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OBALASE, STEPHEN BABATUNDE
PG/M.Ed/06/41154
PERCEIVED OCCUPATIONAL HEALTH HAZARDS AMONG HEALTH CARE
WORKERS IN GOVERNMENT HOSPITALS IN ONDO STATE
Education
A THESIS SUBMITTED TO THE DEPARTMENT OF HEALTH AND PHYSICAL
EDUCATION, FACULTY OF EDUCATION, UNIVERSITY OF NIGERIA,NSUKKA
Webmaster Digitally Signed by Webmaster‟s Name
DN : CN = Webmaster‟s name O= University of Nigeria, Nsukka
OU = Innovation Centre
2009
UNIVERSITY OF NIGERIA
PERCEIVED OCCUPATIONAL HEALTH HAZARDS AMONG
HEALTH CARE WORKERS IN GOVERNMENT HOSPITALS IN
ONDO STATE
BY
OBALASE, STEPHEN BABATUNDE
PG/M.Ed/06/41154
UNIVERSITY OF NIGERIA, NSUKKA
DEPARTMENT OF HEALTH AND PHYSICAL EDUCATION
SUPERVISOR: PROF. C.E. EZEDUM
MAY, 2009.
1
TITLE PAGE
PERCEIVED OCCUPATIONAL HEALTH HAZARDS AMONG HEALTH CARE
WORKERS IN GOVERNMENT HOSPITALS IN ONDO STATE
BY
OBALASE, STEPHEN BABATUNDE
PG/M.Ed/06/41154
A PROJECT REPORT PRESENTED TO THE DEPARTMENT OF HEALTH AND
PHYSICAL EDUCATION, UNIVERSITY OF NIGERIA, NSUKKA IN
FULFILLMENT OF THE REQUIREMENTS FOR THE AWARD OF MASTER OF
EDUCATION DEGREE (M.Ed) IN PUBLIC HEALTH EDUCATION.
MAY, 2009
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Approval Page
This project report has been approved for the department of Health and Physical
Education, University of Nigeria, Nsukka
By
--------------------------------------------- ----------------------------------------
Prof. C. E. Ezedum Dr. (Mrs.) F. C. Ejike
Supervisor Internal Examiner
--------------------------------------------- ----------------------------------------
External Examiner Prof. Okey A. Umeakuka
Head of Department
----------------------------------------
Prof. G. C. Offorma
Dean, Faculty of Education
MAY, 2009
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Certification
Obalase, Stephen Babadunde, a Postgraduate Student in the Department of Health
and Physical Education with Registration Number PG/M.Ed/06/41154 has satisfactorily
completed the requirements for the degree of masters (M.Ed) in Public Health Education.
The work embodied in this masters project is original and has not been submitted in part or
in full for any diploma or degree of this or any other university.
---------------------------------------- ----------------------------------------
Obalase, Stephen Babadunde Prof. C. E. Ezedum
Candidate Supervisor
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Date Date
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Dedication
This project is dedicated to Ifeoluwa, Marvelous and Oyindamola Obalase.
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Acknowledgements
I am very grateful to my research supervisor, Prof. C. E. Ezedum, for his original
ideas, criticisms, directives, corrections and overall supervision of this research. Free access
to his books and other materials which he allowed me is also much appreciated.
The entire members of staff of the Department of Health and Physical Education,
University of Nigeria, Nsukka, deserve appreciation for the encouragement and co-operation
given to me in the course of this work.
Special thanks go to my wife – Mrs. E. O. Obalase for her patience and logistic
support towards the successful completion of this work. May I also extend my thanks to my
research assistants for their relentless efforts during the period of data collection. Their
assistance will ever be remembered.
My sincere and deep appreciation goes to Mr. Joseph Ikusika for his financial
assistance during my fatal accident along OPI-Nsukka road when I was about to handover
my instrument from field to the computer analyst in the course of data collection and
processing made the task easier.
Finally, I am grateful to the Almighty God for making it possible for me to
successfully complete this programme.
Obalase, Stephen, Babatunde
Department of Health and Physical Education,
University of Nigeria, Nsukka.
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List of Acronyms and Abbreviations
AIDS - Acquired Immune Deficiency Virus
ANOVA - Analysis of Variance
BDFM - Board of Directors for Federal Medical Centre
CMD - Chief Medical Directors
FMC - Federal Medical Centre
FSLC - First School Leaving Certificate
HBM - Health Belief Model
HBV - Hepatitis B Virus
HCWs - Health Care Workers
HIV - Human Immuno Deficiency Virus
HMB - Hospitals Management Board
HWPOHHQ - Health Workers Perception of Occupational Health Hazards
Questionnaire
ICN - International Councils of Nurses
ILO - International Labour Organisation
IOHA - International Commission on Occupational Hygiene Association
NCE - Nigeria Certificate of Education
OAUTHC - Obafemi Awolowo University Teaching Hospital Complex
OH - Occupational Health
OHH - Occupational Health Hazards
OL - Ordinary Level
PEP - Post Exposure Prophylaxis
PPDs - Personal Protective Devices
SARS - Severe Acute Respiratory Syndrome
SD - Standard Deviation
UN - United Nations
UNDP - United Nations Development Programme
UNEP - United Nations Environmental Programme
UNICEF - United Nations International Children‟s Fund
UNNTH - University of Nigeria Teaching Hospital
USA - United States of America
WHO - World Health Organisation
WRPI - Work Related Perception Inventory
WRPs - Work Related Problems
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Table of Contents
Title Page ...............................................................................................................……..i
Approval Page ................................................................................................................ii
Certification ....................................................................................................................iii
Dedication .......................................................................................................................iv
Acknowledgements .........................................................................................................v
List of Acronyms and Abbreviations .............................................................................vi
Table of Contents ......................................................................................................... .vii
List of Tables .............................................................................................................. ix
Abstract ....................................................................................................................... .x
CHAPTER ONE: Introduction ................................................................................ .1
Background to the study……………………………………………………………… 1
Statement of problem………………………………………………………………. …5
Purpose of the Study……………………………………………………… ............ …. 6
Research Questions…………………………………………………………………….6
Hypotheses…………………………………………………………… ........... ………..7
Significance of the Study………………………………………………………………7
Scope of the Study……………………………………………………………………..10
CHAPTER TWO: Review of Related Literature………………………….............10
Conceptual Framework…………………………………………………….………….10
Concept of Health ……………………………………………………………………..11
Concept of Occupational Health Hazard ……………………………………………....12
Perception of Occupation Health Hazard ……………………………………………....22
Measurement of Perception……………………………………………………………24
Demographic Factors Influencing Perception of Hazards ............................................ .25
Theoretical Framework…………………………………………………….………….26
Health Belief Model……………………………………………………………………26
Theory of Reasoned Action……………………………………………………………27
Gestalt Theory of Perception…………………………………………………………28
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Empirical Studies on Perceived Occupational Health Hazards ……………… ……...28
Summary of Reviewed Literature………………………………………….………….34
CHAPTER THREE: Methods……………………………………………………….37
Research Design……………………………………………………………… …........37
Population for the Study………………………………………………………………38
Sample and Sampling Techniques…………………………………………………….38
Instrument for Data Collection………………………………………………………..38
Validity of the instrument…………………………………………………………39
Reliability of instrument…………………………………………………………..39
Method of Data Collection…………………………………………………………….40
Method of Data Analysis………………………………………………………………40
CHAPTER FOUR: Results and Discussion ..............................................................41
Results ............................................................................................................................42
Summary of Major Findings ...........................................................................................60
Discussion of Findings ..................................................................................................62
CHAPTER FIVE: Summary, Conclusions and Recommendations ........................68
Summary of the Study ....................................................................................................68
Conclusions ....................................................................................................................69
Recommendations ..........................................................................................................70
Limitations of the Study ................................................................................................71
Suggestions for Further Research ..................................................................................71
References ......................................................................................................................72
Appendices ....................................................................................................................78
Appendix I – Questionnaire ...........................................................................................81
Appendix II – Population of Health Care Workers in Ondo State ................................82
Appendix III – Two Days Training Programme for Research Assistants .....................83
Appendix IV – Guidelines for the Two Days Training Programmes for the
Research Assistants ............................................................................84
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Appendix V – Measurement and Evaluation for the Research Assistants .....................85
Appendix VI – Letter of Introduction from HPE Dept. ..................................................86
Appendix VII – Reliability Coefficient of the instrument ............................................. 87
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List of Tables
1. Health Workers Perception of Physical Hazards ........................................................ 42
2. Health Workers Perception of Chemical Hazards ....................................................... 43
3. Health Workers Perception of Biological Hazard ....................................................... 44.
4. Health Workers Perception of Mechanical Hazard .................................................... 45
5. Health Workers Perception of Psychological Hazard .................................................. 46
6. HCW Perception of OHH According to Age Group .................................................... 47
7. Influence of Level of Education on the Health Workers Perception of OHH ............. 49
8. Influence of Job Type on the Health Workers Perception of OHH .............................. 51
9. Influence of Gender on the Health Workers Perception of OHH ................................. 53
10. Influence of Location on the Health Workers Perception of OHH ............................ 54
11 Summary of ANOVA Verifying the HCWs Perception of OHH According to Age . 55
12. Summary of ANOVA Verifying the HCWs Perception of OHH According
to Level of Education .............................................................................................. 56
13. Summary of ANOVA Verifying the HCWs Perception of OHH According
to Job Type .............................................................................................................. 57
14. T-test Statistical Table Verifying the HCWs Perception of OHH According
to Gender ................................................................................................................. 58
15. T-test Table Verifying the HCWs Perception of OHH According to Location
of the Respondents ................................................................................................... 59
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Abstract
The main purpose of the study was to identify the perceived occupational health hazards
among health care workers in government hospitals in Ondo State. The socio demographic
factors considered were age, level of education, job type, gender and location. To achieve
the purpose of the study, ten research questions and five null hypotheses were postulated.
Cross-sectional survey design was adopted and purposive sampling procedure was
employed to select 1071 respondents from 20 health institutions owned by governments in
Ondo State. The instrument for data collection was a 55 – item modified 7 – point bipolar
adjective scale questionnaire known as HWPOHHQ. Mean and standard deviation were
used to analyse the data collected. The five null hypotheses postulated for the study were
tested using the t-test and ANOVA at P .05 as applicable. The findings of the study showed
that the health care workers perceived occupational health hazards (OHH) positively in
their work places and that health care workers perception of OHH was dependent on their
age, level of education, job type, gender and location. The study further revealed that many
health care workers could recognize occupational health hazard but failed to take necessary
precaution. Finally, age, level of education, job type, gender and location showed
statistically significant influence on the five dimensions of OHH namely physical, chemical,
biological, mechanical and psychological.
CHAPTER ONE
Introduction
Background to the study
Occupational health been variously defined. It was only in 1950 that a joint World
Health Organization/International Labour Organization Committee offered a definition of
the aims of occupational health which was accepted by the world community: the promotion
and maintenance of the highest degree of physical, mental and social well-being of workers
in all occupations; the prevention among workers of departures from health caused by their
working conditions; the protection of workers in their employment from risks resulting from
factors adverse to health; the placing and maintenance of the worker in an occupational
environment adapted to his physiological equipment and the adaptation of work to man and
of each man to his job. The ultimate objective of occupational health is a healthy and
productive worker free from both occupational and non-occupational diseases. Occupational
health also aims at the social and economic well-being of working people and promotes
healthy, safe and motivating work and work environment (WHO,1953).To achieve such an
objective requires continuous improvement of the conditions of work. Workers in various
organizations were exposed to various occupational hazards in the course of discharging
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their duties. Although every occupation has its unique hazards, most workers do not appear
to recognize these until the manifestation of one health impairment or the other (Egbe,
2004).
Occupational hazard according to Robinson and Davidson (1999) is a risk or danger
accepted as a consequence of the nature or working conditions of a particular job.
Occupational hazard (OH) can also be defined as a risk to a person usually arising out of
employment (Park, 2007).It can also be referred to a situation that predisposes, or causes
accidents or diseases, at a workplace (Oji, 1994). According to Mc Cormic and Ilegen
(1980), occupational hazards, refer to all aspects of work condition, which are injurious to
the health of the workers. For the purpose of this study, occupational hazards are referred to
as all aspects of work condition that are injurious to workers.
Omololu (1997) identified many hazards in Nigerian workplace to include excessive
heat/cold, harmful dusts and spores, toxic chemical exposures, lighting radiation, humidity
and physical workload.
WHO, (1997) indicated that hazards could be either mechanical, ergonomics,
biological, physical, and reproductive. It could also be classified according to allergic
agents- precipitating and predisposing allergic occupational hazard.According to WHO
(2000), the practice of health care exposes health care workers to a variety of work related
hazards. These include; working long hours at a high level of concentration, working in a
sedentary state, non ambulant patient, working with anxious patients, exposure to microbial
aerosols generated by high speed rotary hand pieces and exposure to various chemicals used
in clinical practice. According to Lucas & Gilles (2003) ,occupational health hazard can be
classified as physical, biological, psychological, chemical and mechanical hazards. This
classification of occupational health hazards shall be adopted for this study.
This classification becomes necessary because in developing countries workers may
be exposed to workplace hazards without adequate perception about unsafe working
condition and the necessary precautionary measure to be adopted in order to avert hazards
associated with their workplace (Asogwa, 2000). Asuzu (1994) defined occupational hazard
as when an occupation has an associated hazard. In the context of the present study, it is a
potential danger, with health implications, consequent upon the nature of health profession
.It is therefore referred to as occupational health hazard (OHH).
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Today more than 5 million US hospital workers from many occupations perform a
wide variety of duties. They are exposed to many safety and health hazards (WHO, 1995).
Mechanical factors- unshielded machinery, unsafe structures at the workplace and dangerous
tools are one of the most prevalent environmental hazards in Nigeria health institutions
(WHO,1995).According to the report from WHO (1996) Health workers in Nigeria and
other sub-Sahara desert are exposed to organic and biological agents in the course of
discharging their duties. The fact that most people spend significant part of their lives in the
workplace and are exposed to work related hazards on daily basis, such exposure often
affects the workers welfare, health and productivity negatively (Moses,2005).
