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ANALYSIS OF OCCUPATIONAL HEALTH AND SAFETY, ACCIDENT AND SAFETY,

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PHD IN HEALTH PROMOTION: ENVIRONMENTAL AND

UNIVERSITY OF CAPE CAAST

COLLEGE OF EDUDCATION STUDIES

FACULTY OF SCIENCE AND TECHNOLOGY EDUCATION

DEPARTMENT OF HEALTH, PHYSICAL EDUCATION AND

2015
 TERM PAPER: ANALYSES OF OCCUPATIONAL HEALTH AND

SAFETY, ACCIDENT AND SAFETY, SAFETY MEASURES AND

DISEASE PREVENTION

Introduction

There are hazards inherent in every work humankind does. Such hazards

have different probability to causing accidents, injuries, near misses and diseases

(Ana, & Sridhar, 2009). The hazards and risks are as a result of worker

behaviours associated with work processes, work procedures or less compliance

with workplace policies or regulations (Tsai, & Salazar, 2007). Work

environment such as unguarded machinery, poor housekeeping, exposure to

harmful chemical compounds and poor lighting and ventilations also pose as risk

to the worker. These occupational health and safety (OHS) matters do not only

affect the worker, they affect the family, company and the general society.

Therefore, the need for worker protection becomes more a corporate social

responsibility rather than individual worker health protection issue (Health and

Safety Professionals Alliance, 2012). This term paper attempts to elaborate on the

concept of OHS, explore accident and safety, highlight some safety measures

necessary for worker protection. It concludes with explanation of disease

prevention at the work environment.

Occupational Health and Safety

Occupational health and safety (OHS) aimed at procedures and processes

that enhance positive workplace, protecting, preserving and promoting the health,

safety and well-being of the workers in their worksites. OHS is central to the total

improvement of the working conditions for employees and any individual or

groups of individuals associated with the work and the work environment (WHO,

1
2007). Thus, OHS represents an important strategy, not only to ensuring the

safety and well-being of workers but also contributes positively to productivity,

corporate image and social improvement (Alli, 2008; Songstad, Moland, Massay

& Blystad, 2012). Simply, healthy workers become better motivated, enjoy better

job satisfaction and contribute better to productivity and services (Gilbreath &

Karimi, 2012; Seidler et al., 2014). OHS therefore enhances the overall quality of

life of workers, their families, the organization and the society and cannot be

underrated.

The world over, OHS takes it route from the International Labour

Organization’s (ILO) Conventions (Alli, 2008; WHO, 2007). The health and

safety concerns of workers have led ILO to formulate regulations and organized

institutes for their member countries (Jensen, 2005). The conventions provide the

guidelines as bases for the national OHS policies. In addition, organizations or

institutions also draw their OHS policies or regulations from national safety

policies (Alli, 2008). ILO regulations enjoin nations and employers to put in place

measures that serve to protect the safety and well-being of their workers and other

people affected by the operations of their companies or organizations.

ILO as a United Nation’s (UN) body is responsible for labour that caters

for the health and safety of the workers worldwide. ILO also collaborates with

other UN bodies such as WHO, FAO and UNICEF to achieve their aim of worker

protection. Other national institutions like Occupational Safety and Health

Administration (OSHA) of United State, National Institute of Health and Safety

(NIHS) and Health and Safety Executives of United Kingdom and many other are

also collaborators in the health, safety and well-being issues of the worker in the

various countries (Cooper, 2006).

2
 National OHS policy is important for the promotion of workers’ health

and safety in all organizations. Thus, organizations implement such national

policies that in turn serve their workers’ health interests. Besides, such national

policies may have institutions that serve as enforcers to the implementation of the

policies to advance workers’ well-being (Annang, 2014). Even where national

health and safety policies do not exist, like Ghana (Clark, 2008), organizations

have the moral duty to protect and promote the health and well-being of their

most valuable resource [the worker] (Anderson, & Chun, 2014). OHS does not

only save the personal health and safety interest of the worker and the society, it

promotes corporate image and productivity (Chau, et al., 2008), for a healthy

workforce is a productive workforce. Every nation including Ghana needs a

comprehensive national OHS policy, strong well-resourced institutions for

implementing such policies. In addition, organizations need to take practical steps

to providing necessary health and safety measures to safeguard the well-being of

the workers. On the other side of the coin, workers need to protect their health and

safety through complying with worksite safety measures.

Accident and Safety

An accident is an unexpected, unplanned event in a sequence of events

that occurs through a combination of causes that may result in physical harm such

as injury or fatality to an individual, damage to property, a near miss, a loss, or a

combination of these effects (Makhonge, 2009; P. 6). In otherwise, accident is an

unforeseen, adverse event that causes harm or has the potential to cause harm

(Kiwekete, 2009). From the perspective of the work environment, accident can be

described as an unexpected occurrence as a result of human and/or workplace

factors causing harm or having the tendency to cause harm to the worker, visitor,

3
work equipment or a combination of these. Such events include fires, explosions,

leakages or release of toxic or hazardous substances that can cause illness, injury,

disability or death among people, damage to property and environment

(Makhonge, 2009). The work accidents involve falls, accidents while using

machines or equipment, manual handling of equipment, driving or motor vehicle.

