Issue of Compliance with Use of Personal Protective Equipment among Wastewater Workers across the Southeast Region of the United States
Abstract
:1. Introduction
2. Materials and Methods
2.1. Recruitment Procedure and Participants
2.2. Questionnaire Development
2.3. Statistical Analyses
3. Results
3.1. Description of Study Participants
3.2. Participant’s Knowledge of PPE and Occupational Exposures at Their Wastewater Facility
3.3. Perceived Susceptibility and Severity of Contracting an Occupational Illness
3.4. Perceived Benefits and Barriers of Wearing PPE
3.5. Cues to Action and Self-Efficacy of PPE Compliance
3.6. Managers’ Beliefs, Attitudes, and Practices on Enforcing PPE Compliance
3.7. Predictors to Increase PPE compliance
4. Discussion
4.1. Strategies to Improve PPE Compliance among Wastewater Workers
4.2. Limitations
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Acknowledgments
Conflicts of Interest
References
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Variables | Frequency (n) | Percent (%) |
---|---|---|
Gender a | ||
Male | 230 | 84.9 |
Female | 31 | 11.4 |
Other | 1 | 0.4 |
Age (years) a | ||
18–25 | 10 | 3.7 |
26–30 | 23 | 8.5 |
31–35 | 25 | 9.2 |
36–40 | 31 | 11.4 |
41–45 | 42 | 15.4 |
46–50 | 38 | 14.0 |
51–55 | 38 | 14.0 |
56–60 | 32 | 11.8 |
>60 | 24 | 8.8 |
Experience in the Wastewater Industry a | ||
Less than a year | 10 | 3.7 |
1–5 years | 63 | 23.2 |
6–10 years | 33 | 12.1 |
11–15 years | 45 | 16.5 |
16–20 years | 43 | 15.8 |
Over 20 years | 67 | 24.6 |
Prior Training on PPE b | ||
Familiarization Training (i.e., proper use and care of PPE) | 173 | 63.6 |
Basic Safety Training (i.e., purpose of PPE) | 243 | 94.2 |
Hazard Communication (i.e., chemical safety) | 171 | 62.9 |
Supervisor Safety Training (i.e., keeping employees safe) c | 108 | 41.9 |
Advanced PPE Training (i.e., OSHA training) | 123 | 48.1 |
Questions from Section I | Responses (n) | Percent (%) |
---|---|---|
Q1: Do you wear PPE every time you are at work? | ||
Yes | 217 | 79.8 |
No | 55 | 20.2 |
Q1a: If yes, which of the following PPE are mandatory for you to use? a | ||
Safety Shoes | 203 | 82.5 |
Gloves | 181 | 74.0 |
Safety Goggles | 153 | 62.6 |
Hardhat | 122 | 50.0 |
Earmuffs/earplugs | 118 | 48.4 |
Work suit/Coveralls | 75 | 30.5 |
Respirators/Facemasks | 70 | 28.5 |
None of the above | 13 | 5.3 |
Q2: Do you know there are occupational exposures/events at your facility that can cause injuries or harm to your health and/or the health of your fellow workers? | ||
Yes | 262 | 96.3 |
No | 10 | 3.8 |
Q2a: If yes, which are the following occupational exposures/events do you know can cause injuries or harm to your health and/or the health of your fellow workers? a | ||
Slips and falls | 253 | 97.3 |
Chemical hazards | 239 | 91.9 |
Abrasions | 237 | 91.2 |
Blood-borne pathogens | 233 | 89.6 |
Electrical shock | 230 | 88.5 |
Confined Space | 229 | 88.1 |
Excessive noise levels | 227 | 87.3 |
Fires and explosions | 222 | 85.4 |
Respiratory issues | 208 | 80.0 |
Needles | 192 | 73.8 |
Vector-borne diseases | 189 | 72.7 |
Discomfort and psychological problems | 182 | 70.0 |
Musculoskeletal injuries | 181 | 69.6 |
Chronic poisoning | 170 | 65.4 |
UV radiation exposure | 158 | 60.8 |
Burns by steam or hot vapors | 134 | 51.5 |
HBM Constructs (Section II) | Strongly Agree (%) | Agree % | Neither Agree nor Disagree % | Disagree % | Strongly Disagree % |
---|---|---|---|---|---|
Q1–Q6: Perceived Susceptibility | |||||