Physical hazards are those hazards that produce adverse heat effects by transfer of
physical energy like extreme temperature (heat and cold), noise, extreme light intensity and
radiation, while biological agents capable of creating hazard to health cause diseases.
Psychological hazards are conditions and behaviours that pose threat to the psychological
well being of an individual such as anxiety, stress and depression. Chemical hazards are
chemical agents that contaminate the environment and gain entry into the body through
inhalation, injection, and contact. These chemicals may be in the form of vapour, gases or
fumes. Mechanical hazards are those hazards brought about by use of machines, such as
vibration. This vibration may come from such machines and equipment as X-ray machine,
electro-cardiography machine, magnetic resonance machine and scanning machine among
others. These dimensions of hazards may present further challenges to health profession and
their levels of perception of those hazards may differ (Omololu, 1997).
Perception is a process whereby sensory stimulation is translated into organized
experience (Kanfman, 1973).According to Oladele (1989), it is the process of becoming
aware of the objectives, qualities or relations by way of the sense organs. According to
Hornby (2005), it is the ability to see, hear or understand things or situations; perception is
the basis for the individual judgment; it could therefore be defined as the process of
employing the sense organs to become aware of things, situations or conditions and their
integration into organized experience. In the context of present study, perception is the
process in which sensory experiences are organized and made meaningful. Perception
usually requires that one integrates information from several senses at the same time.
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According to Asogwa (2000), the mental alertness of workers determines their
perception and the levels of perception differ among individuals .However, it has to be noted
that people‟s perception of hazards may exist in different ways. According to Igwe (1998),
some individual know about hazard but may not be aware of it‟s presence; some could
recognize hazard but may not think about it; some may deliberately enter a hazardous
situation after appraising the danger and decide that odds of not being injured favour them;
and some may know about the danger in a hazard but believe that they are personally not
vulnerable to danger. Health workers in government hospitals may be exhibiting such
perceptions.
Hospitals, in the context of the present study, are health institutions for diagnostic,
preventive, curative and rehabilitative health services aimed at promoting the health of the
community members .The totality of the workers working in the hospital that has undergone
specialized training and authorized by appropriate professional bodies to practice health care
services in his or her country to attain health promotion and to achieve overall health goals
are known as health care workers. Any one working in a hospital may become a victim of
hazards, nurses and aides who have the most direct contact with patients are at higher risk
(Oji,1994).Other hospital personnel at increased risk of occupational health hazards include
emergency response personnel, hospital safety officers, and all health care providers.
According to Morris, (1976) occupational health hazards may occur anywhere in the
hospitals, but it is most frequent in the following areas: psychiatric wards, emergency
rooms, waiting rooms and geriatric units. The effects of occupational health hazards can
range in intensity and include the following: minor physical injuries, serious physical
injuries, temporary and permanent physical disability, psychological trauma and death.
Bergh (2003) observed that occurrence of occupational hazards is associated with
such personal factors as age. According to him, there is always a high occupational accident
rate between ages 17 to 28 and in people aged 60 years and above. Maladjustment problems
could lead to emotional instability and risky behaviour he affirmed .Borgman (1971) posited
that occupational health hazard perception changes with individual‟s age because
psychological development is enhanced by maturation and learning. It is important to note
that health workers perception of occupational health hazard appear to be influenced by such
socio –demographic variables as location, age, gender, level of education and job type.
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In a study carried out by Ajala and Bolarinwa (2002) in the South-Western Nigeria,
it was reported that male senior non-teaching staff of Colleges of Education in South-
Western Nigeria perceived more occupational hazard than their female counterparts when
exposed to bureaucracy factors. In the same vein, other independent variables like rank, job
type and level of education of individual may have positive or negative influence on their
perception of occupational hazards.
The brief description of the study area include 14 general hospitals,4 state specialist
hospitals, one Neuro Psychiatric specialist hospital and one Federal Medical Centre in the
state. Basically, the 18 local government areas had one general/specialist hospital as
applicable. In essence, about 20 government health institutions with total of 5,329
workforces are going to be dealt with in this study.
Statement of the Problem
Hospitals use special care in disposing of wastes contaminated with blood and other
body fluids, separating these hazardous wastes from ordinary waste. Hospitals and doctors‟
offices must be especially careful with needles, scalpels, and glassware, called „sharps‟.
Pharmacies discard outdated and unused drugs; testing laboratories dispose of chemical
wastes and specimens collected from patients after prescribed test/ investigation has been
done. Health care professionals also make use of significant amounts of radioactive isotopes
for diagnosis and treatment, and these substances must be tracked and disposed of carefully.
The radiology department is usually coated in black colour and their personnel uses
meter to regulate the amount of radioactive substance absorbed on daily basis to prevent
undue occupational health hazards. The surgeons, nurses and other para-medical staff wear
apron, gloves, goggles and other protective devices at the theatre, labour room and at out
patient department when carrying out procedures. Many dangerous substances can be used
with special precautions that decrease their hazards. When discarded, these substances are
no longer under the direct control of the user and may pose special hazards to people or
other organisms that come in contact with them. As a result of such potential hazards,
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hazardous wastes are processed separately from ordinary wastes. The ability of the health
care workers to have positive perception of those occupational hazards assists them to take
precautionary measure in handling those hazardous substances and objects in the course of
discharging their duties.
The incessant occupational health hazard witnessed and encountered by health care
workers are becoming alarming (WHO, 2006). Occupational health hazard encountered by
health workers include needle stick injuries, hepatitis infection, HIV/AIDS, (SARS) severe
acute respiratory syndrome, cancer of occupational origin due to chemical, physical and
biological exposure to hazards in work place. It is sadden that most of the health workers
have been found not to recognize hazards to their health until signs and symptoms of health
impairment manifest (Egbe, 2004). The situation of things at government hospitals in Ondo
state call for immediate action. The lives of health workers in the state are not safe from the
hand of hooligan especially during cases of road traffic accident at the casualty department,
blood transfusion procedure and during any emergency situation. There were various cases
reported at Nigeria police station where health workers were assaulted by patient relatives.
Many health workers had reported dead as a result of deadly diseases contacted in the course
of discharging their duties in the hospital. Five health workers were reported to have lost
their life during 2008 National Immunization Days (NIDs) in course of discharging their
duties in the riverine area of the state.
Incidentally, no study, to the best of the researcher‟s knowledge has been conducted
in Ondo State regarding perceived occupational health hazards among health care workers in
government hospitals. The questions therefore are; what is the health workers‟ perception of
occupational health hazards? Furthermore, are the occupational health hazards among health
workers depend on variables like age, level of education, job type, gender and location?
These constitute the problem of the present study.
Purpose of the Study
The main purpose of the study was to identify the perceived occupational health
hazards among health care workers in government hospitals in Ondo state. Specifically, the
study aimed to ascertain the:
1. perception of the health workers about physical hazards in their work places;
2. perception of the health workers about chemical hazards;
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3. perception of the health workers about biological hazards;
4. perception of the health workers about mechanical hazards;
5. perception of the health workers about psychological hazards;
6. influence of age on the workers‟ perception of occupational hazards;
7. influence of level of education on the workers‟ perception of occupational hazards;
8. influence of job type on the workers‟ perception of occupational hazards;
9. influence of gender on the workers‟ perception of occupational hazards ;and
10. influence of location on the workers‟ perception of occupational hazards.
Research Questions
The following research questions were stated to guide the study
1. What are the health care workers‟ perceptions of physical health hazards?
2. What are the health care workers‟ perceptions of chemical health hazards?
3. What are the health care workers‟ perceptions of biological health hazards?
4. What are the health care workers‟ perceptions of mechanical health hazards?
5. What are the health care workers‟ perceptions of psychological health hazards?
6. What are the perceptions of various age brackets of the health care workers regarding
occupational health hazards?
7. What are the perceptions of various level of education of the health care workers
regarding occupational hazards?
8. What are the perceptions of various job type of the health care workers regarding
occupational health hazards?
9. What are the perceptions of male and female of the health care workers regarding
occupational health hazards?
10. What are the perceptions of various locations of health care workers regarding
occupational health hazards?
Hypotheses
The following hypotheses were postulated and verified at .05 level of significance.
1 .The health workers‟ perception of occupational hazards is not dependent on their age.
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2. The health workers‟ perception of occupational hazards is not dependent on their level of
education.
3. The health workers‟ perception of occupational hazards is not dependent on their job type
4. The health workers‟ perception of occupational hazards is not dependent on their gender.
5. The health workers‟ perception of occupational hazards is not dependent on their location
Significance of the Study
This study was significant not only to the health care workers, but to the Ondo State
Hospitals‟ Management Board and Board of Directors Federal Medical Centre, Owo; Health
educators and researchers. The result has revealed the perception of health care workers in
Ondo State government hospitals‟ regarding physical hazards. The application of this result
will arouse the health care workers consciousness of the existence of hazards. Such arousal
will help them take preventive measures against physical hazards like assault, avoidance of
sharp and skin piercing instrument, undue exposure to radiation, poor ventilation and trauma
from unsafe environment within hospital.
Information revealed by the study on chemical hazards will help the health care
workers, especially the doctors‟, nurses, pharmacists, technicians, laboratory scientist,
technicians and technologist, health attendants/assistants and other para-medical officers,
become aware of the presence of chemical hazards in their work place. For instance, drugs
may constitute poison; disinfectant may be corrosive, allergic contact dermatitis, delayed
potential effects of chemical and dilapidated building structure. This awareness will make
them become sensitive to the presence of hazards with a view to observing necessary safety
guidelines for protection.
The health care workers will benefit from their perception of biological hazards
established at the end of the study. This is because their possible belief of not being
vulnerable to infection at the workplace will be changed .Furthermore, the Hospitals‟
Management Board (HMB) and Board of Directors for Federal Medical Centre (BDFMC)
will be motivated into initiating intervention programme such as routine immunization for
all clinical staff and provision of special remunerations as hazards allowance/benefit to all
their clinical staff.
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In the same vein, information revealed by the study on mechanical hazards will help
the health care workers, become aware of the presence of mechanical hazards in their
workplace. This awareness will make them become sensitive to the presence of mechanical
hazards when operating diagnostic and therapeutic machines with a view to observing
necessary safety guidelines for protection which include among other things competence,
control, cooperation and efficient communication.
Moreover, the perception of psychological hazards that emerged at the end of the
study will be useful to health care workers. The information will help them perceive the
danger in working under a stressful condition. This will enable them to refrain from
deliberately hazarding a stressful work condition with the belief that odds of not being
injured favour them. It will guide the HMB and BDFMC in designing a recreational
programme as a stress reduction strategy for all health workers. This will also assist the
management to establish occupational therapy department in all government hospitals‟ for
therapeutic and recreational purposes. This study will also assist the hospital ward leaders to
give appropriate number of day off to health workers that are running shift duties.
In terms of age, the result of the study on the perception of old and young health care
workers will help the HMB and BDFMC of hospitals‟ determine occupational promotive
programmes based on age. This is the first organized effort to document empirically
Occupational Health Hazards (OHH) of health care workers in government hospitals in
Ondo State. This will remain a reference point for researchers and stakeholders in the health
sector.
The study established the influence of level of education on health care workers
perception of OHH, researchers and health authorities will use it as a guide for further study.
The findings will be useful in formulating policies regarding the establishment of training
institution for middle cadre health workers, generic or hospital based training of health
workers and tertiary based health care workers about OHH.
The study will be useful to researchers because it will serve as a reference point for
studying the influence of job type regarding health care workers perception of OHH. This
will serve as a guide for future researchers. Attendants/non professional had unfavourable
perception of OHH and this had contributed to their incessant breakdown and undue request
20
for sick off / excuse duty. This finding will help to develop a strategy and intervention
programme to take care of this category of HCWs.
In terms of gender, the result of the study on perception of male and female health
care workers regarding OHH will help the HMB and BDFMC of hospitals to determine
occupational promotive programmes based on gender. This is the first organized effort to
document empirically OHH of health care workers in government hospitals in Ondo State. It
will remain as a base line data for researchers, employers of labour and stakeholders in the
health sector.
The result will be useful to researchers because it will serve as a guide for studying
urban and rural areas regarding hazard perception among HCWs. The researcher was able to
ascertain the influence of location on occupational hazards perception among health care
workers in government hospitals in Ondo State. The HCWs in rural areas had favourable
perception of OHH while those in the urban centres had unfavourable perception of OHH
and this have negative impact in their life. This will enable their employer to intervene into
their situation.
Finally, the significance of this study is built on the theoretical frame work of health
belief model, theory of reasoned action and gestalt theory of perception.
Scope of the Study
The study was on perceived occupational health hazards among health care workers
in government hospitals in Ondo State. It was further delimited to the following types of
occupational hazards; physical, biological, psychological, chemical and mechanical .The
study also explored the influence of such independent variables as age, level of education,
job type, gender and location on health care workers perception of occupational health
hazards. The study is also delimited to the following theories; health belief model, theory of
reasoned action and gestalt theory of perception.
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CHAPTER TWO
Review of Related Literature
Literature on perceived occupational health hazards are available especially in
developed countries. This therefore presents a veritable ground for researchers working with
related concept and problems to search for relevant and enough literature. In the contrary,
studies seeking the influence of socio-demographic variables on health workers‟ perception
of occupational hazards are rare especially in the developing countries. The related literature
for this study is, therefore, presented under the following sub- headings:
1. Conceptual frame work;
Concept of Health
Concept of occupational health hazard
Perception of occupational health hazard
Measurement of perception.
Demographic factors influencing perception of hazards
2. Theoretical frame work
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Health belief model
Theory of reasoned action
Gestalt theory of perception
3. Review of empirical studies on occupational hazards and hazards perception.
4. Summary of literature
Conceptual Framework
Concepts of Health
The WHO (1948) has described health as a state of complete physical, mental and social
well-being and not merely the absence of disease or infirmity. Occupational Health is the
promotion and maintenance of the highest degree of physical, mental and social well-being
of workers in all occupations by preventing departures from health, controlling risks and the
adaptation of work to people, and people to their jobs (ILO/WHO, 1950). According to
them, Occupational health should aim at the promotion and maintenance of the highest
degree of physical, mental and social well-being of workers in all occupations; the
prevention among workers of departures from health caused by their working conditions; the
protection of workers in their employment from risks resulting from factors adverse to
health; the placing and maintenance of the worker in an occupational environment
adaptation of work to man and of each man to his job.