They may in some cases include stress related incidents, verbal and physical

abuse (Hrymak, & Pérezgonzález, 2007).

Workplace accident statistics estimate indicate that accidents resulted in

over 300,000 annual worker deaths worldwide. Accidents also caused more cases

of disability. In the European Union these fatalities amounted to nearly 5000

cases annually, with a much higher number of disability cases each year (Eurostat,

2004b). In addition to human costs these deaths and injuries also impose

economic burden to the worker, the family, the organization and the society

(Eurostat, 2004a).

Over the last 10-15 years the safety science literature has emphasized the

multidimensional characteristics of risks to workers, and the understanding of

how to prevent accidents at the workplace (Lund, & Aarø, 2004). Whereas

accidents previously were seen from a technical, legal or human factors

perspective, in recent years cultural and organisational factors have become

important additional perspectives included in safety intervention programmes in

the workplace (Spangenberg, 2010). Safety interventions for the prevention of

accidents at work are thus characterized as a complex process, which usually

integrates a number of components such as safety campaigns, safety training,

legislation or machines guarding. Research has emphasized the importance of

integrating these various components to achieve a high level of safety at work

4
(DeJoy, 2005). A review of safety intervention programmes by Lund and Aarø

(2004) concludes that the largest effect is obtained by a combination of

attitudinal, behavioural and structural approaches, thus multi-faceted

interventions.

A safety intervention may consist of a single component such as a safety

campaign within the workplace aimed at changing attitudes or safety training

aimed at changing behaviour or it can consist of a combination of such

components, involving safety climate, attitudinal, behavioural or structural

components. A safety intervention may run for a shorter or longer period of time

or represent a permanent change, as for example new regulations or legislation. A

safety intervention programme can be initiated at the workplace by the employer

or the employees, or initiated from outside the workplace by public authorities,

social partners or other stakeholders. However, the intervention must take place

and aimed at improving safety in the workplace or during work (Dyreborg, et al.,

2011). Accordingly, European Agency for Safety and Health at Work (2014)

outlined that employers have clear procedures and responsibilities for health and

safety and that everyone be made aware of their own and others’ responsibilities

to safety. Thus, employers must take actions to identify the main risks to health

and safety and taken action to eliminate or reduce them, make arrangements for

the maintenance of work equipment adequate and provide workers with suitable

personal protective equipment (PPE) and train the workforce in the use of such

devices. Additionally, workers be provided information on the risks and be

trained in safe working, emergency procedures and reporting unsafe conditions

and accidents. Moreover, taken prompt actions to investigate accidents, near

misses and reported problems, regularly inspecting workplace, and checking that

5
workers are following safe working procedures are acts responsible safety

management practices (Ansah, & Mintal, 2012). Having a system for reviewing

health and safety policy and working procedures are equally relevant to accident

prevention and safeguarding workers’ lives.

Safety Measures

Safety measures are deliberate practical actions taken by the senior

managers of organizations to protect, maintain and promote the health, safety and

well-being of their workforce both within and outside the work environment.

Safety measures are manifestations of management support and priority for and

commitment to workers’ health and safety. In addition, such measures are based

on organizational participation and communication of safety (Dollard et al.,

2012abc).

In a typical organization, safety measures may include instituting

occupational health and safety policies, forming workplace safety committee,

supervising and/or enforcing compliance to the policies. In addition, PPE and

training workers in safe work procedures, and providing medical care including

pre-employment medical screening and undertaking safety risk assessment and

management improve safety (Boustras, & Hadjimanolis, 2012). These safety

measures are interrelated. Providing for one measure such as instituting worksite

safety policy or providing PPE without enforcing the policy to increase

compliance or supervising workers to wear the protective devices, will leave

much to be desired. For example, enforcing instituted policies without providing

for other workplace safety measures such as training in safety procedures,

providing safety facilities, will to a large extent demoralize and reduce safety

performance of workers. This can lead to high injuries and ill health among the

6
workers. Thus, causing illness absenteeism, presenteeism, low productivity, high

cost of health bills, low work force moral and a general economic burden on the

worker, the family, the company and the public at large (Clarke, 2008; Health and

Safety Executive; 2009a; Occupational Safety and Health Administration

[OSHA], 2010). Providing for these safety measures, not withstanding, grossly

affects the way workers behave to protect themselves at their various workplaces

(Health and Safety Executive; 2008; Oduro, 2006). The safety measures covered

under this write up include safety risk assessment and management, safety policy

and enforcement, safety training/education, provision of safety facilities, and PPE.

