|Year : 2017 | Volume
| Issue : 7 | Page : 867-872
Health education: Effect on knowledge and practice of workplace personal hygiene and protective measures among woodworkers in Enugu, Nigeria
L Ezeugwu1, EN Aguwa2, SU Arinze-Onyia3, TA Okeke2
1 Registry Department, Madonna University, Enugu, Nigeria
2 Department of Community Medicine, College of Medicine, University of Nigeria, Nsukka, Nigeria
3 Department of Community Medicine, Enugu State University College of Medicine, Parklane, Nigeria
|Date of Acceptance||03-Jan-2017|
|Date of Web Publication||8-Aug-2017|
S U Arinze-Onyia
Department of Community Medicine, Enugu State University College of Medicine, Parklane
Source of Support: None, Conflict of Interest: None
| Abstract|| |
Background: There has been increasing incidence of occupational diseases among woodworkers due to exposure to preventable hazards in the workplace. The objective of this study was to determine the effects of health education on the knowledge and practice of workplace hygiene and protective measures among woodworkers in Enugu timber market. Materials and Methods: This was a before and after study conducted among 290 woodworkers using interviewer administered semi-structured questionnaire and manual on workplace hazards prevention. Data were analyzed using Statistical Package for Social Sciences (SPSS) version 17 and P-value of 0.05 was set as the significance level. Results: Two hundred and ninety respondents participated in the study; 282 (97.2%) were males, most completed secondary education and had worked for less than 10 years (71% and 58.3%, respectively). The mean knowledge score of participants pre- and postintervention were 89.5% ± 9.03 and 98.5% ± 1.84, respectively (P < 0.001). Educational status had effect on knowledge of participants (P < 0.001), whereas work experience had no effect (P = 0.285). Preintervention, 37.9% of the participants used protective materials regularly, which increased to 65.8% post intervention (P < 0.001). Personal hygiene practices showed mixed responses most of which improved post intervention. The most common reason for eating in workplace was excessive workload (60.3%), while lack of PPEs (29.3%) and lack of training (23.8%) were the most common reasons for nonuse of PPEs. Conclusion: Majority of the participants had good knowledge of workplace hygiene but had poor use of PPEs. Health education intervention improved the use of PPEs and should be recommended.
Keywords: Health education, Nigeria, personal protective equipment, woodworker
|How to cite this article:|
Ezeugwu L, Aguwa E N, Arinze-Onyia S U, Okeke T A. Health education: Effect on knowledge and practice of workplace personal hygiene and protective measures among woodworkers in Enugu, Nigeria. Niger J Clin Pract 2017;20:867-72
|How to cite this URL:|
Ezeugwu L, Aguwa E N, Arinze-Onyia S U, Okeke T A. Health education: Effect on knowledge and practice of workplace personal hygiene and protective measures among woodworkers in Enugu, Nigeria. Niger J Clin Pract [serial online] 2017 [cited 2019 Nov 15];20:867-72. Available from: http://www.njcponline.com/text.asp?2017/20/7/867/212442
| Introduction|| |
Woodwork is the art of using wood to build or manufacture products. It is an old industry which over time provided a means of livelihood for many families and homes. However, as in most occupations, workers in this industry are exposed to a number of workplace hazards which often result in certain occupational diseases and/or accidents.[2-4] Causes of these hazards are multifactorial and could arise from the wood, work environment, worker, and management.
Wood dust has long been implicated in the pathogenesis of diseases such as pneumonitis, dermatitis, and nasal carcinoma. An uncontrolled woodwork environment constitutes a huge risk for preventable industrial accidents and noise-induced hearing loss. The typical Nigerian woodwork industry is damp and untidy, which creates an ideal environment for the breeding and spread of microorganisms and for industrial accidents.
Carelessness or fatigue on the part of the worker predisposes him to poor concentration and inattentiveness to safety measures, which ultimately could result in high chances of developing occupational diseases. The inability of the management to create an enabling environment for the implementation of prescribed safety measures has been identified as a major factor in the poor safety mechanisms prevailing in most woodwork industries. This in no small measure contributes to high levels of occupational hazards to which the worker is exposed.
In the year 2000, the World Health Organization (WHO) and International Labour Organization (ILO) estimated the work-related deaths as 2 million per year. In addition, over 250 million nonfatal accidents result in work absence every year globally. In Nigeria, the real incidence of workplace accidents, fatalities, as well as deformities are not well documented. However, the result of a 4-year study (1987–1991) reported 2012 cases of industrial injuries in Nigerian factories.