Concept of Occupational Health Hazard
Occupational health is the branch of health science concerned with the promotion
and protection of the health , safety and welfare of workers of all categories (Adeniyi,2002).
Danbenspeck (1974) further viewed occupational health as the study of factors or conditions
influencing the health and well being of the workers not only in their work places but also in
their homes. He also indicated that it was concerned with the detection, evaluation and
control of environmental and safety hazards associated with work environment and their
homes. Occupational health is at the centre of sustainable development as stipulated in
WHO global strategy of Occupational Health for all by the year 2000, (WHO, 2000) this
will enable the workers to know the minimum standard required in any workplace especially
at the health sectors. The prevention of occupational hazards, accidents, injuries and diseases
10
11
23
and the protection of workers against physical and psychological overload. These imply a
parsimonious use of resources, minimizing the unnecessary loss of human and material
resources; the objective of healthy and safe work environment which call for the use of
safest, low-energy, low-emission, low waste (green) technology and in many countries
requires the use of the best available production technology.
The fact that occupational health approach has been shown to facilitate the
undisturbed production that increase the quality of products, productivity and process
management and thus helps to avoid unnecessary loss of energy and materials to prevent
unwanted impact on the environment. The fact that many environmental hazards and
burdens are derived from occupational settings, e.g. hospitals, clinics, industry, agricultural
practices or transportation and services. Experts and others responsible for occupational
health and safety are well informed of processes and agents that may be hazardous to the
environment and often this information is available to them at a very early stage of the
problem, thus enabling primary prevention that is no longer possible into the general
environment.
The impact of occupational health on environment protection in the case of problems
derived from production system is likely to both effective and cost-effective. In many
industrialized countries there are moves to make closer link between occupational health and
environmental health approaches; that occupational health services aim to ensure the health,
safety, working capacity and well-being of the working population. A healthy, productive
and well-motivated workforce is the key agent for overall socioeconomic development.
Moreover, high-quality and productive work can ensure health production of materials,
goods and services, and the consideration and practical implementation of the principles of
sustainable development.
That most environmental health hazards that have been found to affect the health of
the general population were first in the work environment and / or in the working
populations. Thus the occupational environment provides and early warning system for
certain environmental hazards just as it also provides effective models for preventive action.
That for more than half of adults the work environment is most demanding environment in
terms of physical, chemical, ergonomic or psychological stresses and physical workload.
The requirement of the Rio Declaration on healthy and productive life is particularly
24
relevant to the work environment and calls for occupational health action. The state of
general environment and the ecosystem has an impact on the health of workers either
indirectly in several occupations of health professions, agriculture, mining, fishery and
manufacturing. Thus, there is a two-way relationship between occupational health and safety
on the one hand and environmentally sound sustainable development on the other.
Equally important for personal well-being and for socioeconomic development of
communities and countries is an employment policy that ensures access to work for
everyone and enables individuals to sustain themselves and their families by their own.
Highest possible employment is also a key factor in the safe, stable and sustainable social
development of countries while high unemployment rates and others associated problems
endanger such development. In developing countries the health and well-being of the family
is critically dependent on the health and productivity of its working member, thus making
several members of the community dependent on the health of the worker. In a situation
where organized social protection is lacking, the loss of health, life or working capacity of
such a key member of the family, affecting indirectly the well-being, health and economy of
communities at large and of future generations.
Morris, (1976) stated that the knowledge of occupational and industrial health
expose workers, employers, trade unions and the general public to the importance and
relationship of work to health, that of work environment to health, that of attitude, practices
and behaviour at work to health, that of mechanics, equipment and tools to health, that of job
placement to health as well as that of management to health. It also exposes the public to
hazards related to some works and their preventive/ control measures in order to be and
remain safe health while at work and after work.
The health of man in the working environment is the central theme of occupational
health. Its chief goal is the preservation and possible improvement of the health of the work
force which includes everyone from the chief executive officer to the newest unskilled
worker. In other words, the objectives formulated by American Association Council (1971)
include to promote and maintain the highest degree of physical, mental and social wellbeing
of workers within the work place. Also to prevent or minimize deleterious work conditions
and establish regulatory standards for the control of potential and/ or actual hazardous work
conditions.
25
WHO/ILO (1995) asserted that, the most successful economies have demonstrated
that workplaces designed according to good principles of occupational health, safety and
ergonomics are also the most sustainable and productive. Furthermore, wide experience
from countries show that a healthy economy, high quality of products or services and long-
term productivity are difficult to achieve in poor working conditions with workers who are
exposed to health and safety hazards. The available scientific knowledge and practical
experiences of enterprises and countries which have achieved the best results in the
development of occupational health indicate the value of several principles. These principles
are common denominators in occupational setting that have shown the best results in health,
safety, social relations and economic success. Enterprises with such occupational setting are
also the most stable in times of crisis.
The following principles are in international instruments on occupational health and
safety and in the legislations of the countries with the strongest occupational health and
safety traditions: avoidance of hazards - primary prevention, and use of safe technology;
government responsibilities; authority and competence to regulate and control working
conditions; optimization of working conditions; integration of production and health and
safety activities; primary responsibility of the employer or entrepreneur for health and safety
at the workplace; recognition of employees‟ own interest in health at work; cooperation and
collaboration on an equal basis: participation, right to know and transparency; continuous
follow-up and development of working conditions.
According to ILO (1981) occupational safety and health convention No 155 stated
that, key strategy principle of international and national occupational health and safety
policies are, avoidance of hazards ;safe technology; optimization of working conditions;
integration of production and health and safety activities; government‟s responsibility,
authority and competence in the development and control of working condition.
Implementation of such principles requires appropriate legal provisions, administrative
enforcement and service systems for occupational safety and health services.
For occupational health services, the following functional principles are recognized;
prevention and promotion; adaptation and adjustment of working conditions to the worker;
rehabilitation; curative services and acute response (first aid and emergency response). By
implementing such principles occupational health serves as a catalyst for change at the
26
workplace towards the development of better management of production and better control
of hazards at work..
In this study, the term “occupational health” includes the actions for occupational
medicine, occupational hygiene, occupational psychology, safety, physiotherapy,
ergonomics, and rehabilitation. On the other hand, a number of studies have provided
convincing evidence of a positive association between health, well organized work and a
healthy work environment where safety and health are considered and where conditions
conducive to ones professional and social development are provided. It is universally
accepted and confirmed in several documents by the WHO (1995) Global strategy for
Health For All by year 2000, World Bank (1999), International Labour Organization (ILO
1981) and others that every citizens of the world has a right to health and safe work and to a
work environment that enable him or her to live a meaningful and economically productive
life. Virtually all countries are still far from this objective, as evidenced by the high numbers
of occupational hazards and diseases (WHO, 1995).
Several sectors in the society are involved in or have an impact on occupational
health. Intersectoral and inter-agency collaboration is thus needed between various sectors,
such as employers, workers, governments and experts bodies at national level. At
international level more collaboration in issues of occupational health is needed between
WHO and other UN organisation such as International Labour Organization (ILO), United
Nations Environment Programme (UNEP), the United Nations Development Programme
(UNDP), the World Bank and Non Governmental Organisations such as International
Commission on Occupation Hygiene Association (IOHA). According to the principles of the
United nations, WHO and ILO, every citizen of the world has a right to health and safe work
and to a work environment that enable him or her to live a socially and economically
productive life, (WHO, 1995).
According to ILO (1995), occupational health problems are not only problems for
the worker, but above all they are problems of work and the work environment. The work
environment varies greatly according to types of economic activity, occupation, company
and size of workplace. Geographic and climate conditions also have a great impact on the
work environment, particularly in outdoor activities such as fishing, forestry and agriculture.
However, due to differences between the work environments in different countries with
27
otherwise similar socioeconomic and climatic conditions and between different companies
with similar types of production, it has been concluded that a major part (vary according to
the activities and the method of estimate, (50-90%) of occupational health hazards are in
principle preventable. Thus there is much room for prevention in virtually all countries and
particularly in countries with lower standards of occupational health and safety.
Many industrialized countries with the strongest traditions in occupational heath and
safety can show constantly declining trends of occupational hazards and traditional
occupational diseases as in impact of adopting the above principles. Some national and
international industries have adopted a strategy setting zero risk as an objective in the work
environment. Though not totally achievable such a strategy has stimulated programmes and
actions for planning and designing the work environment and working practices according
to the best available technology and principles and carrying out production according to
good practices, operation and maintenance. This has led to substantial reduction of
hazardous exposures at work, elimination or decrease in occupational hazards and diseases,
and saving of costs by reduction of disturb production and cost of sickness. Such
experiences demonstrate that a safe and healthy work environment can be planned,
constructed, organized and maintained if the best occupational healthy and safety standards
are applied. They also demonstrate that a healthy and safe work environment is a realistic
and achievable objective, a positive investment rather than a burden for economy.
Occupational health problems are not only problems of individual workers health, but
they are also problems relating to the healthiness and safety of work and the work
environment, the organisation of work and the management philosophy of the enterprise and
workplace.(WHO,1995). The way that work is organised, the management style, and the
extent to which the workers can determine or regulate his/her work and participate in
decisions about it have been shown in several study to make a positive impact on health,
prevent overload at work, counteract stress and promote work motivation and productivity.
In the midst of rapid change, the need to learn new jobs and new skills requires an
environment which is conducive to learning and adaptation. Effective management of such
changes requires further development of the principles of right to know, transparency,
openness and participation.
28
A number of studies have shown that organized work in this way tends to be
supportive of health and well-being, provides social contacts and gives opportunity for the
development of personal abilities and skills. Such an approach also aims at adjustment of the
workload and other work requirements to match the personal needs and capacities of the
individual worker. This latter objective is particularly important for enabling older
individuals, handicapped persons, chronically ill individuals, pregnant workers and others
with special needs or vulnerability to participate in work. Meeting such multiple criteria for
a “good workplace” also meet the best occupational health standards. There is also recent
evidence on better management of crises caused by economic difficulties of the companies,
uncertainty of jobs, threat of unemployment in organisations which have adopted new
participatory and collaborative principles as a part of organisations management culture.
According to Joint Committee of WHO/ ILO (1995), successful prevention of
occupational health hazards, requires information on the causal relationship between risk
factor and health outcome, knowledge of the mechanism of action of hazardous factors and
conditions; and knowledge of how the causal relationship can be broken. It also requires
resources, tools and mechanisms for the implementation of preventive measures; and
political, managerial and target group support for the preventive programme. Many of these
conditions are met in the modern occupational health approach. Obtaining the needed
support requires effective information and education of several actors and decision-makers
and implies a need to raise awareness on the importance of occupational heath. Knowledge
of mechanism of action and of the causal relationship between exposure principles in the
industrialize countries and international organisations, including WHO, is that all policy and
practical actions should be founded on a “sound scientific basis”.
Successful prevention requires scientific knowledge of the sources, mechanisms of
generation, transmission and magnitude of problems together with technical knowledge and
practical skills for the prevention and control. Thus multidisciplinary expert competence and
practical technical competence should collaborate (WHO/ILO, 1995). The constitution of
WHO stipulates the fundamental right of all people to the highest attainable standard of
health. In addition, article 2 of chapter II of the constitution specifies prevention of
occupational hazards and the promotion of improvement of working condition as functions
of WHO. WHO has had a special programme for occupational health since 1950 and close
29
coordination and collaboration has taken place with ILO. The Alma Ata declaration
emphasized the need to organized primary health care services (both preventive and
curative) “as close as possible to where people live and work”. The declaration emphasized
that in the organisation of such services, high priority should be given to the people most in
need, including the working populations at high risk.
Every nation needs industrialization to develop her economy. Such industries will
produce wastes, accidents and injuries to health. The health of the people must be protected,
promoted and maintained. This is dilemma of industry conscious nation. Industries with
their corresponding economic boost have concomitant threat to the existence of man and
their environment. The components of the work environment in occupational health and
safety are those factors of the work place from which may arise the hazards of work to
health. Achalu (2000) stated that the health hazards inherent in a particular industry or work
place are determined by special features, problems, resources and its circumstance.
The occupational health hazards among health care workers could be understood
from physical-chemical-biological-mechanical and psychological dimensions. A health
hazard, according to Asuzu (1994), is a circumstance which poses a danger to human health
and well-being. This definition is hereby adopted for this study. Occupational hazards is said
to be anything or condition or omission or commission in the work environment which carry
or have the potential of engendering deleterious health condition among workers employed
in such workshop or plant (Nwankwo, 2003).
The health careworkers may be exposed to five types of hazards, depending upon his
occupation. (Nwankwo 2003, Lucas & Gilles 2003, Park 2007): physical, chemical,
biological, mechanical, and psychological hazards. The physical hazards include heat,
noise, accidents, poor ventilation, radiation and pressure. Trauma arising from unsafe
environments accounts for a large proportion of preventable human illness, and noise in the
workplace is responsible for the most prevalent occupational impairment: hearing loss or
permanent deafness. Noise is a health hazards in many industries. The effects of noise are of
two types: auditory effect which consist of temporary or permanent hearing loss and non
auditory effects which consist of nervousness, fatigue, interference with communication by
speech, decrease efficiency and annoyance. Exposure to vibration may also produce injuries
of the joints of the hands, elbows and shoulders. The radiation hazards comprise genetic
30
changes, malformation, cancer, leukaemia, depilation, ulceration, sterility and in extreme
cases death.
Chemical hazards, on other hand, are inorganic materials such as lead, mercury,
arsenic, cadmium, and asbestos, an organic substance such as polychlorinated biphenyls
(PCBs), Vinyl chloride, and the pesticide DDT. Of particular concern is the delayed
potential for the chemicals to produce cancer, as in the cases of lung cancer and
mesothelioma caused by asbestos, liver cancer caused by vinyl chloride and leukaemia
caused by benzene. Minamata disease, caused by food contaminated with mercury, and
Yusho disease, from food contaminated with chlorinated furans are examples of acute toxic
illnesses occurring in non occupational settings. Chemical agents act in three ways which
include local action, inhalation and ingestion.