I believe my chances of developing an occupational illness are great | 9.6 | 34.9 | 25.4 | 23.9 | 6.3 |
I worry about getting an occupational illness | 7.4 | 31.6 | 25.7 | 26.1 | 9.2 |
I feel that I have good chance of getting an occupational illness in my career | 7.4 | 27.2 | 33.5 | 25.4 | 6.6 |
I know people in this career field who have an occupational illness | 7.0 | 33.8 | 21.3 | 28.7 | 9.6 |
Small exposures to occupational hazards won’t lead me to an occupational illness | 1.8 | 11.8 | 19.1 | 46.0 | 21.3 |
I can prevent an occupational illness | 24.6 | 43.4 | 19.1 | 9.6 | 3.3 |
Q7–Q13: Perceived Severity | |||||
The thought of getting an occupational illness is deeply concerning | 7.7 | 38.2 | 27.2 | 20.6 | 6.3 |
If I developed an occupational illness, my career would be in jeopardy | 8.8 | 48.2 | 25.0 | 15.8 | 2.2 |
Problems I would experience from an occupational illness would last a lifetime | 11.4 | 43.4 | 34.6 | 8.4 | 2.4 |
An occupational illness will not lead to permanent changes in my health | 2.9 | 9.9 | 25.4 | 43.4 | 18.4 |
My financial security would be endangered if I developed an occupational illness | 22.4 | 47.8 | 16.2 | 11.4 | 2.2 |
I believe I could die prematurely if I developed an occupational illness | 11.8 | 41.2 | 35.3 | 8.8 | 2.9 |
I am afraid to even think about getting an occupational illness | 6.6 | 17.6 | 34.2 | 32.4 | 9.2 |
Q14–Q17: Perceived Benefits | |||||
Wearing PPE will prevent future health problems for me | 19.1 | 52.6 | 16.1 | 8.8 | 3.3 |
PPE prevents exposure to the kinds of hazards I am around on the job | 21.7 | 54.0 | 12.9 | 8.5 | 2.9 |
I don’t worry about getting an occupational illness when wearing PPE | 7.4 | 31.6 | 26.8 | 28.7 | 5.5 |
I benefit by wearing PPE | 32.7 | 56.3 | 7.4 | 2.2 | 1.5 |
Q18–Q25: Perceived Barriers | |||||
Wearing PPE is uncomfortable | 4.0 | 39.7 | 30.5 | 22.1 | 3.1 |
PPE interferes with my ability to do my job | 0.4 | 19.1 | 34.2 | 39.3 | 7.0 |
PPE is not always available to me | 2.7 | 11.4 | 9.6 | 45.2 | 30.9 |
My coworkers would make fun of me for wearing PPE | 1.1 | 4.8 | 6.6 | 51.8 | 35.7 |
My supervisor seldom wears PPE when required | 4.0 | 8.5 | 18.0 | 42.3 | 27.2 |
My supervisor is aware of my compliance with PPE guidelines | 26.5 | 58.5 | 9.9 | 2.9 | 2.2 |
I would need to develop a new habit for wearing PPE, and that is difficult | 1.5 | 10.3 | 16.5 | 50.7 | 21.0 |
Wearing PPE is just too inconvenient for me | 1.1 | 3.7 | 9.6 | 54.8 | 27.2 |
Q26–Q34: Cues to Action | |||||
A reminder from my supervisor everyday would be important to my wear of PPE | 5.1 | 25.3 | 28.7 | 26.1 | 14.7 |
My supervisor checking on me would improve my wear of PPE | 4.4 | 31.2 | 23.5 | 29.0 | 11.8 |
OSHA fining me or my employer for NOT wearing PPE is important | 18.4 | 46.7 | 22.4 | 8.1 | 4.4 |
Posters in my facility would serve as important reminders to wear PPE | 11.4 | 52.2 | 25.7 | 8.5 | 2.2 |
The threat of disciplinary action is an important factor in ensuring I wear PPE | 14.7 | 39.3 | 21.0 | 20.2 | 4.8 |
Having PPE at location of hazard is critical to ensure that I wear it | 21.0 | 54.4 | 14.7 | 8.8 | 1.1 |
If I see others wearing PPE in my area, then it reminds me to use it | 14.3 | 58.5 | 15.1 | 10.7 | 1.5 |
Regular and frequent education on the importance of PPE improves how often I wear it | 18.0 | 52.3 | 18.8 | 9.2 | 1.5 |
My supervisor sets the example on wearing PPE when being exposed to hazards | 18.0 | 48.9 | 22.4 | 5.5 | 5.1 |