These occupational maladies could be largely controlled through workplace and personal hygiene, use of personal protective equipment (PPE), and health education. The International Occupational Hygiene Association (IOHA) defines workplace hygiene as the discipline of anticipating, recognizing, evaluating, and controlling health hazards in the workplace with the objective of protecting workers' health and well-being and safeguarding the community at large. Closely related to workplace hygiene is personal hygiene which is the act of ensuring that our bodies are kept in clean and good condition. Thus, maintaining a good workplace and personal hygiene is critical in ensuring safety in the woodwork industry.
Furthermore, PPEs, which are by no means substitutes to requisite control measures are useful in mitigating the effects of workplace accidents. Expectedly, for PPEs to be this effective, the correct types and sizes should be available at all times to enable consistent use and workers should be trained on how to use them. Studies have, however, shown that majority of workers in the woodwork industry work under extremely hazardous conditions without the use of appropriate protective clothing., This highlights the need for concerted efforts geared towards enabling consistent use of appropriate PPEs by woodworkers while at work.
Health education is essential in achieving a safe work environment. As has been reported, workers who are exposed to regular health education are less vulnerable to occupational hazards than their counterparts who are not similarly disposed. Most workers in developing countries are not trained on safety measures and many are unaware of the hazards they face daily in their workplace. This study aimed at determining the effects of health education on knowledge and practice of workplace personal hygiene and protective measures among woodworkers in a timber market. It is hoped that findings will inform policy decision aimed at improving safety and health of this group of workers.
| Materials and Methods|| |
The study was a before and after study conducted among woodworkers in Enugu timber market between June 2014 and January 2015. Two hundred and ninety woodworkers who gave informed consent participated in the study. Simple random sampling method was used to select four lines out of the six lines in the market. Each line had an average of 80 shops. Using cluster sampling, all the traders in the selected lines were invited to participate in the study. The study was carried out in three phases. Preintervention survey done within the first week of June 2014 using a pretested interviewer-administered questionnaire. The pretest was done among woodworkers in a timber market in Imo state. The questionnaire which was prepared by the researchers in English was translated to the native language (Igbo) and back translated to English by an independent language specialist. Health education intervention using a manual on workplace hazards prevention done on a shop after shop in an one on one basis, and was carried out at different times and dates over a period of 6 weeks, which was concluded in July 2014. Educational content included occupational hazards of woodworking, work place and personal hygiene, and the use of PPE. Lessons were delivered by the researchers in both English and Igbo. Postintervention survey done 6 months later in January 2015 with the same questionnaire used in the preintervention survey.
Ethical Permission for the study was obtained from the Ethics Committee of University of Nigeria Teaching Hospital, and written informed consent was obtained from both the management and workers of Enugu timber market Association. Every positive knowledge was scored 1 while every negative knowledge was scored 0. Data were entered and analyzed using the Statistical Package for Social Sciences (SPSS) version 17. Results are presented as tables, and chi-square test was used to test for significance. The significance level was P ≤ 0.05.
| Results|| |
A total of 290 wood workers participated in the study; 282 (97.2%) were males and 181 (62.4%) were married. The modal age range was 30–39 years, and most had at least secondary education and had worked for less than 10 years (71% and 58.3%, respectively), [Table 1]. The mean knowledge score of participants pre- and postintervention was 89.5 ± 9.03% and 98.5 ± 1.84%, respectively (P < 0.001), [Table 2].. Educational status had a statistically significant effect on participants' knowledge of workplace hygiene (P < 0.001), while work experience had no significant effect (P = 0.285), [Table 3].
|Table 2: Knowledge of workplace and personal hygiene and protective equipment before and after intervention|
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|Table 3: Educational status and years of experience versus knowledge of workplace hygiene|
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Preintervention, only 37.9% of the participants used protective materials (dust masks model B636 appropriate for control of dust and mist) regularly, which increased to 65.8% post intervention. This change was statistically significant (P < 0.001). Personal hygienic practices improved significantly post intervention (P < 0.05) in all the variables considered. Regarding workplace hygiene, dust control by floor wetting improved significantly post intervention; however, although daily sweeping of the workplace improved post intervention, the change was not significant (P = 0.057). The proportion of participants who eat and drink in the workplace reduced significantly at post intervention from 87.9% to 47.9% ([Table 4]). The most common reason for eating in the workplace was excessive workload (60.3%), [Table 5] whereas nonavailability of PPEs (29.3%) and lack of training (23.8%) were the most common reasons for nonuse of PPEs ([Table 6]).
|Table 4: Workplace personal hygiene and use of protective measures before and after intervention|
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|Table 5: The most important reasons for eating and drinking in the workplace|
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|Table 6: The most important reasons for not wearing personal protective equipment|
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| Discussion|| |
Expectedly, over 97% of the respondents were males. This is probably because most risky occupations particularly those involving heavy-weight lifting such as woodwork are commonly male dominated. To potentiate this, in a recent study in Ghana among a similar group of workers, all the respondents were males.