Local actions of some chemicals cause dermatitis, eczema, ulcers and irritation.
Inhalation of chemical substances comprises of dusts, gases metal and their compound,
which are releases into the atmosphere during crushing, foundry, quarry among others and
strictly hazardous to healthful living. Occupational disease may also result from ingestion of
chemical substances such as lead, mercury, arsenic, zinc, phosphorus and these substances
are swallowed in minute amounts through contaminated hands, food or cigarettes. Much of
the ingested material is excreted through faeces and only a small proportion may reach the
general blood circulation.
The mechanical hazards arise from, the relationship between man and machine and
tools. Those machines used by the health workers were obsolete and capable of causing
more harm than good. The man-machine interphase in the work place must be smooth and
cordial, otherwise, the workers is predisposed to risk of injuries, accidents, deaths, falls,
fractures and dislocations, poor work output, fatigue, body aches, anxiety, stress and trauma.
In hospital environment machine like sterilizer and autoclave are capable of causing burns
and even deformities in severe cases. According to Orji, Fasuba, Onuidiegwa, Dare &
Ogunniyi (2003), about 10 per cent of occupational hazards in hospital environment are said
to be due to mechanical causes like effect of sterilizer and diathermy.
Psychological factors include the responses and behaviour that health workers
exhibit on the job. These behaviours come from the attitudes and values learned from their
culture, life experiences and work site norms. They are the health workers responses to the
31
work and the milieu. Similar work conditions can evoke different responses. Within the
same hospital setting some health workers may seem fatigued, tense, bored, angry,
depressed or agitated while others may seen enthusiastic and energized (Ahasan, 1994).
Repetitive work may bore some people, while others may see it as an opportunity for
reflection. Certain types of work may challenge some but threaten others. Unrealistic
personal expectations and unattainable aspirations can lead to chronic stress and fatigue and
eventual burnout (World Bank,1999). Work that is time sensitive or those conflicts with
personal values may create tremendous stress for some employees (Gough, 1988).
Health workers may be predisposed to the propensity for psychological or
psychosocial hazards like man-man problems of stress, anxiety, frustration and aggression.
The psychosocial problems include: shift work, overload, under-load, repetition and
monotonous assignments, poor remuneration and other benefits, lack of job mobility,
uncondusive work environment, poor health condition, queries, memos, retrenchment, and
enquiries among others.
Regarding the biological hazards, Park, (2007) maintained that health profession
could expose health workers to biological agents and hazards consisting of bacteria, viruses,
fungi, parasites and animals. These can predispose them to the effects of infection,
infestation, and allergy. Such effects are pronounced in the hospital environment. Health
workers are exposed to insect bites, worms, flies and infections and infestations by micro
organisms, causing tetanus, Leptospriosis, schistosomiasis, helminthes infections, allergy,
diarrhea, tuberculosis, streptococcus and Brucellosis (Banford, 1994). Other sources include
over crowding, poor ventilation, poor hygiene and lack of hand washing and lack of waste
disposal facilities in most of our health institutions.
Asogwa (2000) and Nwankwo (2003) asserted that, the hospital environment is a
very hazardous place. The hazards can be classified as endogenous or exogenous.
Exogenous hazards are those brought into the hospital from the outside. For example, a
nurse who has undiagnosed pulmonary tuberculosis may spread this among patients and
staff before a diagnosis is made. Endogenous sources are those that are transmitted to health
care workers from patients (Blood, sera, laboratory specimens) in the course of their work.
Park (2007) maintained that it is convenient to classify hospital hazards according to
their sources. Consequently all health personnel‟s that are exposed to the same sources run
32
the same risks depending on the degree of exposure (ILO, 1990). Hazards due to exposure of
infected blood or other body fluids of patients are: HIV, HBV, HCV, Cytomegalovirus and
protozoa including malaria parasites. Occupational groups among health workers that are
exposed to various occupational health hazards include all those involved in invasive
procedures (doctors, nurses, endoscopists, workers in renal dialysis suites), technicians of
various categories working in different places (theatres, injection room, accident and
emergency department, laboratories and maternity) and cleaners or house keeping staff.
Location of accidents in hospitals environment include wards, theatres, intensive
care units, various clinics, dialysis units, accident and emergency departments, others like
mortuary, and instrument repair workshops. Sources of injuries and occupational hazards
include needles (assorted), lancets, scapel blades, dental material, sterilizers, autoclave and
other skin piercing instruments. Activities associated with accidents include; administrating
or drawing of injections with syringe, wrong disposal of syringe and needles, recapping of
needles and syringes, suturing and related activities, cleaning waste bags containing sharp
improperly disposed of, needle left in tray or and trolley, re-sheathing needle and passing
instrument to doctor or nurse among others.
The term “Occupation risk factor” is defined as a chemical, physical, biological or
other agent that may cause harm to an exposed person in the workplace and is potentially
modifiable (Takala,2000). Ergonomics, on the other hand, is the study of the relationship
between people and their working environment. It combine all other factors like physical
,biological, mechanical, psychological and physical issues to improved workers efficiency
and well being and maintain industrial production through the design of an improved
workplace. As a health worker, the first thing to do is to identify the hazards in the work
environment and then put control measures in place. Health workers in this study refers to
health personnel who had undergone specialized training for specified number of years in
the care and management of the sick and licensed to practice.
Occupational health problems among health workers are not only problems of
individual healthworkers‟, but they are also problems relating to the healthiness and safety
of work and the work environment, the organization of work and the management
philosophy of the enterprise and workplace (WHO, 1995).
33
Perception of Occupational Health Hazard
The individual perception of occupational health hazards varies from place to place,
gender, level of education and job type. Perception as explained by Katz & Kahn (1978) is
being described as the act of perceiving or apprehension with the mind or the sense with an
immediate or intuitive recognition, as it relates to a moral quality. There are two main types
of perception very popular in current psychological literature. They are the perception of
things and the perception of person or social characteristics. The first type of perception is
called classical perception or psychophysics, while the second type constitutes what is called
social perception. This second type is obviously the concern of the present study.
Perception is not simply a matter of “sensing” or “sensation”. People‟s sensory
receptors provide them with raw sense data that needed to be process so as to arrive at
meaning. In fact, one‟s perceptual system not only receives but also “hunts” stimuli until it
achieves a clear understanding of the nature of the stimuli (Kanfman, 1973). Social
perception, on the other hand, refers to those processes by which we come to know and
think about others, that are characteristics qualities and inners states ( VanderZanden, 1977).
Kuppuswamy (1973) stated that social perception, or interpersonal perception, is the process
by which impressions, opinions or feeling about others persons are formed. Without denying
that learning can play some role in perception, many theorists took the position that
perceptual organization reflects innate properties of the brain itself. Indeed, perception and
brain functions were held by Gestaltists to be formally identical (or isomorphic), so much so
that to study perception is to study the brain. Much contemporary research in perception is
directed toward inferring specific features of brain function from such behaviour as the
reports (introspections) people give of their sensory experiences. More and more such
inferences are gratifyingly being matched with physiological observations of the brain itself.
According to Nweke (1996) perception is the process by which we receive, interpret
and respond to the stimuli which register in our central nervous system through one or a
combination of the sense mechanism. According to Carole & Carol (1990), “perception is
the process of becoming aware of objects, qualities or relations by way of the sense organ”.
However, sensory contact is always present in perception but what is perceived is influenced
by one‟s set, orientation and prior experience. Perception is more than a passive registration
of stimuli impinging on the sense organs. It is an established fact that the meaning or
34
interpretation (i.e. perception) of issues, people or events determines the response or action
of the perceiver.
In the present study, perception is the process in which sensory experiences are
organized and made meaningful. The individual keep making sense of our world. How this
is done varies from one individual to another. Perception usually requires that one integrates
information from several senses at the same time. The primary function of perception,
however, is recognition of stimuli as familiar things. To achieve this goal, both external data
and internal concepts are usually involved in some balance. Sometimes our minds produce
precepts on their own. When the individual perceive something that is not there, it is called
hallucination. Hallucination is a percept that has no basis in objective reality. Another
indication of the way that perception modifies reality is provided by illusions are usually
misinterpretations of the environment (Objective reality). Most people have the experience
of going down a long straight tarred road on a hot day and seeing a pool of water off in the
distance. Therefore, occupational hazard perception is the process by which the health care
workers receive, interpret and respond to the stimuli which register in their central nervous
system through one or a combination of the sense mechanism.
Measurement of Perception
A number of recent studies bordering on social perception have been conducted
using various measurement parameters. One of such studies conducted by Ogbonnaya
(1997) used a five-point-scale questionnaire of „Strongly Agree‟, „Agree‟, „Undecided‟,
„Disagree‟, and „Strongly Disagree‟. The response options attracted the scores of 5,4,3,2,
and 1 respectively. In their own study, Jatau and Kajang (2002), like Ogbonnaya (1997),
adopted the five-point scale. However, they scored 5,4,3,2, and1 for each of the positive
statements, while the negative statements were scored 1,2,3,4 and 5, respectively.
Enebechi (2008) conducted research on perceived occupational health hazards
among teachers in government secondary schools in Udi education zone of Enugu State. The
purpose was to establish the perception of teachers in Udi education zone of Enugu State
regarding occupational health hazards. The instrument was Likert type questionnaire with 4-
response options of „Strongly Agree‟ (SA), „Agree‟ (A), „Disagree‟ (D) and „Strongly
35
Disagree‟ (SD) weighted 4,3,2, and 1 for favourable statements and 1,2,3, and 4 respectively
for unfavourable statements.
Onwugbufor (1998) in his own study adopted semantic differential instrument called
the Work Related Perception Inventory (WRPI) for data collection. The instrument was
developed by Osgood, Suci and Tannenbaum (1967) and has since then been used by the
developers in 1971 and Hunt (1979). Ogbazi and Okpara (1994) opined that it is used in
measuring indirectly the perception of subjects. According to Hunt (1979) it has several
features that distinguish it as an instrument for socio-psychological research. The responses
were weighted according to the Bipolar Adjective Scale as recommended by Osgood, et al.
(1967). This was a 7-point choice continuum obtained by rating the degree of agreement
with the concept statements on the perception of University workers about work and
recreation. In order to maintain consistency, the most unfavourable pole of each scale was
score 1 and the most favourable pole given the score of 7. The perception score was got by
adding the overall rating. The criterion mean of 4 was used in making decision in the study.
Following the review of various studies conducted by researchers on measurement of
perception, the present study adopted the semantic differential instrument called the Work
related perception Inventory (WRPI).
Demographic Factors Influencing Perception of Hazards
Perception of occupational hazards varies among groups of individuals; among
individuals and in the same individual from one time to another and from one place to
another. In support of this Sorenson et al (1971) remarked that no two people perceive any
scene or situation in exactly the same way. According to them the first two factors that
influence perception of occupational hazards are the sex of the individual and sensations
themselves.
Knowledge, according to Sorenson et al (1971) is probably the third most important
element in the making of accurate perceptions. They stated further that the more a person
knows about a type of object, scene or situation, the better he can usually perceive a new
example of it. Hence, knowledge will often permit accurate perceptions to be made on the
basis of poor material whereas the most vivid sensations can be misinterpreted if knowledge
is lacking or inadequate. Since knowledge determines the types and level of work an
36
individual does, it follows that there may be variations in the perception of various
categories of health workers in government hospitals in the areas under study.
According to Ajala and Bolarinwa (2000), gender is another factor that influences
perception. Since sex is a function of inheritance, it follows that there could be differences in
the perceptual capacities of males and females as they do not inherit the same traits from
their parents. However, Olayemi (2005) revealed that it is difficult; to assess the degree to
which differences related to the sex of the perceiver are biologically based or are the cultural
product of traditional differences in sex role. Nevertheless, he further stated that males and
females have different styles of perception. It therefore follows that male health care
workers could perceive occupational hazard differently from female health care workers.
The meaning a person gives to work depends on his perception about it. The statement could
rightly be applied to occupational hazards.
According to Takala 1991, one‟s past experience or learning may influence one‟s
perception of occupational hazards. In fact the differences in perception between members
of different cultures result in most cases from past experience. Past experience quickens or
retards perception. Somebody who is familiar with vases will quickly see the vase while it
will take a long time for the person who has little or no idea about vases. One‟s perception
may be motivated. This is preperception or has already made his mind on what he wants to
see (Bates &Julian, 1969).
Bergh (2003) concluded that occurrence of occupational accidents are related to such
personal factors as age, there is always a high occupational accident rate between ages 17 to
28 and in people aged 60 years and above. Borgman (1971) opined that perception changes
with individual‟s age because psychological development is enhanced by maturation and
learning.
In another development, Svanstron and Sunstrom (1996) noted that industrializations
had made injuries a major public health problem. According to them, location and cultural
influences are related because rurality promotes taboos and superstition while urban centres
harbour a great percentage of mechanization and modernization and this could exert
influence on occupational hazard perception.
Oji (1994) concluded that level of education and job type were parts of basic
determinants of occupational health hazards among health workers in oral surgery and
37
dentistry. According to Enebechi (2008) concluded that occupational hazards were
dependent on age, location ,rank and sex of individual when conducting studies on teachers
perception of occupational hazards in Udi education zone of Enugu State .
Theoretical Framework
Current models/theories that help to explain human perception and behaviour,
particularly as it relates to health education, can be classified on the basis of being directed
at the level of individual (intra-personal), interpersonal, and community.
Health Belief Model
The Health Belief Model (HBM) of Rosenstock, Becker, Kirserit (1988) was one of
the first models which adapted theories from the behavioural science to examine health
problems. It is still one of the most widely recognized and used models in health
applications. This model was originally introduced by a group of psychologists in the 1950‟s
to help explain why people would or would not use available preventive services. These
researchers assumed that people feared diseases and that the health actions of people were
motivated by the degree of fear (Perceived threat) and the expected fear reduction of actions,
as long as that possible reduction out weighted practical and psychological barriers to taking
action (net benefits). The HBM can be outlined using four constructs which represents the
perceived threat and net benefits. These, according to Rosenstock, Becker, & Kirserit (1988)
are:
1. perceived severity or a person‟s opinion of how serious this condition is;
2. perceived susceptibility or a person‟s opinion of the chances of getting a certain
condition;
3. perceived benefits or a person‟s opinion of the effectiveness of some advised
action to reduce the risk or seriousness of the impact ; and
4. perceived barriers or a person‟s opinion of the concrete and psychological costs
of this advised action.