Safety Risk Assessment and Management

Risk assessment is a systematic evaluation of all workplace activities to

identify the hazards present and gives an estimate of the extent of the risks

involved (Biron, Ivers, Brun, & Cooper, 2006). It involves an examination of the

workplace and the work procedures to identify what could cause harm to the

people (hazard) and an assessment of the chance, (high or low) that somebody

could be harmed by the hazards identified and an indication of how serious the

harm could be to the worker (Badenhorst, 2004). It is also the process of

identifying hazards in the workplace and assessing the likelihood that these

hazards will cause harm to employees and others. It is an approach required by

law in many countries, but not in Ghana, to manage health and safety effectively

at workplaces. Risk assessment is the cornerstone to preventing occupational

accidents and ill health among workers. It is a dynamic process that allows

organisations to put in place a proactive policy of managing workplace risks

(European Agency for Safety and Health at Work, 2013). Furthermore, it

facilitates the drafting of occupational exposure monitoring, medical surveillance

7
and occupational health education programmes (Badenhorst, 2004; Biron, et al.,

2006).

The purpose of an assessment is to enable a valid decision to be made

about measures necessary to control health hazards arising from any workplace

and/or activity. It also enables the employer to demonstrate readily, that all the

factors pertinent to the activities have been considered and that an informed and

valid judgment has been reached about the risk posed by the hazards. Moreover, it

highlights the steps that needed to be taken to achieve and maintain adequate

control, the need for monitoring exposure at the workplace and the need for

medical surveillance and biological monitoring have been put together

(Badenhorst, 2004). For example, risk assessment identifies and quantifies the

risk resulting from a specific use of a chemical taking into account possible

harmful effects on the workers or society from using the chemical in the amount

and manner proposed and all the possible routes of exposure.

Risk assessment is conducted with the employees and their representatives

and/or safety committee based on some basic principles (Badenhorst, 2004; Biron,

et al., 2006). It is structured to ensure that all relevant hazards and risks are

identified and addressed. It begins from first principles by asking whether the risk

identified can be eliminated (European Agency for Safety and Health at Work,

2013). Risk assessment also depends on several methods - nature of the

workplace (fixed establishment, or a transitory), the type of process (repeated

operations, developing/changing processes, or work on demand), the task

performed (repetitive, occasional or high risk) and technical complexity.

Risk assessment goes through various steps; establishing a programme of

risk assessment, structure the assessment, collect information, identify hazards

8
with information collected, identify those at risk, identify patterns of exposure

among those at risk, evaluate the risks (the probability of harm/severity of harm in

actual circumstances), investigate options for eliminating or controlling risks,

prioritize action and decide on control measures, implement controls, record the

assessment, measure the effectiveness of actions taken, review and evaluate the

programme of risk assessment (European Agency for Safety and Health at Work,

2013). Risk assessment must be the bane of every organization and one sure

means of providing a justification for instituting occupational health and safety

measures for the protecting, preserving and promoting the health, safety and well-

being of the worker.

Safety Policy Enforcement

The idea of regulating labour at the international level gradually gained

ground in 19th century after the First World War (Jensen, 2005; LaDou, 2003).

Labour regulation of in the industries, national and international level called for

the introduction of various workplace policies (Asogwa, 2000). The aims of such

policies are to protect the health, safety and well-being of workers (Health and

Safety Executive, 2010). For example, Sawacha, Naoum and Fong (1999) found

that organization health and safety policy is the most dominant factor influencing

workers’ safety behaviour in industries. Moreover, Boustras, and Hadjimanolis

(2012) revealed that companies with workplace safety policies are more likely to

have better worker safety performance than those without such policies.

Additionally, Zohar, and Luria (2003) found an increased in the supervisory

safety-oriented interaction corresponding with a significantly increase in the

workers' safety behaviours and safety climate scores in their sampled companies

workers. On the contrary, Rickie, and Sieber (2010) found that the presence of

9
written workplace health and safety policy on wearing PPE seemed to make no

difference on the percentage of workers wearing hearing protection. The result

further revealed that of 41 workers exposed to noise greater than 85 dBA, only

41% were wearing some form of hearing protection. Similarly, Klick, and

Stratmann (2003) found that more inspections or enforcement of workplace safety

regulation was related to higher death rates among some workers. According to

Klick, and Stratmann, increase in worker safety measures induces riskier

behaviour on the part of workers. Therefore, having a health and safety policy

becomes one of the first practical steps towards providing and maintaining work

environment safe or with less risk to workers’ health but adding enforcement will

be more effective (Health and Safety Executive, 2009a).

A successful policy is developed by senior management of organizations

in consultation with health and safety representatives and employees (Health and

Safety Executive, 2009b; 2010). The policy statement may include the company’s

health and safety policy objectives and the arrangements made to achieving these

objectives. The policy stipulates, among other things, the functions and

responsibilities, the commitment senior management to health and safety of their

workers and the integration of that commitment into the general organizational

activities. For instance, Sawacha, et al. (1999) are of the view that provision of

safety booklets, safety equipment and appointing trained safety representative on

worksite are core components of the safety policy. Furthermore, commitment to

set down the functions and duties of all people in the organization for maintaining

workplace health and safety are important components of such policies (Cooper,

2006).