Almost 90% of the present respondents had good knowledge of workplace hygiene and protective measures. This is similar to findings from previous studies where over 90% of the respondents had good knowledge of workplace hazards and hygiene., However, the present finding is higher than the report from Oyo State, Nigeria where only 57.6% of the respondents showed good knowledge of hazards and hygiene practices of workplace.
Though the workplace in Oyo State was among carpenters and may be different from the present study workplace; this finding may signify an improvement in the awareness of workplace hygiene and hazards over the years, which could be attributed to the general massive improvement in communication and information sharing techniques all over the world. In addition, contributions from interventional studies such as the present one could have positively impacted on workers knowledge as the years rolled by. The study population was selected from urban dwellers and this also could have contributed to the high knowledge in the present study.
The knowledge score rose to almost 99% at the post intervention survey. Thus, the difference between the preintervention and postintervention knowledge score was statistically significant. This is in line with previous reports that showed that health education is a known process of significantly improving knowledge.
In the present study, as in previous studies, level of education was positively correlated with te knowledge of workplace hygiene., This is not surprising as high level of education has always been known to positively affect health and people with higher educational qualifications are often better aware of the environmental factors that may endanger their health and are hence more likely to apply preventive measures. Contrary to expectations, there was no significant relationship between years of experience and knowledge of workplace hygiene. This could be because the knowledge of workplace hazards was generally high among the respondents such that the minor variations contributed by years of experience was not high enough to make a statistical significant difference. Second, younger workers with less experience are more likely to learn about workplace hazards from social media and other means of communication than the older workers. Knowledge of workplace hygiene naturally should increase with years of experience, as reported by a study, which found a significant relationship between years of experience and knowledge of workplace hazards and hygiene.
Consistent and correct use of PPEs has been known to limit occupational hazards and the attendant consequences. Unfortunately, the present finding revealed a low level of PPE use among the respondents in the preintervention survey. Reasons adduced for nonuse of PPEs included among others unavailability of PPEs and the fact that they were not exposed to PPE use when they were learning their trade. Similar level of use has been reported and indicates the need for concerted efforts targeted at ensuring the provision and regular use of PPEs among workers in occupations where they are required. At the postintervention survey, the use of PPEs significantly increased showing that these workers are willing to play their part in protecting themselves at work if they are well informed. Similar positive impact of health education on use of PPEs by workers has been previously documented.
In line with previous findings,, health education intervention significantly improved the practice of personal and workplace hygiene among the respondents, further buttressing the need for regular health education among this group of workers.
Majority of the participants had good knowledge of workplace hygiene, however, had poor knowledge of use of PPE. Health education intervention improved the practice of personal and workplace hygiene and the use of PPE. Regular health education should be carried out among this group of workers.
Financial Source of Support
Conflicts of Interest
There are no conflicts of interest.
| References|| |
Farlex Woodwork. The Free Dictionary. www.thefreedictionary.com/woodwork. [Last accessed on 2016 Nov 11].
Pesch B, Pierl CB, Gebel M, Gross I, Becker D, Johnen G, et al.
Occupational risks for adenocarcinoma of the nasal cavity and paranasal sinuses in the German wood industry. Occup Environ Med 2008;65:191-6.
Adei D, Kunfaa EJ. Occupational health and safety policy in the operations of the wood processing industry in Kumas, Ghana. J Sci Tech 2007;27:159-69.
Ochire-Boadu K, Kusi E, Lawer EA. Occupational hazards and safety practices: A concern among small scale sawmilling indsutries in Tamale metropolis, Ghana. Int J Sci Tech Res 2014;3:234-6.
Aguwa EN, Okeke TA, Asuzu MC. The prevalence of occupational asthma and rhinitis among woodworkers in South-east Nigeria. Tanzania Health Res Bull 2007;9:52-5.