The above four tenets of HBM apply to this study because HBM attempts to explain
health behaviour in terms of individual decision making and proposes that the likelihood of
a person adopting a given health related behaviour is a function of the individual‟s
38
perception of a threat to their personal health and their belief that the recommended
behaviour will reduce this threat .This model has its focus on the prevention of disease
rather than control.
HBM states that the perception of a personal health behaviour threat is itself
influenced by at least three factors: general health values, which include interest and concern
about health; specific health beliefs about vulnerability to a particular health threat; and
belief about consequences of the health problem. Once an individual perceives a threat to
one‟s health ,such a person is stimulated into action .When perceived benefits outweighs
perceived loses, then such a person is most likely to undertake the recommended preventive
health action .In doing this ,the health workers perception of occupational health hazards in
government hospitals in Ondo state will be sought based on this theory.
Theory of Reasoned Action
The theory of reasoned action was designed to explain not just health behaviour but
all volitional behaviours. This theory was articulated by Fisher and Fisher (1992).This
theory explains when people actually engage in disease prevention behaviours. According to
this theory, one of the determinants of diseases prevention (in this study occupational
hazards) is the belief of their negative impacts on human health and their severity .It
premised that individuals are likely to adopt health behaviour if they perceive that ; they are
susceptible to illness ;consequences of infection are severe ;and effective solutions exist. In
this study it was assumed following from the above, those workers are likely to adopt one or
more preventive measures if they perceive that the work environment is full of potential
dangers (hazards); consequences of these hazards to the individual health are severe, and
effective ways of averting such situations exists.
Gestalt Theory of Perception
The gestalt theory of Kohler which is one of the cognitive field theories believes that
individual react to pattern of their own perception ,when they face a problem ,depending
upon the set of stimulating conditions in the environment .These stimulating conditions
could be socio-demographic variables like age ,gender, level of education, job type and
marital status. The individual responds or functions in terms of what he perceives or believes
39
and the explanation of this functioning must be sought in terms of the factors and relation,
which govern such perception of occupational hazards among health workers. The ability of
the health workers to recognize hazards in their workplace is very important and this
depends on their cognitive reasoning of the potential /existing hazards.
Empirical Studies on Perceived Occupational Health Hazards
Arun Garg (2006) conducted a study in America on occupational health hazards and
safety engineering that deal with the protection of worker‟s health, through control of the
work environment to reduce or eliminate hazards The purpose of the study was to find out
the factors affecting the protection of workers‟ health putting into consideration the socio
demographic variables like location, gender marital status, level of education and job type.
The sample for the study was 2065 respondents. Survey research method was used with the
administration of self developed; validated and reliable questionnaire (reliability of 0.87)
was used to collect the data. Out of the 2065 that adequately fill the questionnaire, 1,155
(55.9%) were male and 910 females. It was found that there were no significant differences
in the perception of male and female workers in the occupational hazard with respect to
location and level of education (location x2 = 3.32; df =3; p>.05). The researcher then
recommended intensive education through seminars and campaign to improve the awareness
level of male and female workers.
Hazards related to the handling of agro-chemicals and existing facilities for health
and hygiene were surveyed by Ahasan, (2001). Sanitary system (e.g. latrines, toilets), water
supply (e.g. drinking, washing)and canteen facility, provision of storage, first aid facility,
and so on were investigated since agro-chemical factories were built in the vicinity of
human habitation without maintaining enough health, hygiene and safety precaution.
The workers in agro-chemical factories had less access to health and hygiene
practice as well as safety measures because a low priority of occupational health and
safety/ergonomics application was attached to the national program. The workers had had
poor health due to a poor hygienic situation and non-ergonomic tasks. Many toxic
substances were available and many workers are thus exposed to poisonous effects from
handling of agro-chemicals. The agro-chemical factories were built in the vicinity of human
habitation with a poor maintenance of health, hygiene and safety precaution. The sources of
40
work-related problems (WRPs) in these factories were suspected to be the unhygienic and
congested space, informal work-setting and rare use of personal protective devices (PPDs).
With regard to health, hygiene and safety measures, 90% of the small-scale factories
were found to be poorly maintained. About 58% of the medium-sized factories did not have
health and safety measures according to any bylaw or revised article of the factory Act
(1965) and factory rules (1979). Approximately 31% of the small-scale factories had poor
latrines and 50% of these factories had no good supply of safe drinking water and canteen
facility. In the medium-sized factories, 83% of the latrines were found to be of average
condition (e.g.; limited access to women workers), with no toilet papers and other facilities.
Small number of factories (14%) had a good system for safe drinking and washing water
(e.g., supplied by the local municipality) but working environment was observed as very
poor and non-hygienic. In all, 28% of the medium-sized factories had subsidized food (or
nasta, a piece of bread and a banana) for the workers but these are perhaps offered as
incentives.
Another survey study was conducted by Odd, Kjell and Olar (2000) in U.S.A among
catering personnel working on a drilling platform at the Continental Shelf in the North sea.
The purpose of the study was to find out the factors responsible for occupational hazards
perception in their workplace. About forty respondents were used for the survey study. It
was observed that twenty six respondents (65%) perceived hazards in their working
environment more than others. By contrasting the extreme groups, i.e.; the high and low
hazards perceivers it was found that socio demographics, e.g.; gender, marital status, age
and working experience possessed no descriptive power. However, the findings revealed
that the worker segment prone to perceive high hazards also reported higher degree of burn
out, anxiety and depression than did the low hazards perceivers. They (the high hazards
perceivers) were also less satisfied with their stay on the platform, and they reported more
health problems as well. The findings indicated that hazards perceptions of hazards go
beyond mere “cold cognition”, also tapping into negatively feelings and emotional states.
A study conducted by Olayemi (2005) at Psychiatric Hospital, Aro-Abeokuta which
was aimed at assessing and increasing the level of awareness of occupational hazards among
clinical psychiatric staff in Aro-Abeokuta. This was done by identifying hazards and making
recommendations to prevent them. The study population consisted of psychiatrist, nurses,
41
therapist, social workers, clinical psychologist and consultant psychiatrist. An original list of
101 clinical staff participants was created for the study. Ninety six clinical staff responded to
the study giving a response rate of 96%.
Data were obtained through the use of a self- administered questionnaires that
included questions on personal data, awareness to occupational hazards, seminar attendance,
possession of health insurance policy, safety measured practiced, and experience of
occupational hazard while in practice. Data were analysed using frequency tables to display
the responses of the psychiatric staff. Where necessary, cross tabulations were carried out to
determine the significant difference between variables using chi-square. The age distribution
of the staff ranged from 25 years to 55years. The age range of 30-40 years had the highest
frequency (30.5%). Forty males (50%) and 36 females (45%) responded to the study. The
male ward I and II had the greatest number of staff with 28 members (35%). The majority of
the staff have been employed from 10-15 years (67.5%). All responding psychiatry
personnel (96 or 100%) were aware of occupational hazards occurring in the workplace.
About 60% of the staff had attended workshops/seminars thrice while only 40% had
attended once.
The findings revealed that about 20 respondents (26.4%) did not have a health
insurance policy while the largest percentage of the respondents (74.6%) had health
insurance policy. The study further revealed that occupational hazard usually common at the
patient waiting room, visiting hours, and when serving a meal especially the dinner. The
respondents (72%) added that the following categories of psychiatry staff were more prone
to occupational hazards: the nurses, health attendants, and psychiatrist. The findings also
revealed that assaults occurred when service was denied, when a patient was involuntarily
admitted, or when a health care workers attempt to set limit on eating, drinking, or tobacco
or alcohol use. About 67% of the respondents indicated the above.
In a survey carried out by Ahansan (2000) on the perceived health of dentists in the
United Kingdom and United States of America it was found that the most common
manifestation of organic disease among this group included backache, haemorrhoids,
chronic indigestion and disease of the circulatory systems. These maladies tend to occur in
larger percentages among this group than in the general population. In his study he used one
42
hundred and thirty respondents. The purpose was to know the most common manifestation
of organic disease. He used interview method to conduct his study.
Fasunloro and Owotade (2004) conducted a study on perceived occupational hazards
among the clinical dental staff of the Obafemi Awolowo University Teaching Hospital
Complex, Ile-Ife in Osun State. Thirty eight of the 40 staff responded, yielding a response
rate of 95%. Subject ages ranged from 26 to 56 years with approximately 25% in the 31-46
years age bracket. The findings revealed that all of the staff were having good occupational
hazards perception and aware of the occupational exposure to hazards. The majority had
attended seminars workshops on the subject. Only five staff members (13.2%) owned a
health insurance policy and 26 (68.4%) had been vaccinated against Hepatitis B infection.
All dentists (24) had been vaccinated compared with only two non dentists; this relationship
was significant (p=30.07, x2=0.0000). Fourteen members of the clinical staff (36.8%) could
recall a sharp injury in the past six months, and the majority (71.1%) had regular contact
with dental amalgm. Wearing protective eye goggles was the least employed cross infection
control measure, while backache was the most frequently experienced hazard in 47% of the
subjects. The need for Hepatitis B vaccinations for all members of the staff was emphasized,
and the enforcement of strict cross infection control measures was recommended. The
physical activities and body positions that predispose workers to backaches were identified
and staff education on the prevention of backaches was provided. They emphasized further
that the sources of these hazards is the work environment which can include physical,
chemical, biological, mechanical and social aspects. The occupational hazards found among
dentists and other chemical workers were similar worldwide and included a wide range of
risks and sometimes even legal hazards.
In September, 2003, the WHO and the International Council of Nurses (ICN)
(WHO/ICN ,2003) began a pilot study in three countries, South Africa, Tanzania, and
Vietnam, to prevent HIV and Hepatitis infection from occupational exposures to blood-
borne pathogens. Recognizing the need for integration between disciplines, the WHO and
the ICN joined together with the national nurse associations, occupational health
professionals, and ministries of health to assess and address policy gaps, implement
universal (or standard) precautions, educate workers and health systems mangers, develop
surveillance systems, immunize against Hepatitis B, and implement appropriate post-
43
exposure follow up including prophylactic medication. The goal of the project was to reduce
needle stick injuries and transmission of hepatitis viruses and HIV to HCWs. Secondary
process measures was to increase reporting of NSIs, improve follow up of injured workers,
including Post Exposure Prophylaxis (PEP), and utilize the data regarding exposures for
prevention. The study recommended, among other things that all health care workers must
enforce safety universal precautions in handling of all body fluids and in their dealings with
all patients within their care. They also recommended the use of auto disposable needle and
syringes to prevent needle stick injuries and transmission of HIV/AIDS. HCWs are enforced
to maintain primary prevention of hazards by placing strict penalty like withdrawal of
practicing license of the culprit or total revoking of his registration. WHO/ICN (2006)
evaluated the outcome of their recommendations in six selected countries around the world
which include USA, U.K, Bangladesh, Nigeria, South Africa and Germany. It was
discovered that NSIs had reduced by (56%) compared with the past. About (47%) of the
HCWs had complied strictly to the use of safety universal precaution for the prevention of
occupational hazards in their work place (WHO/ICN, 2007).
Oji (1994) conducted a study of occupational hazards in oral surgery and dentistry at
College of Medicine University of Nigeria, Nsukka. The purpose of the study was to find
out the occupational hazards and diseases encountered by health care workers in oral surgery
and dentistry. The sample for the study were forty eight health care workers selected in the
dental department of the UNNTH. The design used for the study was cross sectional survey.
Frequency and percentages were used to answer research questions while t-test was
employed to test the hypotheses. The findings indicated that the oral and maxillofacial
surgeons as well as the dental surgeon were exposed to certain dangers because of the nature
of their profession. Forty per cent of the respondents (40%) indicated that surgical
procedures in the month result in an exposure to tissues especially blood. About seventy-one
per cent (71%) of the respondents indicated that such body fluids can habour viruses or
bacteria that must be considered as a significant health hazards to patients and staff. The
frequency of occupational related hazards varied from 21% to 43% depending on the
prevailing material used. Furthermore, 64% of the respondents indicated that later sensitivity
reactions are occurring more frequently among health care providers and their patients. The
only hypothesis for the study was tested using t-test statistic at .05 level of significant. It was
44
found that, there were statistically significant difference between the health care workers
perception of occupational hazards and their job type.
Amunega, (2002) conducted research on occupational hazards in Odo-Okun sawmill
in Ilorin west local government area of Kwara state. The purpose of the study was to identify
the various occupational health hazards of sawmill workers in Odo-Okun local government
area of Kwara state and to know whether there were statistically differences in respect to
their socio demographic variables. The research design used was cross sectional research
survey. The sample for the study were 62 sawmill workers in Odo-Okun sawmill. The study
revealed that few workers were exposed to various occupational health hazards at various
degrees and intensity. The study revealed the occupational health hazard among saw mill
workers; organic hazard 68%, physical hazard 70%, biological hazards 49% chemical
hazards 64% and psychological hazards to be 78%.The t-test analysis for significance of
difference between urban and rural sawmill workers in Odo Okun local government area of
Kwara state with regard to their location, age, marital status and gender revealed no
statistical difference in their occupational health hazard. The t-critical value required at 5%
level of significance for degree of freedom of 7 (df=7) was 1.96 (t=1.44< 1.96). With the
calculated t-value of 1.44, the null hypothesis was accepted. The t-test calculated from the
study was less than t-test critical value and it indicated that there was no statistical difference
with regard to age and gender of saw mill workers of occupational health hazards.
Enebechi (2008) conducted research on perceived occupational health hazards
among teachers in government secondary school in Udi education zone of Enugu State.