10
 Health and safety policies may differ in every organization and may

include specific issues such as smoking, drugs, alcohol and infectious diseases

(Worksafe-Victoria, 2006). Such health and safety policies also outline specific

work safety practices which when not observe could cause debilitating health

effects to workers. Besides, the policies are not written in a vacuum. The policies

should be written in consonance with the organization’s general health and safety

policy. In addition, the policies must fulfill the requirements of relevant

legislation(s). In a like manner, the policies must be enforced to achieve their

intent and purposes for the workers. Safety of individual occupants should also be

paramount. Therefore, the right of an individual workplace occupant should not

supersede the rights to personal safety of other employees in any working

environment (Health and Safety Executive, 2009a).

Effective implementation of health and safety policies at workplace is as

crucial as their formulation. The effectiveness of health and safety policies

implementation depends largely on the development of effective plan. The

implementation of this plan involves consultation and cooperation between

management and employees with the aim of effectively translating the policy

objectives into effective actions. Regular monitoring, reviewing and enforcement

of the policies and plans by the health and safety committee or any responsible

representation promote workers’ compliance. For instance, Schloz, and Gray

(1990) found that 10% increase in the enforcement of workplace safety regulation

will decrease by about 1% the rate of injury occurrence among the workers.

Hence, companies are required to display a copy of the policy document in a

prominent place(s) for all employees to view. However, understanding the written

workplace safety policies is equally important just as implementing them. This

11
calls for educating the workers on the policies and their interpretations (Health

and Safety Executive, 2009a; Worksafe-Victoria, 2006).

Needless it is to institute occupational health and safety policies without

appropriate enforcement that will enhance the achievement of the policy

objectives. In addition, workers’ behaviour is a key determinant of whatever

“good” or “bad” that occurs to their health and safety at their workplaces now or

in the future (Lovato, Sabiston, Hadd, Nykiforuk, & Campbell, 2006). Moreover,

workers’ perceptions of the management commitment to their safety influence

their safety behaviours (Dollard, et al., 2012ab). Colley, Lincolne, and Neal

(2012) found that individuals who perceived their cooperation to emphasize

employee well-being reported higher levels of safety climate and fewer incidents

than their co-workers who perceived their organizations to emphasize

productivity and profit over workers well-being. Similarly, in assessing the impact

of safety management system on workers attitudes toward safety, Remawi, Bates,

and Dix (2011) found an increase in safety attitude of workers between pre and

posttest. On the contrary, Oltedal, and McArthur (2011) found that lack of

attention to safety by senior personnel significantly relate to low frequency of

reporting dangerous work procedures. Therefore, implementing safety

management system such as instituting safety policy, forming safety committee

and safety supervision promote positively the safety performance of the workers.

One of the key structures of safety policies is the formation of workplace

health and safety committee (McTernan, Dollard, & LaMontagne, 2013; Parker,

et al., 2009). In assessing the impact of safety committee on safety practices of

workers with a randomized controlled trial, Parker et al. found that there was a

remarkable increase in the machine safety practices among the study samples.

12
Accordingly, businesses with safety committee in place increased in their

machine safety practices than those without safety committees. In Parker, et al’s.

(2009) view as supported by other authors (Ariyoshi, 2008; Parker, et al., 2007;

Samant, et al., 2006), the present of and effectiveness of a safety committee at

workplace serve as an important instrument for improving workers’ safety

behaviours. The presence of safety committee is the most single indicator of an

effective workplace safety (Clarke, 2008; 2008; OSHA, 2010). Tsung-Chih, Chi-

Wei, and Mu-Chen (2008) also indicated that the existence of safety committee

influenced positively the safety work practices that reduced injury rate among

some university laboratory workers. Contrarily, Anderson, McGovern, Kochevar,

Vesley, and Gershon (2000) assert that no relationship exist between the presence

of safety regulation and safety climate perception, and worker safety performance.

However, they observed a positive association between safety climate perception

and healthcare worker compliance with worksite safety regulations. Thus,

worksite safety policies promote effective safety behaviours of workers that

safeguard their health and safety.

Safety Training/Education

Employee safety training or education has been recognized since the era of

industrial revolution as an effective instrument in promoting workers’ safety

practices (Jensen, 2005). OHS training embodies instructing workers to

recognizing known hazards and assisting them to use available work processes

and procedures to protect themselves. In addition, worker education prepares

them to deal with potential hazards or unforeseen problems at workplaces. Thus,

training or education gives guidance in ways to become better or informed worker

13
that takes action(s) aimed at eliminating workplace hazards and protecting lives

and property.