Building and Wood Worker's International (BWI). Fact Sheet: Health and safety management in the woodworking industry. June, 2006 [Last accessed from www.bwint.org on 2016 Feb 2].
Esenwa EC. Epidemiology of eye diseases among timber workers in Owerri, Nigeria. JNOA 2008;14:22-6.
Lerman SE, Flower DJ, Gerson B, Hursh SR. Fatigue risk management in the workplace. J Occup Environ Med 2012;54:231-58.
Jegatheswaran R, Florin I, Ishak I, Lim TW, Geetha R. Respiratory effects in woodworkers exposed to wood coatings dust: A regional evaluation of Southeast Asian countries. J Appl Sci 2014;14:1763-8.
World Health Organization Document (WHO)Hazard prevention and control in the work environment: Air borne dust. WHO. Geneva; 1999. pp. 2-3.
Ezenwa AO. Industrial injuries and safety enforcement activities in Nigerian factories. Niger Med Pract 1997;33:83-8.
International Occupational Hygiene Association (IOHA). www.ohlearning.com/organisations-people/ioha.aspx [Last accessed on 2016 March 14].
Johnson J. What is personal hygiene? Hygiene experts. www.hygieneexpert.co.uk/whatispersnalhygiene.html. [Last accessed on 2016 November 11].
Boy S. Safety of woodworking machinery: benefitting from workers' experience. TUTB Newsletter 2007;28:20-3.
Rongo LMB, Barten F, Msamanga GI, Heederik D, Dolmas MV. Occupational health problems affecting small scale industry workers in Dar-Es-Salaam, Tanzania. Occup Med 2004;54:42.
Bankole AR, Lawal IO. Perceived influence of health education on occupational health of factory workers. Br J Arts Soc Sci 2012;8:57-65.
Ennin IE, Adzaku FK, Dodoo D, Adukpo S, Antwi-Boasiako C, Antwi DA. A study of lung function indices of woodworkers at the Accra timber market in Ghana. Donnish J Med Med Sci 2015;2:120-4.
Kripa RH, Sachdev R, Malllure ML, Saiyed HN. Knowledge, attitude and practices related to occupational health problems among salt workers working in the Desert of Rajasthan, India. J Occup Health 2005;47:85-8.
Amosu AM, Degun AM, Atulomah NOS, Olanrewju MF, Aderibigbe FA. The level of knowledge regarding occupational hazards among nurses in Abeokuta, Ogun State, Nigeria. Curr Res J Biol Sci 2011;3:586-90.
Bolaji AO. Analytical study of carpenters' attitude towards safety and occupational health practices in Oyo state of Nigeria. J Ecol 2005;18:99-103.
Arinze-Onyia SU, Onwasigwe CN, Uzochukwu BSC, Nwobi EA, Ndu AC, Nwobodo Ed. The effects of health education on knowledge and attitudes to emergency contraception by female students of a tertiary educational institution in Enugu, South East Nigeria. Nigeria. J Physiol Sci 2010;165-71.
Nasab HSF, Ghofranipour F, Kazemnejad A, Khavanin A, Tavakoli R. Evaluation of knowledge, attitude and behavior of workers towards occupational health and safety. Iranian J Publ Health 2009;38:125-9.
Baker DP, Leon J, Greenaway EGS, Collins J, Movit M. The education effect on population health: A reassessment. Popul Dev Rev 2011;37:307-32.
Ahmed HO, Newson-Smith MS. Knowledge and practice related to occupational hazards among cement workers in United Arab Emirates. J Egypt Public Health Assoc 2010;85:149-67.
Adewoye KR, Awoyemi AO, Babatunde OA, Atoyebi OA, Salami SK, Issa FY. Effect of health education intervention on the awareness and use of personal protective equipment among small scale electric arc welders in Ilorin, Nigeria. Indian J Occup Environ Med 2014;18:3-8.
] [Full text]
Lormphongs S, Morioka I, Miyai N, Yamamoto H, Chaikittiporn C, Thiramanus T, et al.
Occupational health education and collaboration for reducing the risk of lead poisoning of workers in a battery manufacturing plant in Thailand. Indus Health 2004;42:440-5.
Abiola AO, Nwogu EE, Ibrahim MT, Hassan R. Effect of health education on knowledge, attitude and practices of personal hygiene among secondary school students in rural Sokoto, North West, Nigeria. Niger Q J Hosp Med 2012;22:181-90.
[Table 1], [Table 2], [Table 3], [Table 4], [Table 5], [Table 6]