Purpose was to establish the perception of teachers in Udi education zone of Enugu State
regarding occupational health hazards. Research design used was cross sectional survey. The
population for the study was 1385 and the sample for the study was 315 respondents. The
instrument was Likert type questionnaire with 4-response options of „Strongly Agree‟ (SA),
„Agree‟ (A), „Disagree‟ (D) and „Strongly Disagree‟ (SD) weighted 4,3,2, and 1 for
favourable statements and 1,2,3, and 4 respectively for unfavourable statements.
The findings revealed that teachers perceived physical hazards in their workplace
positively (t-cal=2.40>1.96), biological (t-cal=1.92<1.96) and chemical (t-cal=3.29>1.96)
hazard was dependent on rank. Perception of psychological (t-cal=0.82<1.96) and
mechanical (t-cal=0.29<1.96) hazards does not depend on their rank. Age exerts significant
45
influence on the teachers perception of physical (t-cal=8.80>1.96), biological (t-
cal=3.38>1.96), psychological (t-cal=2.29>1.96), chemical (t-cal=3.63>1.96) and
mechanical (t-cal=3.0>1.96) hazards. There was a significant difference between male and
female teachers regarding their perception of physical (t-cal=2.5>1.96) and chemical (t-
cal=2.75>1.96) hazards. There was no significant difference between male and female
teachers in their perception of biological (t-cal=0.62<1.96) psychological (t-cal=0.13<1.96)
and mechanical (t-cal=1.75<1.96) hazards.
Summary of Reviewed Literature
Occupational hazard can be defined as a risk to a person usually arising out of
employment. It can also refer to a work, material, substance, process, or situation that
predisposes, or itself causes accidents or disease at a work place. The practice of health care
worker in hospitals exposes the professionals and non-professionals to a variety of work-
related hazards. These include working long hours at a high level of concentration, working
in a sedentary state, working with anxious patients, exposure to microbial aerosols generated
by high speed rotary hand pieces, exposures to various chemicals used in clinical practice
and shift duties.
The occupational hazards found among health care workers in government hospitals
in Ondo state are similar with what obtains world wide and include a wide range of risks and
sometimes even legal hazards. The source of these hazards is the work environment which
can include physical, chemical, biological, mechanical and social aspects. Many occupations
involve exposure to special and peculiar hazards. The most pernicious are not those where
the effects appear immediately, as in accidents, but rather those that run an insidious cause
over a period of years.
Hospital hazards ranged from offensive or threatening language to homicide. Bailey
(1994), defines hospital hazard as violent acts (including physical assaults and threats of
assaults directed toward persons at work or on duty. Health care workers in different types
of health institutions are exposed to a wide variety of health hazards. In most industrialized
countries, they are catered for in a purpose built, well organized comprehensive
occupational health service which is both curative and preventive in content. This is the case
in industrialized countries. In most health institutions in developing countries occupational
46
health service for hospital staffs rarely thought of. In fact, hospital personnel only have in
most cases a haphazard and uncoordinated arrangement.
Three theories were reviewed. The health belief model which recognized perceived
threat and net benefits. Theory of reasoned action was designed to explain not just health
behaviour but all volitional behaviours. Gestalt theory of perception which recognizes
process in which sensory experiences are organized and made meaningful is one of the
cognitive field theories believes that individual react to pattern of their own perception,
when they face a problem, depending upon the set of stimulating conditions in the
environment. These stimulating conditions could be the socio-demographic variables.
The review also presented measurement of perception using bi-polar adjective scale.
The Bi-polar adjective scale is scale made up of two opposite adjective –one favourable, the
other unfavourable. The scale is scored as follows: Favourable Adjective (e.g. Necessary)
7,6,5,4,3,2,1 Unfavourable Adjective (e.g. Unnecessary). Demographic factors influencing
hazard perception include gender and age (Bergh 2003 & Borgman 1971);gender ( Sorenson
,Malm & Forehand 1971);culture (Newman & Newman 1983;Hattingh (2003);location
(Svanstron & Sunstron 1996 ,Amunega,2002), level of education, job type and years of
experience (Nweke 1996 , Oji,1994). The review also presented empirical studies conducted
on occupational health hazards in developed countries and other developing countries.
Fasunloro and Owotade (2004), conducted study on occupational hazards among the clinical
dental staff of the OAUTHC, Orji et al (2003) in UNTH, Arun Garg (2006) in USA, and
Olayemi (2005) at Aro-Abeokuta Psychiatric Hospital among others established the
influence of job type and location on occupational hazards perception. Majority of the
studies conducted in Nigeria put into consideration a section of health care workers and
specifically in teaching hospitals like OAUTHC but no such studies have so far been
conducted in Ondo State. This gap is therefore, filled by the present study.
47
CHAPTER THREE
Methods
This chapter presents description of the research design, population for the study, area
of the study, sample and sampling technique, instrument for data collection, validity of the
instrument, reliability of the instrument, method of collection and method of data analysis
which was used for the present study.
Research Design
In order to accomplish the objectives of this study the cross sectional survey research
design was adopted. According to British Dental Association (2007), cross sectional survey
research is a method used to gather information from representatives of a population, with
the intention to describe current practice or to evaluate a programme or activity in which the
participants have been involved. Levine (2006) stated that cross sectional studies are usually
conducted to estimate the prevalence of the outcome of interest for a given population
commonly for the purpose of public health planning. Cross sectional survey provides a snap
shot of a situation in a population, and the characteristics associated with it at a specific
point in time. This is in line with the observation of Thomas and Nelson (1990) that the
purpose of survey is to reveal current state of a condition and to show the need for change.
The cross sectional survey research design was considered appropriate for the
present study because it was successfully used by Oji (1994) in conducting a research on
occupational hazards in oral surgery and Dentistry at the College of Medicine University of
Nigeria, Nsukka. The design was also used by Amunega (2002) in conducting research on
occupational hazards in Odo-Okun Saw mill in Ilorin West Local Government Area of
Kwara State. In addition, cross sectional survey research design is considered appropriate
for the present study because it was successfully used by Orji, Fasuba, Onuidiegwa, Dare &
Ogunniyi (2003) in conducting a research on occupational health among health care workers
in an obstetric and gynaecology unit of a Nigerian teaching hospital
37
48
Population for the Study
The population for this study comprised 4150 Ondo State Hospitals Management
Board (HMB) staff and 1179 staff of Federal Medical Centre (FMC), Owo. A total of 5,329
health care workers constituted the population for the study (Office of statistic and
personnel management of HMB and FMC,2008).
Sample and Sampling Techniques
The sample for the study was 1,116 respondents. The researcher adopted a
purposefully sampling technique to select one general hospital and one state specialist
hospital in each of the three senatorial districts of Ondo State. In addition, the only
Psychiatric hospital and Federal Medical Centre was purposefully selected by the researcher
as part of the sample for the study due to the peculiar nature of those hospitals.
The researcher purposefully selected one out of the three general hospitals located at
the difficult terrain areas as the only general hospital to be selected in the Ondo South
Senatorial district so that the interest of the health care workers in those areas will be
represented in the study. According to the rule of thumb principle of Nwana (1990), which
suggest that if the population is a few hundreds, a 40 per cent or more sample will do; if
many hundreds a 20 per cent sample will do; and if several thousands a 5 per cent or less
sample will do. Therefore 40 per cent of the population of FMC, Owo using simple random
sampling technique of balloting without replacement to select 472 respondents was used.
Furthermore, proportionate sampling technique was used to select 644 respondents
from 1,610 health care workers in the selected seven (7) hospitals under HMB. The
researcher selected 40 per cent each from all the hospital staff stratified for the study.
Instrument for Data Collection
The instrument for data collection was 55 items, Bi-polar Adjective scale.
According to Hunt (1979); Ogbazi and Okpara (1994), it has several features that distinguish
it as an instrument for socio-psychological research. Meanwhile, Bi-polar adjective scale
will be adopted the questionnaire otherwise known as Health Workers Perception of
Occupational Health Hazards Questionnaire (HWPOHHQ) is made up of two sections.
49
The section A comprised of five relevant demographic information about age, level
of education, job type ,gender, marital status and location of the respondents while section B
involved statements to measure the health workers perception of occupational health hazards
using Bi-polar adjective Scale (Bi-polar adjective Scale is a scale made up of two opposite
adjective-one favourable, the other unfavourable) each with 7-response options to cover all
the five dimensions of physical, biological, psychological, chemical and mechanical hazards
studied. The scale is scored as follows: Favourable Adjective (e.g.
Necessary)7,6,5,4,3,2,1.Unfavourable Adjective (e.g. Unnecessary). The ten items
addressing each of the dimensions of occupational health hazards studied- physical,
biological, psychological, chemical and mechanical hazards respectively were stated in the
instrument.
Validity of instrument.
The face and content validity of the research instruments were established through
expert judgment of five lecturers; three in the Department of Health and Physical Education
and two in the Department of Psychology of University of Nigeria, Nsukka.
Reliability of instrument.
The reliability of the instrument was established using the split-half method. Copies
of the questionnaire were administered on twenty (20) health workers drawn from
neighbouring government hospitals within Ekiti State that will not be part of the sample for
the study. The twenty (20) copies were split into two (2) halves of even and odd numbers.
The Spearman-Brown correction formular for calculating correlation statistic was
employed to determine the reliability co-efficient of the test. Abonyi (2005) adjudged this
procedure suitable for computing the correlation of two sets of scores obtained from each
half to determine the reliability of the test. The reliability coefficient index value of .9697
was obtained and considered reliable. This is because, according to Ogbazi and Okpala
(1994), if the value of “r” obtained on an instrument is .85 and above, the instrument will be
deemed reliable for the study.
50
Method of Data Collection
In order to facilitate access to the area of the study and to obtain maximum
cooperation from the respondents, a letter of introduction from the Head, Department of
Health and Physical Education, University of Nigeria, Nsukka was presented to the
Permanent Secretary, Hospitals Management Board, Akure and the Chief Medical Director
(CMD), Federal Medical Centre, Owo, State Specialist Hospital and General Hospitals to be
visited, accordingly.
The research assistants were trained to be familiar with the contents of the
questionnaire, manner of approach and the location of the hospitals. The distribution and
collection of the questionnaire was enhanced by the training of eight research assistants after
which an examination was conducted to select the best four among them. See Appendix V
for (M&E) Measurements and Evaluation.
Method of Data Analysis
The result of the influence of socio demographic characteristics on occupational
health hazards and the statements to measure the health workers perception of occupational
health hazards using Bi-polar adjective Scale were based on a score of 7 point scale ranging
from 7 to 1 . The responses on the completed questionnaire were coded and data analysed
on an item-by-item basis using arithmetic mean for the research questions and t-test statistics
for the hypotheses.
The criterion-mean score for the study was 4.5 this was the lower limit of
„favourable‟ which attracted a composite score of 5 in the 7-point continuum. Any item
Mean of 4.5 and above was indicative of the respondents‟ agreement with the statement.
That was their perception of the role of that item with regard to the hazard in question. The
reverse applies to the mean score below 4.5. The same condition were used to interpret the
scores obtained for the research questions. The null hypothesis 1-6 were verified at 0.05
level of significance using the t-test statistics and ANOVA as applicable.
51
CHAPTER FOUR
Results and Discussions
This chapter presents the findings and discussions of the results of the study. The
study mainly focused on the perceived occupational health hazards among health care
workers in government hospitals in Ondo State.
A total of 1,116 copies of the questionnaire (HWPOHHQ) were administered of
which 45 suffered mortality for varying reasons. In all, a 96 per cent return was recorded.
The data collected has been organized in such a way that answers to the research questions
were provided using mean scores. This was then followed by summary of t-test, ANOVA
and multiple comparisons to verify the five null hypotheses at .05 level of significance.
41
52
Research Question One
What are the health care workers‟ perceptions of physical health hazards? Table 1
contains the data that provide answer to the above research questions.
Table 1
Health Care Workers’ (HCWs) Perception Regarding Physical Health Hazards
S/N Item x Decision
1. Assault may lead to physical weakness of the body 5.3520 Agree
2. Sharp objects could be dangerous and capable of causing
discomfort to ones‟ life
5.0719 Agree
3. Exposure to ionizing radiation e.g. x-ray may damage tissue and
be life-threatening
4.9449 Agree
4. Noise from hospital machine may cause hearing disability or
deafness.
4.6788 Agree
5. Poor ventilation as a result of overcrowding may lead to
suffocation
4.7843 Agree
6. Extreme cold or hot weather may lead to physical health hazard
and altered body thermo regulation
5.3193 Agree
7. Trauma arising from unsafe environments within hospital may be
injurious and life threatening.
5.0906 Agree
8. Hospital machine may produce noise capable of causing
nervousness and fatigue.
4.5686 Agree
9. Exposure to vibration may also produce injuries of the joints of
the hand; elbows and shoulders.
5.0205 Agree
10. Radiation hazards may cause sterility, genetic changes and
malformation.
4.7264 Agree
Grand mean 4.9557 Positive
Data reported in Table 1 reveal that assault may lead to physical weakness of the
body with the highest mean score of 5.3520, followed by the statement extreme cold or hot
53
weather may lead to physical health hazard of mean score of 5.3193. However, the statement
trauma arising from unsafe environments within hospital may be injurious and life
threatening has the mean score of 5.0906 while this was followed by statement no 9;
exposure to vibration may also produce injuries of the joints of the hand; elbows and
shoulders of mean score of 5.0205. This means that the perception of health care workers
regarding physical health hazard was positive, because the grand mean was above the cut off
mean of 4.5.
Research Question Two
What are the health care workers‟ perceptions of chemical health hazards? Data in
Table 2 provide the answer to the above research question.
Table 2
Health Care Workers’ Perception Regarding Chemical Hazards
S/N Item x Decision
11. Drugs may constitute poison if not well administered 4.8142 Agree
12. Disinfectant may be corrosive 5.1214 Agree
13. Allergic contact dermatitis may lead to skin infection 5.4192 Agree
14. All chemicals like formalin used in laboratories and anaesthetic
agents may cause heart failure and other health related problems
4.9841 Agree
15. Delayed potential effects of chemicals include cancer 5.1662 Agree
16. Chemical agents may cause disorientation 4.8992 Agree
17. Inhaled chemicals from hospital may cause blood circulatory
problems.