Q35–Q39: Self-Efficacy | |||||
I am confident that I will remember to use PPE when I am exposed to hazards at work | 30.9 | 59.9 | 6.3 | 2.2 | 0.7 |
I am confident I can obtain the proper PPE when I am exposed to hazards at work | 33.8 | 59.6 | 3.7 | 2.2 | 0.7 |
I am confident that my job performance will NOT be impacted by wearing PPE | 23.9 | 48.5 | 15.8 | 8.8 | 2.9 |
I am confident that the PPE I use when I am exposed to hazard is the proper equipment to protect my health | 22.4 | 61.4 | 11.8 | 2.2 | 2.2 |
I am confident that after wearing the proper PPE throughout my career will prevent me from getting an occupational illness | 13.2 | 39.7 | 33.1 | 11.8 | 2.2 |
Section III Questions | Response | Frequency (n) | Percent (%) |
---|---|---|---|
Q40: How often do you enforce wearing personal protective equipment? | |||
Always | 68 | 55.3 | |
Very often | 40 | 32.5 | |
Sometimes | 13 | 10.6 | |
Rarely | 0 | 0 | |
Never | 3 | 2.4 | |
Q41: How often do you set the example on wearing personal protective equipment when being exposed to hazards? | |||
Always | 76 | 61.8 | |
Very often | 35 | 28.5 | |
Sometimes | 10 | 8.1 | |
Rarely | 1 | 0.8 | |
Never | 1 | 0.8 | |
Q42: How often are you aware of your employee’s compliance to wear personal protective equipment? | |||
Always | 50 | 40.6 | |
Very often | 53 | 43.1 | |
Sometimes | 18 | 14.6 | |
Rarely | 2 | 1.6 | |
Never | 0 | 0 | |
Q43: How often do you threaten disciplinary action if personal protective equipment regulations are not followed? | |||
Always | 18 | 14.6 | |
Very often | 23 | 18.7 | |
Sometimes | 32 | 32.2 | |
Rarely | 19 | 15.4 | |
Never | 31 | 25.2 | |
Q44: How often do you ensure that personal protective equipment is available for your employees? | |||
Always | 85 | 69.1 | |
Very often | 23 | 18.7 | |
Sometimes | 12 | 9.8 | |
Rarely | 1 | 0.8 | |
Never | 2 | 1.6 | |
Q45: How often do you provide frequent and regular education on the importance of personal protective equipment? | |||
Always | 38 | 30.9 | |
Very often | 43 | 35.0 | |
Sometimes | 34 | 27.6 | |
Rarely | 3 | 2.4 | |
Never | 5 | 4.1 |
Univariate Linear Regression Model | ||||
Predictor Variable | Estimate | Standard Error | p-Value | 95% CI |
Knowledge level | 0.05 | 0.04 | 0.16 | (−0.02, 0.13) |
Experience in the wastewater industry | −0.14 | 0.13 | 0.30 | (−0.41, 0.14) |
Perceived susceptibility | 0.16 | 0.05 | 0.01 | (0.04, 0.27) |
Perceived severity | 0.20 | 0.05 | 0.00 | (0.10, 0.30) |
Perceived benefits | 0.06 | 0.08 | 0.48 | (−0.12, 0.24) |
Perceived barriers | −0.03 | 0.04 | 0.45 | (−0.11, 0.05) |
Cues to action | 0.05 | 0.03 | 0.11 | (−0.01, 0.11) |
Self-efficacy | 0.06 | 0.06 | 0.30 | (−0.06, 0.19) |
Management impact on PPE compliance | 0.00 | 0.08 | 1.00 | (−0.17, 0.17) |
Multiple Linear Regression Model | ||||
Predictor Variable | Estimate | Standard Error | p-Value | 95% CI |
Knowledge level | 0.04 | 0.06 | 0.52 | (−0.08, 0.16) |
Experience in the wastewater industry | −0.07 | 0.15 | 0.64 | (−0.40, 0.26) |
Perceived susceptibility | 0.11 | 0.06 | 0.10 | (−0.02, 0.24) |
Perceived severity | 0.20 | 0.06 | 0.01 | (0.06, 0.33) |
Perceived benefits | −0.02 | 0.16 | 0.92 | (−0.37, 0.33) |
Perceived barriers | 0.02 | 0.04 | 0.62 | (−0.07, 0.11) |
Cues to action | −0.03 | 0.03 | 0.39 | (−0.09, 0.04) |
Self-efficacy | 0.05 | 0.06 | 0.63 | (−0.18, 0.27) |
Management impact on PPE compliance | 0.02 | 0.06 | 0.81 | (−0.12, 0.15) |
Predictor Variable | Responses | Estimate | Standard Error | p-Value | 95% CI |