Generally, training refers to instruction and practice for acquiring skills

and knowledge of rules, concepts or attitudes necessary for workplace hazard

recognition and measures taking to controlling such hazards. Workers training

also involve learning safe work practices, proper usage of PPE, acquiring

knowledge of emergency procedures and preventive actions necessary for safety

(Health and Safety Executive, 2008). In addition, training provides workers with

ways to obtain additional information about potential occupational health hazards

and how to control these hazards (Kitchener, & Jorm, 2004). Furthermore,

training provides workers with skills to assume a more active role in

implementing hazard control programmes or to effect organizational changes that

enhance worksite protection (Burke, et al., 2006).

OSHA (2010) recommends that employers provide training for their

employees on the hazards of their jobs in a language that the workers understand.

The workers must be trained after being hired and before they begin their job

especially in the jobs perceived to having high risks to health (Health and Safety

Executive, 2009a). For example, training in first aid might be essential. The

availability of first aid facilities with trained person encourages provision of

health assistance to injured or ill workers before professional help is sought

(Salwa, Abu-Elseoud, Heybah, & Azhar, 2010). According to Lingard (2002),

first aid training is important to increase workers’ knowledge about their

likelihood of suffering from work-related injury or illness. In addition, workers

willingness to accept the levels of OHS risks could be minimized through first aid

14
training. Moreover, first aid training provides workers with the ability to control

the workplace risks and also safeguard their well-being (Salwa, et al., 2010).

Training and intervention efforts designed in whole or in part are also

believed to enhance worker knowledge of workplace hazards and affect behaviour

change that ensure compliance with safe work practices. Training also prompts

other actions aimed at improving workplace safety and health protection and

reducing the risk of occupational injury or disease. Evidence also suggest that

most training interventions can lead to positive effects on safety knowledge,

adoption of safe work behaviours or practices and safety outcomes at workplaces

(Colligan, & Cohen, 2004).

According to Health and Safety Executive (2010), person should not be

employed in connection with the storage, conveying or dispensing of petroleum

(fuel) until he has received adequate training. Such training should be provided to

newly recruited employees. In addition, regular refresher courses are important

for all other employees. All staff who may have a role in dealing with an

emergency should receive comprehensive training on the procedures for dealing

with such emergency situations. For instance, such training should involve

functions, operations and use of electrical devices for regulating delivery of petrol

to underground storage tanks or fuel tanks of vehicles, in the case of fuel station

attendants (Health and Safety Executive, 2008). Cooper, and Phillips (2004)

concluded that training workers in safety techniques of their jobs has a strong

influence on the actual levels of their safety behaviours.

In the relationship between occupational and organizational factors and

work related injuries, Gimeno, Felknor, Burau, and Delclos (2005) pointed out

that employees reporting lack of safety training had higher work related injuries

15
rate ratios than those who did report some amount of training. Moreover, workers

reporting lack of safety training were more exposed to chemical and physical

hazards than employees who received safety training. In the views of Gimeno et

al., lack of safety training remains significant risk factors for determining work

related injuries (Trepka, et al., 2008). Moreover, training workers in the

appropriate use of PPE is strongly advised (Tsung-Chih, et al., 2008). On-time-

training is also likely to provide adequate preparation for groups of workers

requiring the use of specialized PPE during work (Knight, & Goodman, 2009).

The protective capability of the PPE may otherwise be defeated by improper

handling, incorrect assembly, maintenance, improper put on and take off

procedures. Stress, discomfort and physical hindrance may also weaken

performance in the use of PPE. However, acclimatization through training will

mitigate these effects and enhance the compliance with the appropriate use of PPE

among workers.

Lormphongs, et al. (2004) revealed that more than 80% of workers noticed

and understood the toxicity of lead when they were trained in occupational health

and safety matters. The workers also understood the importance of protecting

themselves against lead exposure after receiving training. Moreover, the trained

workers regularly protect themselves by wearing PPE such as long sleeved shirts,

trousers and masks while at work. In the opinion of these authors, training also

increases understanding of and compliance to safety regulation at work

(Kendrick, et al., 2008; Vinodkumar, & Bhasi, 2010). Similarly, Runyan,

Vladutiu, Rauscher, and Schulman (2008) added that training workers in the use

of PPE is as important as their supply if workers were to make beneficial use of

such advices. Thus, to Runyan, et al., workers trained in the use of self-protective

16
devices would always ware PPE on the job compare with untrained ones.

Therefore, occupational health education including safety training, collaboration

between workers and their managers are always effective tools to promote safety

behaviours of workers and reduce the risk of ill health among them. For example,

an observation by Öz, Özkan, and Lajunen (2010) indicated that motorists with

less safety orientation made higher frequencies of road errors than those with

higher orientation. Additionally, such motorists with less safety orientation violate

more regulations than those motorists with high work orientation. In the views of

Öz, et al., workplace safety orientation is one major influencing factor in the

safety behaviour of drivers. In agreement, van der Molen, Zwinderman, Sluiter, &

Frings-Dresen (2011) found that safety training workshop led to the highest

reduction in the number of self-reported needle stick injuries among some

registered nurses. Besides, Oltedal, and McArthur (2011) recorded that enhanced

safety training and feedback on reported events related significantly to higher

reporting frequency of unsafe work procedures. These evidences underscore the

importance of safety training in the delivery of health and safety measures to

workers.