4.5182 Agree
18. Chemical agents may constitute respiratory tract infection 5.2362 Agree
19. Non adhensive surface floor can lead to fall and fracture of bone 5.3063 Agree
20. Dilapidated building structure may harbour rodents to constitute
life threatening hazard.
5.1120 Agree
Grand Mean 5.0577 Positive
54
Results from Table 2 shows that health care workers perception regarding chemical hazards
was positive. All the ten item statements were agreed upon by majority of the health care
workers signifying their positive perception of chemical health hazards. The mean score for
the statement like allergic contact dermatitis may lead to skin infection was 5.4192, surface
floor can lead to fall and fracture of bone was 5.3063. In the same vein, statement like
chemical agents may constitute respiratory infection has the mean score of 5.1662 while the
statement like inhaled chemicals from hospital may cause blood circulatory problems with
the least mean score of 4.5182 which also above the criterion mean score for the study.
Results from Table 2 shows that a grand mean response of 5.0577 which is above the cut off
mean of 4.5.
Research Question Three
What are the health care workers‟ perceptions of biological health hazards? Answer
to this research question is provided by the data in Table 3.
Table 3
Health Care Workers Perceptions Regarding Biological Hazards
S/N Item x Decision
21. Exposure to blood could cause deadly disease and shorten life 5.4090 Agree
22. Body fluids from patient may be deleterious and lead to transfer
of infection
4.8861 Agree
23. Exposure to tuberculosis and yellow fever patients may lead to
air and blood borne infection.
5.2054 Agree
24. Exposures to infectious patients weaken ones immunity. 5.0233 Agree
25. Lack or inadequate of waste disposal facilities may cause
biological hazards.
4.7115 Agree
26. Untidy environment may harbour and support the growth of
mosquito leading to malaria attack.
5.1858 Agree
27. Irregular hand washing after attending to patients may constitute
hazards.
4.7190 Agree
28. Unhealthy environment may constitute to biological hazards. 5.4967 Agree
29. Biological agents like viruses, bacterial, fungi, parasites and
animals may cause health hazards like Pneumonia,
gastroenteritis and hepatitis.
5.0896 Agree
30. Over crowding is capable of causing suffocation. 4.9869 Agree
Grand Mean 5.0713 Positive
55
Result from table 3 shows that the health care workers perceive biological hazards
positively in their work places. According to the Table, the grand mean response was 5.0713
which is above the criterion mean of 4.5. The respondent agreed with all the ten item
statements in the above table showing favourable perception of HCWs of biological hazards.
Items no 28 with the mean score of 5.4967 has the highest, followed by item 21 with the
mean score of 5.4090 and none of the statement on biological hazard mean score less than
the criterion mean of 4.5.
Research Question Four
What are the health care workers‟ perceptions of mechanical health hazards? Data in
Table 4 provide the answer to this research question.
Table 4
Health Care Workers’ Perceptions Regarding Mechanical Hazards
S/N Item x Decision
31. Needle pricks can constitute mechanical injury 4.7255 Agree
32. Injury from burns may lead to shock and loss of body
electrolyte.
5.3007 Agree
33. Injury from sterilizer or autoclave machine may be harmful and
cause sudden death.
4.6629 Agree
34. Injury from other equipment like scissors and forceps may be
tasking.
4.6704 Agree
35. Hospital machines are capable of causing body aches, fatigues
and anxiety.
4.5238 Agree
36. Sharp instruments or skin piercing instrument should be well
kept after use otherwise it can harbour infection.
5.0626 Agree
37. Needle recapping can lead to transfer of deadly disease like
HIV/AIDS
4.7862 Agree
38. Indiscriminate disposal of syringe and needle may lead to needle
stick injury.
4.6928 Agree
39. Passing of instrument to doctor/nurse carelessly may be life
threatening by causing injury to the caregiver.
4.8114 Agree
40. Lifting of heavy patient may cause back ache and fatigue 5.2418 Agree
Grand Mean 4.8478 Positive
Data in Table 4 shows that injury from burns may lead to shock and loss of body
electrolyte had a mean score of 5.3007, and lifting of heavy patient may cause back ache and
56
fatigue with the mean score of 5.2418. However, sharp instruments or skin piercing
instrument should be well kept after use otherwise it can harbour infection had the mean
score of 5.0626 showing positive perception of mechanical hazard among the respondents.
According to the data in Table 4, the Health care workers showed a positive perception of
mechanical hazards in their work place with the grand mean of 4.8478.
Research Question Five
What are the health care workers‟ perceptions of psychological health hazards?
Answer to this research question is provided by the data in Table 5.
Table 5
Health Care Workers Perception Regarding Psychological Hazards
S/N Item x Decision
41. Rape may cause emotional imbalance 5.0672 Agree
42. Stress from work causes boredom 4.8431 Agree
43. Shift duties may lead to breakdown, untrust and psychosocial
problems among families
4.7330 Agree
44. Strained relationship among staff could constitute to emotional
breakdown
4.3193 Disagree
45. Sexual harassment may occur in workplace among staff to staff
or from staff to patient and lead to emotional imbalance.
4.8674 Agree
46. Repetitive work may cause boredom and hazardous to health 5.0112 Agree
47. Unrealistic personal expecations and unattainable aspirations
may cause chronic stress, fatigue and burnout.
4.8319 Agree
48. Work that conflict with personal values may create tremendous
stress for employees.
4.2764 Disagree
49. Frustration and aggression within workplace may cause
psychological hazard.
4.3287 Disagree
50. Poor remuneration, queries and retrenchment to workers may
ruin workers career and be life threatening.
5.0990 Agree
Grand Mean 4.7377 Positive
Data in Table 5 above shows that the respondents had a favourable perception
(positive) of statement like poor remuneration, queries and retrenchment to workers may
ruin workers career and be life threatening with a mean score of 5.0990. Similarly, rape may
cause emotional imbalance had a mean score of 5.0672 and repetitive work may cause
burden and boredom/hazardous to health with a mean score of 5.0112. Consequently, the
respondents disagreed with statements like work that conflict with personal values may
57
create tremendous stress for employees ( 2764.4x ), Frustration and aggression within
workplace may cause psychological hazard ( 3287.4x ) and strained relationship among
staff could constitute to emotional breakdown ( 3193.4x ) showing negative
(unfavourable) perception of psychological hazards.
Research Question Six
What are the perception of various age brackets of the health care workers regarding
occupational health hazards?
Table 6
HCWs Perceptions of Occupational Health Hazards According to Age Groups using
Mean Scores and Standard Deviation
Age Physical
Hazard
Chemical
Hazard
Biological
Hazard
Mechanical
Hazard
Psychological
Hazard
Overall
occupational
hazards
18-25
n
SD
4.5205
78
1.3079
4.7731
78
1.3048
4.6436
78
1.3464
4.4231
78
1.4808
4.585
78
1.4300
4.5897
78
1.2969
26-33
n
SD
5.1917
193
1.1579
5.2383
193
1.1412
5.3534
193
1.1177
4.9829
193
1.1882
4.9560
193
1.1931
5.1445
193
1.0319
34-41
n
SD
5.3637
245
1.1118
5.5155
245
1.1328
5.5114
245
1.0237
5.2400
245
1.1381
5.0065
245
1.1928
5.3274
245
.9652
42-49
n
SD
5.1307
293
1.1652
5.2188
293
1.1628
5.2065
293
1.2244
5.0713
293
1.2265
4.9044
293
1.2084
5.1063
293
1.0815
50 and
above n
SD
4.3344
262
1.5522
4.4011
262
1.5673
4.4282
262
1.5830
4.2580
262
1.5287
4.1836
262
1.4675
4.3211
262
1.4412
Total
n
SD
4.9557
1071
1.3299
5.0577
1071
1.3377
5.0713
1071
1.3387
4.8478
1071
1.3555
4.7377
1071
1.3268
4.9341
1071
1.2258
Table 6 reveals that HCWs perception of occupational hazards for the following age
brackets were positive (favourable) with the following results for physical hazards 18-25
58
( )5205.4x ; 26-33 ( 1917.5x ); 34-41 ( 3637.5x ); 42-49 ( 1307.5x ). The perception
of physical hazards for the age bracket of 50 and above was unfavourable with the mean
score of 4.3344 which was below the criterion mean of 4.5.
In addition, the HCWs perception of chemical hazards were also positive for all the
age brackets except for 50 and above with the mean score of 4.4011 as compared with the
criterion mean score of 4.5.
Furthermore, the age bracket 34-41 has the highest mean score for biological
hazards, followed by 26-33 ( );3534.5x 42-49 ( )2065.5x ; 18-25 ( );6436.4x 50 and
above has the mean score of 4.4282 which was unfavourable perception as regard biological
hazards.
The HCWs perception of mechanical hazards was positive (favourable) for the
following age brackets with their respective mean score; 34 - 41 ( );2400.5x 42-49
( );0713.5x and 26-33 ( )9829.4x while unfavourable (negative perception) for age
bracket 18-25 ( );423.4x and 50 above (4.2580).
The results for the psychological hazards revealed positive perception for the age
brackets under review as follows: 18-25 ( );585.4x 26-33 );9560.4x 34 – 41
( );0065.5x and 42-49 ( )9044.4x while the age bracket 50 and above ( )1836.4x has
negative (unfavourable) perception of occupational health hazards.
59
Research Question Seven
What are the perception of various level of education of the health care workers
regarding occupational hazards?
Table 7
Health Care Workers Perceptions of Occupational Health Hazards According to Level
of Education
Level of
Education
Results Physical
Hazards
Chemical
Hazards
Biological
Hazard
Mechanical
Hazard
Psychological Overall
occupational
hazards
FSLC
n
SD
3.6820
133
1.5672
3.7707
133
1.6235
3.9023
133
1.5433
3.5451
133
1.4924
3.5090
133
1.4233
3.6818
133
1.4286
O‟LEVEL
n
SD
4.0720
125
1.4978
4.2808
125
1.4844
4.1196
125
1.6150
3.9512
125
1.6209
3.9728
125
1.4324
4.0853
125
1.4282
NCE/DIPL
OMA
n
SD
4.9248
420
1.0625
5.0338
420
1.1051
5.0848
420
1.1410
4.8940
420
1.1357
4.9055
420
1.0892
4.9686
420
1.0070
FIRST
DEGREE
n
SD
5.5972
322
.8616
5.6829
322
.8803
5.6559
322
.8346
5.4453
322
.9013
5.1519
322
1.1030
5.5066
322
.7082
HIGHERDE
GREE
n
SD
6.1718
71
.6264
6.1423
71
.6283
6.1535
71
.6489
5.8831
71
.6204
5.5155
71
1.1357
5.9732
71
.5108
Total
n
SD
4.9557
1071
1.3299
5.0577
1071
1.3377
5.0713
1071
1.3387
4.8478
1071
1.3555
4.7377
1071
1.3268
4.9341
1071
1.2258
The answer to the question above is provided in table 7 above. Higher degree had
highest mean score ( = 6.1718, SD = .6264) for physical health hazard, ( = 6.1423, SD =
60
.6283) for chemical hazards, ( = 6.1535, SD = .6489) for biological hazards, ( = 5.8831,
SD = .6204) for mechanical hazards, ( = 5.5155, SD = 1.1357), and for ( )5155.5
psychological hazard with much variability as compared with others.
The influence of level of education on the health care workers perception of
chemical health hazards revealed that those with higher degrees had the highest mean score
( = 6.1423, SD = .6283), while those with first degree ( = 5.6829, SD = .8803),
NCE/Diploma ( = 5.0338, SD = 1.1051), O‟ Level ( = 4.2808, SD = 1.4844). It was
observed that those with FSLC had unfavourable perception of chemical health hazards
with the mean score of 3.7707 and SD of 1.6235.
Level of education has the same influence on HCWs perceptions of biological
hazards as follows: FSLC ( = 3.9023, SD =1.5433), O‟ Level ( = 4.1496, SD = 1.6150),
NCE/Diploma ( = 5.0848, SD = 1.1410), first degree ( = 5.6559, SD = .8346) and higher
degree with the highest mean score of 6.1535 and SD = .6489 showing little variability.
The influence of level of education on health workers perceptions of mechanical
hazards as indicated in above table revealed the following findings: FSLC ( = 3.5451, SD
= 1.4924), and O‟ Level ( = 3.9512, SD = 1.6209) where unfavourable with the mean
scores lesser than the criterion mean of 4.5, NCE/Diploma ( = 4.8940, SD = 1.1357), first
degree ( = 5.4453, SD = .9013) and higher degree ( = 5.8831, SD = .6204). The higher
the level of education, the higher the influence on health care workers perceptions on
mechanical hazards and the least the variability of their influence on mechanical hazards.
The psychological hazard perception with regards to various level of education
according to the result from the above table 7 revealed that those with higher degrees had
the mean score of 5.8831, those with first degree had mean score of 5.1519 and
NCE/Diploma 4.9055 which were positive perception while those with FSLC and O‟ Level
had unfavourable perception of psychological hazards with the mean score of 3.5090 and
3.9728 respectively.
61
Research Question Eight
What are the perception of various job type of the health care workers regarding
occupational health hazards?
Table 8
Health care workers Perception of Occupational heath Hazards According to Job type
Job type Results Physical
Hazards
Chemical
Hazards
Biological
Hazard
Mechanical
Hazard
Psychological
Doctor
n
SD
5.8759
87
.9136
5.9299
87
.7994
5.9034
87
.8334
5.5069
87
.9800
5.2908
87
1.1276
Nurses/Mid
wives
n
SD
5.5402
373
.8175
5.6826
373
.8536
5.6598
373
.8258
5.4614
373
.8691
5.3560
373
.9624
Pharmacist
n
SD
5.2000
98
.9541
5.2191
89
.8980
5.3213
89
.9056
5.2596
89
1.0045
5.2225
89
1.1116
Scientist/te
chnician
n
SD
4.9590
178
1.0100
5.0702
178
.9637
5.1056
178
1.0385
4.8792
178
1.0602
4.5730
178
1.0204
Attendants/
non
professiona
l
n
SD
4.0244
344
1.5335
4.1113
344
1.5566
4.1414
344
1.5723
3.8930
344
1.5346
3.8872
344
1.4213
Total
n
SD
4.9557
1071
1.3299
5.0577
1071
1.3377
5.0713
1071
1.3387
4.8478
1071
1.3555
4.7377
1071
1.3268
62
The data from the above table 8 revealed the influence of job type on the HCWs
perception of occupational health hazards as follows: Doctor ( = 5.8759, SD = .9136) had
the highest influence on health care workers perception of physical hazard, followed by the
Nurses/midwives ( = 5.5402, SD = .8175), next to nurses were the pharmacist ( = 5.200,
SD = .9541), scientist/technicians ( = 4.9590, SD = 1.0100) and HCWs under the
categories of attendants/non professional had the least influence with the mean score of
4.0244 which was unfavourable perception of physical hazards.