---|---|---|---|---|---|
How often do you enforce wearing PPE? | Always | - | - | - | - |
Very often | 0.35 | 0.47 | 0.47 | (−0.67, 1.37) | |
Sometimes | −0.72 | 0.72 | 0.34 | (−2.29, 0.85) | |
Rarely | * | * | * | * | |
Never | 0.90 | 1.81 | 0.63 | (−3.05, 4.85) | |
Intercept | 3.58 | 0.40 | <0.0001 | (2.72, 4.45) | |
How often do you set the example on wearing PPE? | Always | - | - | - | - |
Very often | −0.13 | 0.29 | 0.66 | (−0.76, 0.50) | |
Sometimes | −1.81 | 0.43 | 0.00 | (−2.73. 0.88) | |
Rarely # | 1.14 | 0.34 | 0.01 | (0.41, 1.87) | |
Never # | 3.14 | 1.81 | <0.0001 | (2.41, 3.87) | |
Intercept | 3.86 | 0.40 | <0.0001 | (3.13, 4.59) | |
How often are you aware of your employee’s compliance to PPE guidelines? | Always | - | - | - | - |
Very often | 0.15 | 0.97 | 0.88 | (−1.97, 2.27) | |
Sometimes | 0.10 | 1.20 | 0.94 | (−2.52, 2.71) | |
Rarely | 1.09 | 2.50 | 0.67 | (−4.35, 6.53) | |
Never | * | * | * | * | |
Intercept | 3.59 | 0.64 | 0.00 | (2.19, 4.99) | |
How often do you threaten disciplinary action if PPE regulations are not followed? | Always | - | - | - | - |
Very often | 0.21 | 0.85 | 0.81 | (−1.64, 2.05) | |
Sometimes | 1.13 | 1.09 | 0.32 | (−1.23, 3.50) | |
Rarely | 0.23 | 0.80 | 0.78 | (−1.52, 1.98) | |
Never | −0.07 | 0.60 | 0.91 | (−1.38, 1.24) | |
Intercept | 3.32 | 0.69 | 0.00 | (1.81, 4.84) | |
How often do you ensure you have PPE available for your employees? | Always | - | - | - | - |
Very often | 0.08 | 0.54 | 0.88 | (−1.08, 1.25) | |
Sometimes | −1.13 | 0.60 | 0.08 | (−2.43, 0.17) | |
Rarely # | 3.31 | 0.36 | <0.0001 | (2.54, 4.09) | |
Never # | 1.81 | 0.36 | 0.00 | (1.04, 2.59) | |
Intercept | 3.69 | 0.36 | <0.0001 | (2.91, 4.46) | |
How often do you provide regular and frequent education on the importance of PPE? | Always | - | - | - | - |
Very often | 0.52 | 1.22 | 0.68 | (−2.13, 3.18) | |
Sometimes | 0.34 | 0.90 | 0.71 | (−1.62, 2.31) | |
Rarely | 1.96 | 1.55 | 0.23 | (−1.42, 5.34) | |
Never | −0.42 | 0.69 | 0.55 | (−1.92, 1.08) | |
Intercept | 3.35 | 0.65 | 0.00 | (1.93, 4.77) |
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Wright, T.; Adhikari, A.; Yin, J.; Vogel, R.; Smallwood, S.; Shah, G. Issue of Compliance with Use of Personal Protective Equipment among Wastewater Workers across the Southeast Region of the United States. Int. J. Environ. Res. Public Health 2019, 16, 2009. https://doi.org/10.3390/ijerph16112009
Wright T, Adhikari A, Yin J, Vogel R, Smallwood S, Shah G. Issue of Compliance with Use of Personal Protective Equipment among Wastewater Workers across the Southeast Region of the United States. International Journal of Environmental Research and Public Health. 2019; 16(11):2009. https://doi.org/10.3390/ijerph16112009
Chicago/Turabian StyleWright, Tamara, Atin Adhikari, Jingjing Yin, Robert Vogel, Stacy Smallwood, and Gulzar Shah. 2019. "Issue of Compliance with Use of Personal Protective Equipment among Wastewater Workers across the Southeast Region of the United States" International Journal of Environmental Research and Public Health 16, no. 11: 2009. https://doi.org/10.3390/ijerph16112009
APA StyleWright, T., Adhikari, A., Yin, J., Vogel, R., Smallwood, S., & Shah, G. (2019). Issue of Compliance with Use of Personal Protective Equipment among Wastewater Workers across the Southeast Region of the United States. International Journal of Environmental Research and Public Health, 16(11), 2009. https://doi.org/10.3390/ijerph16112009