Provision of safety training may not be enough to protect the health and

safety of workers. Öz, et al. (2010); Trepka, et al., 2008; Parimalam, Kamalamma,

and Ganguli (2007) pointed out that more than one half of the trained employees

were not using PPE regularly. Accordingly, the workers demonstrated awareness

of the benefits of the regular use of PPE at work. However, the result revealed

some-what negative attitude of the workers towards the regular use of PPE.

Parimalam, et al. and Tsung-Chih, et al. (2008) explained that gap exist between

the workers’ knowledge and practices with respect to using personal protective

17
devices. Parimalam, et al. pointed out that knowledge acquired as a result of

training does not necessarily leads to practice of safety behaviour but the attitudes

of workers, to a greater extent, may influence behaviours towards safety.

Lipscomb, Dale, Kaskutas, Sherman-Voellinger, and Evanoff (2008) also

observed inconsistencies in the principles apprentices have been taught and what

they practice at work. The participants reported higher knowledge about safety

such as identification of residential fall hazards but expose themselves

continuously to many of such hazards. Again, Lipscomb, et al. revealed that the

low safety behaviour of the participants was influenced largely by job insecurity.

Therefore, not only the training to increase knowledge but other factors as attitude

and insecurity influence the safety behaviours of workers (Parimalam, et al.,

2007). Thus, training in addition to the presence of a strong safety culture, open

safety communication and strong leadership skills may produce the desired safe

work behaviours necessary for the well-being of workers (Lehmann, Haight, &

Michael, 2009).

Safety Facilities

The important of safety facilities to promoting health and safety of

workers has been recognized in OHS since the end of the Second World War

(LaDou, 2003). The provision of safety facilities enhances the behaviours of

workers to protect and promote their health and well-being (Jensen, 2005). For

instance, van der Molen, et al. (2011) believed that provision of needed safety

devices and interaction with workers led to reduction in the number of self-

reported needle stick injuries among public hospital nurses. In addition,

Vinodkumar, and Bhasi (2010) noted that the attitude of workers towards work

and improved personal hygiene such as no smoking at work, washing hands with

18
detergent before drinking water or having lunch and taking a bath after work has

changed when they were provided with appropriate facilities.

Safety facilities or equipment are appliances, except PPE, use by workers

in their day-to-day operations at work. These equipment or facilities facilitate the

“smooth” operation of workers and help prevent exposure, injuries and ill health

(Attfield, et al., 2012). For example, such equipment, in the fuel service stations,

may include filled fire extinguishers, fire alarm system, bucket with sand,

emergency telephone lines and alarms systems (switches), washing, bathing and

toilets facilities, dress storage apartments, well stocked first aid box, food and

water (Health and Safety Executive, 2007; 2009b; Worksafe-Victoria, 2006).

Safety facilities may also include proper drainage system, security services,

lighting system and adequate materials to deal with fuel spillage. Provision of

these safety facilities aimed at giving workers the opportunities to effectively

handle situations that adversely affect their health and well-being in their working

environment (Health and Safety Executive, 2008).

United State Department of Health and Human Services Food and Drug

Administration’s Center for Food Safety and Applied Nutrition (CFSAN) (1998)

in their guidance for industries, entreats all employers to make more facilities

accessible to their employees. CFSAN pointed out that the more accessible these

facilities are, the greater the likelihood that they will be used. The association

believes such facilities will help to increase the safety behaviours of workers.

Jointly, CFSAN, and Electronic Industry Citizenship Coalition (2009) also

recommended for the provision of facilities such as hand washing stations

equipped with basins, water, soaps, sanitary hand drying devices (disposable

paper towels) and waste containers. These facilities are to be maintained, cleaned

19
and safe for workers’ use. Moreover, the association encourages the provision of

private facilities such as separate toilet for men and women where necessary.

Additionally, the guidelines for petrol stations, (Health and Safety Executive,

2010) suggested that employers provide and clearly describe to their employees

the emergency response equipment on site, the functions of each of these

equipment and how to effectively operate them. The employers are encouraged to

provide firefighting facilities, safety devices, system for emergency shutdown of

sources of flammable fuels, systems for raising alarm, telephone and mobiles

emergency contacts. Alternatively, contact details for the nearest medical facility

or professional should be provided to the workers at petrol stations. Thus, lack of

access to safety facilities or equipment may be a major hindrance to their use

(Mathew, et al., 2008). Mathews, et al. believe that the more safety equipment or

facilities are provided to the workers, the more the culture of self-protective

attitude increases among workers. The use of such safety facilities mitigates the

harm caused to workers as a result of negligence or inappropriate behaviours

(CFSAN, 1998; Health and Safety Executive, 2008). Therefore, it is imperative to

supply the necessary devices for the use of workers to protect themselves in time

of emergencies, situations more associated with fuel service station work

(Olaotse, 2010).

