduced and prevented to the barest minimum. This is where 
workers also have a role to play in ensuring that the workplace is safe and healthy through 
mechanisms and measures they put in place.  
To this end, artisans were asked to indicate how they prevent injury at the workplace. Responses 
from the artisans indicated that, they did not have adequate measures of reducing or preventing 
hazards and risks associated with their respective jobs. The artisans claimed to have some 
mechanisms for preventing occupational and workplace accidents and hazards. However, during 
the field study, one of the critical observations made was that in many instances, artisans were 
working without the appropriate or required (PPEs) and were not following established procedures. 
For example, some sprayers were seen entering the spraying area without any nose mask, gloves 
and eye goggles. Those who were seen wearing any protective equipment were mainly using 
surgical mask to protect themselves from exposure to volatile organic compounds. Similar to the 
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Working Conditions and Exposure to Work Related Injuries and Accidents at Kokompe 
findings of this study, Okuga et al. (2012) reported a very low use of PPEs among small-scale 
welders in the Jinja Municipality of Uganda.  
The general attitude and perception of the artisans including the owners/masters and their workers 
towards accident reduction was fatalistic. That is a belief that most of the accidents and injuries 
are unavoidable part of their daily work, and that little or nothing can be done to prevent them. 
This means that masters/owners neither invests much time nor, - resources to ensure accident 
reduction and prevention.  
Conclusion 
Occupational Health and Safety are critical health and developmental issues, especially in a 
growing economy like Ghana where there is dearth of credible OHS data especially in the informal 
small-scale sector. Almost every workplace, including informal small-scale enterprises and 
business in the formal sector, suffer from one or more hazards. Occupational hazards may have 
health consequences for both workers and for any other person in the proximity of a production 
process. As indicated in the employment statistics, the informal sector and small scale enterprises 
play an important role in the labour market as well as in the diversification of the economy in 
Ghana. In view of this, the safety and health of workers in the informal small-scale enterprises 
should be recognized as it is in medium–size and large enterprises. Protecting the safety and health 
of workers in the face of hazards related to work activities is crucial because it promotes a healthy 
and vibrant economy in any country.  
The paper concluded that, Kokompe, with its youthful nature of artisans and male dominance is 
due to the nature of work. In addition, a large section of the artisans is not educated beyond the 
basic (Primary and JHS) levels. The physical environment and the nature of work are both 
hazardous since the work entails improper sitting posture, lifting of heavy objects and generally 
working without any safety measures. Whilst these artisans and their apprentices know about some 
of the hazards associated with their work, they are oblivious to the many dangers associated their 
work. No wonder that the artisans complained of musculoskeletal disorders, allergic reactions, and 
noise induced hearing loss, physical strain, fatigue, cut and burns. Thus, the predisposing factors 
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Ghana Journal of Geography Vol. 11(2), 2019 pages 52-76 
to workplace accidents that have been identified are non-use of protective equipment, carelessness, 
inexperience defective equipment or tools and bad luck (uncontrollable external forces). 
Workplace accidents lead to various costs on the artisans including: illness/injury, loss of income, 
possible loss of job, limb, or life and the cost of health care. Their working environment is hardly 
regulated by the bodies mandated to do so. 
The workshop owners had no explicit safety policy although some owners expressed an explicit 
positive and proactive approach to safety. In most of the cases though, the owners had an 
ambivalent attitude towards working with safety. On one hand they emphasized the importance of 
safety and on the other, they did not feel that they could do anything to promote it. In general, the 
owners ‘reacted’ to safety issues and problems by dealing with them as they arise, and most were 
of the opinion that accidents in general are due to worker faults or unforeseeable factors/bad luck 
– both of which they meant are beyond their control. 
The results of this paper confirmed earlier findings regarding the level of preventive safety 
activities in informal small-scale enterprises (Hasle and Limborg, 2006; Limborg, 2003).  If 
prevention measures are undertaken they are mainly on an ad hoc basis. Accidents are, considered 
as unforeseeable and/or attributed to a worker’s carelessness. Difficulties in explaining the causes 
of the actual accident and the lack of a safety policy of the enterprises also seem to indicate that 
safety activities are not a priority. It is therefore fair to conclude that, because the owners as well 
as their workers and apprentices are fatalistic, (believing that workplace accidents and injuries are 
an unavoidable part of their work), little has been done in terms of putting in place mechanisms 
and measures to ensure the reduction and prevention of accidents and injuries. The paper 
recommends, that city authorities should consider a re-engineering of the entire workplace of the 
artisans by planning and demarcating the structure in accordance with standard practice to enable 
work to be done in a safe and healthy environment as well as the need for artisans to be educated 
on the need and importance of PPEs in their work activities 
  
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