This study sought to determine the prevalence of use of seven types of PPE by road construction workers in Ghana. It also sought to determine the presence or absence of signage related to use of PPE. No site had any type of signage cautioning workers to use PPE of any kind. PPE use was moderate and ranged from most workers using shoes to very few workers using goggles or hearing protection. PPE use varied among the professions, being higher for flagsmen and safety officers and lower for labourers. PPE use varied dramatically by type of company. Workers in foreign-owned companies used all of the seven types of PPE significantly more often than workers in locally-owned companies.
In one of the few prior studies on the topic of PPE use by road construction workers in Africa, Nyende-Byakika studied four road construction sites in Uganda [13]. Interviews with workers and managers were conducted. Self-reported use of PPE ranged from 0% to 20% for the different sites, averaging 14%. Subjectively, many contractors indicated that they felt investing in PPE was not warranted. There have been several other studies that reported PPE use and other aspects of safety among building construction workers in Africa, including Ethiopia and Uganda. Self-reported PPE use ranged from 16% to 38% [8,9,10,11,12].
Prior studies from Ghana have also looked at safety in building construction, but not yet road construction. Ofosu et al., found that PPE use among building construction workers was not encouraging (15% for helmets, 20% goggles among welders and 15% for safety shoes) [17]. Agyekum et al., evaluated factors that influenced the performance of safety programmes in 60 Ghanaian building construction firms, identifying 13 elements that improved safety programmes, such as providing safety managers on site and providing safety orientation training [18].
This study thus adds to the literature on PPE use by constructions workers in Ghana, and especially by road construction workers. It uses direct observation of PPE use, in comparison to the self-report used by the above studies and it reports on use of specific types of PPE. The types of PPE evaluated in the current study protect against injuries (e.g. hard hats and safety boots), as well as lung damage from dust and silica inhalation (e.g. nose masks), and hearing loss (e.g. hearing protection). The effectiveness of the various types of PPE is well documented [15, 16]. It is also notable that one of the above studies from Ethiopia reported an annual prevalence of injury of 32.6%. This was decreased by half by both PPE use and safety training [9].
It is also notable that the current study showed a large difference between foreign-owned and locally-owned companies. Foreign-owned companies might be slightly better resourced than locally-owned companies. The improved PPE use in foreign-owned companies may also be the effect of different management practices. There have been several reports of the effect of different management practices. For example, in Addis Ababa, Ethiopia, Alemu et al. reported that prior training in PPE use and presence of on-site supervisors both increased use of PPE around five-fold each [12]. Nyende-Byakika looking specifically at road construction workers in Uganda reported that, subjectively, workers felt that there was a bigger emphasis on safety by the same companies on bigger projects that had international involvement [13]. A study conducted in Kenya by Mitullah et al. revealed differences in safety practices depending on the type of worker. About 70% of casual workers were not provided with welfare-related facilities and safety materials at most project sites [17].
The current study showed that none of the 19 sites visited had signage about PPE use. One other study on PPE use in road construction in Africa in the literature reported that all four sites studied had signage to warn passing vehicles to slow down, but did not comment on signage about PPE [13].
It is also important to note that similar issues on construction safety pertain in many other low- and middle-income countries. For example, a study of 23 building construction companies in Jordan revealed that only nine had safety policies and most construction sites visited had no evidence of health and safety practices in place, such as posted safety signs or PPE in use [19]. In Honduras, interviews with 108 building construction workers and 18 managers revealed that management did not feel it was in their interests to improve safety, only 25% of companies had safety programmes, and workers rarely used PPE [20]. In Indonesia, a study of 200 construction workers at an airport renovation project showed that only 25% used PPE consistently [21].
The study had the following limitations: First, construction sites were purposively selected, rather than randomly. This was necessary as permission from the government highway authorities and the construction companies was needed in advance. Second, as observations were carried out anonymously and unobtrusively with no interactions with the workers, the only information on the worker’s characteristics that could be gathered was gender and profession. This limited the ability to analyse associations among other worker characteristics and PPE use. Third, observations of PPE use were one time and it was not possible to ascertain usage over time during the course of a shift. Fourth, observations were done only in the middle belt of the country and during the dry season, limiting the ability to make nationwide conclusions or to assess differences in PPE in different seasons, respectively. Finally, it was not possible to ascertain the quality of the PPE observed. This was especially an issue for shoes. It would have been ideal to assess whether workers were wearing steel-toed safety shoes, but with the unobtrusive observations, the best that could be done was to distinguish full shoes from sandals and bare feet. Despite these limitations, the study has the strengths of being one of the first studies to address PPE use in road construction workers in Africa, of having a large sample size, and of using direct observation, which is more reliable than self-report.