Personal Protective Equipment (PPE)

The concern for the use of PPE as protective measure at workplaces dates

back to mid-1500 centuries that witnessed the upsurge of occupational respiratory

(Boschetto, et al., 2006) and pulmonary diseases among workers such as miners,

smelters and metallurgists (Jensen, 2005). PPE includes clothing of approved

standard provided by or to and use by a person at work (Health and Safety

20
Executive, 2008; WHO, 2010; 2007). The purpose for the provision or acquiring

PPE is for the protection of the individual worker from any health or safety

hazards associated with his or her job (Health and Safety Executive, 2007).

Therefore, there is the need for provision of appropriate PPE and train work to

motivate them to adequately use such devices (Mathew, et al., 2008). For

example, Strong, Thompson, Koepsell, and Meischke (2008) found that workers’

safety behaviour was largely determined by the constant provision of PPE by their

employers.

There are varied reasons for which workers or workplace occupants use or

not use PPE. The use of such devices appeared to be most strongly associated

with their availability, affordability and user comfortability. Possible predictive

factors on the use of PPE revealed that PPE use across all pesticide classes was

poor and that only about 40% of farmers routinely use personal protective devices

(Tiramani, Colosio, & Colombi, 2007). Accordingly, workers are likely to use

personal protective devices regularly when they are made available, affordable

and comfortable on the workers. Moreover, workers who have high knowledge or

receive training in the use of these devices observe better self-protection than

workers who do not benefit from such education. Similarly, Green‐McKenzie,

Gershon, and Karkashian (2001) found a strong positive relationship between the

availability of PPE and infection control practices among some health care

workers. According to Green‐McKenzie, et al. these workers are likely to always

wear PPE when such devices were made available all the times. Conversely,

Carpenter, Lee, and Stueland (2002) found in their availability and use of PPE

study that in spite of readily accessibility to PPE, there was very minimal use of

21
these devices. Accordingly, the availability of PPE does not necessarily translate

into increased utilization among workers, especially young ones.

In fuel chemicals exposure, Jo-Yu, and Stuart (2010) indicated that fuel

truck drivers had the highest uptake through inhalation based on the personal

measurements. To complicate matters, those drivers with no use of respiratory

protectors had higher uptake rate than those drivers using respirators. In addition,

fuel station attendants were recorded to have had highest uptake through skin

exposure. Attendants using gloves had less exposure through skin than attendants

who do not wear gloves. Besides, Jo-Yu, and Stuart are of the view that

gasoline/petrol has the highest permeation rate among the fuels and that the use of

the best PPE is the safest means to protect lives. Moreover, in examining the

provision and use of PPE, Mathew, et al. (2008) found that paramedics in

California were provided safety devices more often than paramedics in the United

States as a whole. Accordingly, for each type of device available, there was a 40%

increase in the use when the device was always provided compare with when it

was not always provided. Mathew, et al. and Reed, Browing, Westneat, and Kidd

(2006) are also of the opinion that lack of access to safety equipment is the major

barrier to their use. Hence, they suggested that inadequate provision and failure to

use self-protective devices may be contributing significantly to the increase rate

of injury and illness among the workers. Thus, provision and use of PPE becomes

essential in protecting the health and safety of workers.

Disease Prevention

Human health and well-being is affected by a plethora of factors. Among

the factors that influence human health include the kind of food eaten, the type

and among of water they drink, among and quality of rest, exercise and whether

22
they smoke and/or drink alcohol. Workplace conditions and the type of work also

affect human health and vitality (Aldana, et al., 2005). At work, humans may be

exposed to different hazards that cause various illnesses. In addition, humans

carry out activities at their workplaces that result in various degrees of accidents

and injuries (Commission on Health and Safety and Workers’ Compensation,

Labor Occupational Safety and Health & Labor Occupational Health Program,

2010). Thus, work and work environment become important to human health and

well-being. More than half of very nation’s population engages in work of various

kinds. This segment of the population contributes in great measure to the

personal, family and economic development and sustainability of their families

and their nations (Carnethon, et al., 2009). Moreover, workplace health promotion

(WHP) interventions do not only provide for the health and safety support of the

workers and their families, such interventions “proved beneficial for budgets and

productivity as well” (Baicker, Cutler, & Song, 2010, P. 1). Therefore, providing

effective health promotion interventions or disease prevention measures at the

worksite become the “heart” for the survival of very organizations and nation.

The workplace then becomes much a suitable setting for providing “appropriate”

disease prevention interventions for workers and even their families.

Available WHP evidence indicates that many of such interventions

resulted in preventing various illnesses. WHP interventions addressed both

communicable and non-communicable diseases. They address multiple health risk

factors from which workers have the options to participate in the programme(s)

that best suit their health needs and interest (Carnethon, et al., 2009).

Interventions of such nature may address health issues such as prevention of

cardiovascular diseases (CVD), regular physical activity, smoking and alcohol

23
cessation and prevention, nutrition education, stress management and reduction

among others (International Labour Organization, 2013).

A Cochrane review of workplace interventions for smoking cessation

revealed that interventions that targeted behaviour modification resulted in better

outcomes than incentive schemes and company repetitions (Cahill, Moher, &

Lancaster, 2008). This review identified 51 studies in the literature and covered

53 different interventions between 1966 and 2008. Thirty-seven of these

interventions focused on workers’ behaviour modification strategies such as

group therapy, self-help materials, individual counseling, pharmacological

treatment for nicotine addiction and social support. The rest of these studies

included interventions aimed at modifying the workplace and included incentive

schemes and company competitions. Cahill and colleagues concluded that

treatments that targeted individual smokers like group counseling and

pharmacological agents were most successful. Their review proved that

participant quit rates and sustained cessation rates for 6 to 12 months after the

intervention were comparable to those when interventions were implemented in

other settings, targeting incentive schemes and company repetitions.

Regular physical activity participation is also evidenced to promote and

maintain health and prevents the development of cardiovascular disease risk

factors and related chronic diseases (Haskell, et al., 2007). Physical activity

opportunities can be sought during leisure time and can also arise in response to

occupational duties. However, the workplace now serves more a sedentary

environment rather than providing opportunities for workers to regularly engage

in physical activity. Researchers recently reported that less active adult workers

who exclusively used stairs in place of elevators at work demonstrated increases

24
in cardiorespiratory fitness and reductions in body weight, waist size, and blood

pressure (Meyer, et al., 2008). In addition, the participants increased from 5 to 23

per day the average daily number of floors ascended or descended. In a similar

study, a worksite intervention that provided pedometers to workers to achieve

10,000 steps daily succeeded in increasing physical activity, weight loss and

reducing blood pressure (Gemson, Commisso, Fuente, Newman, & Benson,

2008). Adopting a similar intervention, Goris (2008) reported that the combined

use of an accelerometer and World Wide Web site that tracked activity also

improved physical activity behaviours in previously sedentary employees.

Worksite stress management programmes have also been suitable for

preventing and improving health of workers (Linnan, et al., 2008). Approaches

such as cognitive behavioural therapy, relaxation techniques, and individual

counseling focused on adopting healthy lifestyles are effective to equipping the

worker with skills for managing job pressures and demands (van der Klink,

Blonk, Schene, & van Dijk, 2001). A systematic review of the job-stress literature

revealed that the greatest impact occurred when the intervention was both

organizationally and individually focused (Lamontagne, Keegel, Louie, Ostry, &

Landsbergis, 2008). Although individual-centered approaches may favourably

modify behavioural issues such as smoking cessation or sedentary behaviours,

they are less likely to reduce workplace stress because they do not address the

organization or workplace management approach (Noblet, & LaMontagne, 2006).

Moreover, Egan, et al. (2007) reviewed 18 relevant studies, 11 of which noted

improvements in health and none reported adverse health effects. However, the

authors acknowledged that the organizational interventions were complemented

by health education efforts. Also prospective study of ischemic heart disease

25
events associated with employees subjected to different approaches of supervision

gives insight into potential interventions and the role of organizational policy.

Employees whose supervisors provided clarity in goals and role expectation,

communicated well, offered feedback about performance and encouraged

employee participation and control were significantly less likely to experience

acute myocardial infarction and unstable angina (Church, Earnest, Skinner, Blair,

2007).

Reducing these chronic diseases and their underlying risk factors through

good nutritional practices may result in economic benefits, decreased healthcare

costs, and greater employee productivity in the workplace. Two reviews evaluated

studies detailing the effects of worksite wellness interventions and reported that

availability of nutritious foods, point-of-purchase information, systematic

reminders and training of healthcare providers to provide nutrition counseling,

and incentives encouraged the purchase of nutritious foods (Matson-Koffman,

Brownstein, Neiner, & Greaney, 2005; Seymour, Yaroch, Serdula, Blanck, &

Khan, 2004). The intervention strategies varied from providing health education

opportunities, changing the availability of healthy foods, and providing incentives

such as lower prices, games, and prizes, most of which were associated with

favourable outcomes (Seymour, et al., 2004). Thus, multivariable interventions

are necessary for favourable outcomes in disease prevention.

Disease prevention is an integral portion of OHS programmes. WHP

programmes do not only benefit the worker health and safety and worker’s

families, such interventions increase worker moral, productivity, and reduce

health care cost. They provide such services that reduce employee risk behaviours

such as smoking, alcohol use, promote regular physical activity, and stress

26
management and reduction interventions. These interventions are protective

against ill conditions of overweight and obesity and CVD. In addition, insurance

and compensation costs are reduce while corporate image of such organizations is

lifted give competitive business advantage.

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