In the same vein, doctor ( = 5.9299, SD = .7994) had the highest influence on
HCWs perceptions of chemical hazards with little variability as compared with others and
this is followed by Nurses/midwives ( = 5.6826, SD = .8536), pharmacist ( = 5.2191, SD
= .8980), scientist/technicians ( = 5.0702, SD = .9637) and the least influence among the
HCW was exerted by the attendants/non-professional ( = 4.1113, SD = 1.5556) which was
unfavourable.
The influence of job types on HCWs perceptions of biological hazards revealed a
positive perception for the following categories of health care workers: Doctor ( = 5.9034,
SD = .8334), and Nurses/midwives ( = 5.6598, SD = .8258), pharmacist ( = 5.3213, SD =
.9056), scientist/technicians ( = 5.1056, SD = 1.0385) and (unfavourable) negative
perception of chemical hazards for attendants/nonprofessional ( = 4.1404, SD = 1.5723).
Similarly, the influence of job types on HCWs perceptions of mechanical hazards
had the same trend as other types of occupational health hazards. The results revealed that
doctor ( = 5.5069, SD = .9800), Nurses/midwives ( = 5.4614, SD = .8691), pharmacist
( = 5.2596, SD =1.0045), scientist/technicians ( = 4.8792, SD = 1.0602) and
attendants/nonprofessional ( = 3.8930, SD = 1.5346).
The study revealed further the influence of job type on HCWs perceptions of
psychological hazards as follows: Nurses/midwives ( = 5.3560, SD = .9624) with the
63
highest mean score, followed by doctor ( = 5.2908, SD = 1.1276), pharmacist ( = 5.2225,
SD = 1.1116), scientist/technicians ( = 4.5730, SD = 1.0204) while
attendants/nonprofessional ( = 3.8872) had unfavourable psychological hazards
perception.
Research Question Nine
What are the perception of male and female of the health care workers regarding
occupational health hazards?
Table 9
Health care workers Perception of Occupational Hazards According to Gender
Gender More
Unfavour
Unfavour Neutral Favour More
Favour
Most
Favour
SD
M 19 36 72 225 192 20 5.03 13.4
F 39 69 69 127 175 28 2.91 12.09
In answer to research question 9, table 9 above provides the means and standard
deviations of the male and female on HCWs perception of occupational hazards. Male had
higher mean score ( = 5.03); SD = (13.4); which points to the fact that male tend to have
more favourable perception of occupational hazards when compared to their female
counterpart with the mean score ( = 2.91) which was below the criterion mean of 4.5; SD
= (12.09). The variability of the male respondents was higher than the female respondents
signifying that male had much more influence on HCWs perception of occupational hazards.
64
Research Question Ten
What are the perception of various location of health care workers regarding
occupational health hazards?
Table 10
Health care workers Perception of Occupational Health Hazards According to
Location
Location More
unfavour
Unfavour Neutral Favour More
favour
Most
favour
Total
SD
Rural 45
74
97 231
170 10
627
4.51
13.4
Urban 13
31
44
121
197
38
444 2.91 12.09
In answer to research question 10, table 10 above provides the means and standard
deviations of the rural and urban respondents of HCWs perceptions of occupational health
hazards. Rural respondents with slightly higher mean score perception of ( =4.51); (SD =
13.4) than urban respondents with the mean score of ( = 2.91); (SD = 12.09) on perception
questionnaire. The variability of the rural respondents is higher than the urban respondents
signifying that rural respondents have higher influence on HCW perception. The mean
score of the respondent in the rural area was 4.51 signifying favourable perception while
those in the urban area showing unfavourable perception of occupational hazards with the
mean score of 2.91 which was below the criterion mean score.
65
Hypothesis One
The health workers‟ perception of occupational hazards is not dependent on their age
Table 11
Summary of ANOVA Verifying the HCWs Perception of Occupational Health Hazards
According to Age Groups
Age Sum of
squares
df Mean
square
F-cal F-tab p Decision
18-25 176.427 4 44.107 27.399 2.37 .05 Rej.
26-33 184.507 4 46.127 28.420 2.37 .05 Rej.
34-41 190.781 4 47.695 29.442 2.37 .05 Rej.
42-49 161.055 4 40.264 23.778 2.37 .05 Rej.
50 above 117.228 4 29.307 17.686 2.37 .05 Rej.
According to the Table, the F-calculated values of hazard were greater than the F-
critical table values at.05 level of significance. The age brackets were 18-25 (F = 27.399 >
2.37), 26-33 (F = 28.420 > 2.37), 34-41 (F = 29.442 > 2.37), 42-49 (F = 23.778 > 2.37) and
50 and above (F = 17.686 > 2.37). Consequently, the null hypothesis (Ho1) was rejected. It
then follows that health care workers perception of occupational health hazards was
dependent on their ages. Data in Table 11 revealed that age was statistically significant and
dependent on the health care workers perceptions of the five dimensions of occupational
hazards.
66
Hypothesis Two
The health workers‟ perception of occupational hazards is not dependent on their
level of education
Table 12
Summary of ANOVA Verifying the HCWs Perceptions of Occupational Health
Hazards According to Level of Education
Level of
education
Sum of
squares
df Mean
square
F-cal F-tab p.05 Decision
FSLC 551.320 4 137.830 109.553 2.37 .05 Rej.
O‟ Level 505.375 4 126.344 95.568 2.37 .05 Rej.
NCE/Diploma 481.235 4 120.309 89.282 2.37 .05 Rej.
First degree 518.158 4 129.539 95.367 2.37 .05 Rej.
Higher degree 383.925 4 95.981 68.224 2.37 .05 Rej.
Data in Table 12 revealed that level of education was statistically significantly
influential on the health care workers perceptions of the five dimensions of occupational
health hazards. According to the Table, the F-calculated values of occupational health
hazards were greater than the F-critical table values at .05 level of significance. The various
level of education under review in this study are FSLC (F = 109.553 > 2.37), O‟ level (F =
95.568 > 2.37), NCE/Diploma (F = 89.282 > 2.37) and higher degree (F = 68. 224 > 2.37).
Consequently, the null hypothesis (Ho2) was rejected. It then follows that health care
workers perceptions of occupational health hazards was dependent on their level of
education.
67
Hypothesis Three
The health workers‟ perception of occupational hazards is not dependent on their job
type
Table 13
Summary of ANOVA Verifying the HCW’s Perceptions of Occupational Health
Hazards According to their Job type
Job type Sum of
squares
df 2)(
F-cal F-
tab
p.05 Decision
Doctor 504.761 4 126.190 96.936 2.37 .05 Rej.
Nurses/midwives 522.259 4 130.565 99.959 2.37 .05 Rej.
Pharmacist 493.292 4 123.323 92.293 2.37 .05 Rej.
Scientist/technicians 507.082 4 126.770 92.620 2.37 .05 Rej.
Attendants/non-
professional
443.795 4 110.949 82.142 2.37 .05 Rej.
Data in Table 13 revealed that job type statistically significantly influenced the
health care workers‟ perceptions of occupational hazards. According to the Table, the F-
calculated values for the occupational hazards were greater than the F-critical table values at
.05 level of significance. The various job types studied among health care workers are
doctor (F =96.936> 2.37), Nurses/midwives (F = 99.959 > 2.37), pharmacist (F = 92.620 >
2.37) and attendants/nonprofessional (F = 82-142 > 2.37). Therefore, the null hypothesis
(Ho3) was rejected. It then follows that health care workers perceptions of occupational
health hazards was dependent on their job type.
68
Hypothesis Four
The health workers‟ perception of occupational hazards is not dependent on their
gender.
Table 14
Summary of t-test statistic verifying the HCW’s perception of occupational health
hazards based on gender
Dimension of
Hazard
Gender N
SD df t-cal t-tab p Decision
Physical M
F
564
507
5.0986
4.7968
1.2037
1.4422
1069
3.730
1.960
.05
Rej.
Chemical M
F
564
507
5.1771
4.9249
1.1818
1.4820
1069
3.094
1.960
.05
Rej.
Biological M
F
564
507
5.1952
4.9335
1.2132
1.4547
1069
3.208
1.960
.05
Rej.
Mechanical M
F
564
507
4.9264
4.7604
1.2342
1.4752
1069
2.005
1.960
.05
Rej.
Psychological M
F
564
507
4.8135
4.6535
1.2195
1.4333
1069
1.973
1.960
.05
Rej.
Overall
occupational
hazards
M
F
564
507
5.0422
4.8138
1.0803
1.3606
1069
3.056
1.960
.05
Rej.
In Table 14 above, data revealed that the five dimensions of hazard showed the
existence of significant difference between male and female health care workers in their
responses. In other words, health workers perceptions of occupational hazard was
dependent on their gender. The five dimensions of occupational hazards revealed, the t-cal >
t-tab at.05 level of significance, therefore the null hypothesis (Ho4) was rejected. The
dimensions are physical (t-cal = 3.730 > 1.960), chemical (t-cal = 3.094 > 1.960), biological
(t-cal = 3.208 >1.960), mechanical (t-cal = 2.005 > 1.960) and psychological (t-cal = 1.973 >
69
1.960). The overall occupational health hazard in respect to the respondents gender revealed
(t-cal = 3.058 > 1.960). Consequently, the null hypothesis (Ho4) was rejected. It then
follows that HCW‟s perception of occupational hazards was dependent on their gender.
Hypothesis Five
The health workers‟ perception of occupational hazards is not dependent on their
location.
Table 15
Summary of t-test Statistic Verifying the HCW’s Perception of Occupational Health
Hazards Based on their Location
Dimension of
Hazard
Location N
SD df t-cal t-tab p Decision
Physical Urban
Rural
444
627
5.3027
4.7100
1.2608
1.3238
1069
7.361
1.960
.05
Rej.
Chemical Urban
Rural
444
627
5.4050
4.8118
1.2375
1.3523
1069
7.323
1.960
.05
Rej.
Biological Urban
Rural
444
627
5.3962
4.8413
1.2631
1.3441
1069
6.823
1.960
.05
Rej.
Mechanical Urban
Rural
444
627
5.1903
4.6053
1.2601
1.3693
1069
7.118
1.960
.05
Rej.
Psychological Urban
Rural
444
627
4.9869
4.5612
1.2888
1.3260
1069
5.236
1.960
.05
Rej.
Overall
occupational
hazards
Urban
Rural
444
627
5.2562
4.7059
1.1386
1.2350
1069
7.418
1.960
.05
Rej.
Data in Table 15 revealed that health care workers‟ perceptions of occupational
health hazards was dependent on their location. The entire five dimensions of occupational
health hazards were grossly dependent on the respondents‟ location in terms of urban and
rural locations. According to the Table, the t-calculated values for the five dimensions of
hazards were greater than the t-critical table values at .05 level of significance. The
70
dimensions are physical (t-cal = 7.361 > 1.96), chemical (t-cal = 7.323 > 1.96), biological (t-
cal = 6.823 > 1.96), mechanical (t-cal = 7.118 > 1.96) and psychological (t-cal = 5.236 >
1.96). Consequently, the null hypothesis (Ho5) was rejected. It then follows that health care
workers perceptions of occupational health hazards was dependent on their location.
Summary of Major Findings
The perception of the health care workers on the five dimensions of occupational
health hazard studied were as follows:
1) The health care workers agreed with all the items on physical hazards; hence their
perception was positive. See Table 1.
2) The chemical hazards in the workers‟ workplace were positively perceived. This was
evidenced in their agreement with all the relevant statements regarding this category
of hazards. See Table 2.
3) Regarding perceived biological hazards, the health care workers agreed with all the
relevant statements with much emphasis on unhealthy environment and undue
exposure to unscreen blood products that could cause deadly disease and shorting
life. See Table 3.
4) The respondents perceived mechanical hazards in their workplace positively.
However, their perception of injury from burns, sharp/skin piercing instrument and
lifting of very heavy patient had the highest mean scores. See Table 4.
5) The health care workers perceived psychological hazards in their workplace
positively (Table 5). Meanwhile, poor remuneration, queries and retrenchment to
workers, rape may cause emotional imbalance and repetitive work may cause
boredom and hazardous to health had the highest mean scores respectively.
6) The perception of various age brackets of the health care workers regarding
occupational health hazards were favourable. See Table 6.
7) The perception of various level of education of the health care workers regarding
occupational health hazards varing from higher degrees (most favourable) to FSLC
(most favourable) with negative perception of OHH. See Table 7.
8) The various categories of job type among the health care workers revealed that
doctor, nurses/midwives, pharmacist and scientist/technicians had favourable
71
(positive) perception of physical, biological, mechanical and psychological health
hazards. Meanwhile, attendants/non professional had negative (unfavourable)
perception of occupational health hazards. See Table 8.
9) The perception of male health care workers regarding occupational health hazards
was most favourable with mean score of 5.03 while female had unfavourable
(negative perception) of occupational health hazard with mean score of 2.91. See
Table 9.
10) The perception of the respondents location in terms of urban and rural locations of
health care workers regarding occupational health hazards was favourable (positive)
for rural respondents with the mean score of 4.51 while that of urban location was
unfavourable (negative perception) with the mean score of 2.91. See Table 10.
11) Age exerted significant influence on the health care workers perceptions of
occupational health hazards 18-25 age group (F = 27.399 > 2.37), 26-33 (F = 28.420
> 2.37), 34-41 (F = 29.442 > 2.37), 42-49 (F = 23.778 > 2.37) and 50 and above (F =
17.686 > 2.37).
12) Level of education exerted significant influence on the health care workers
perception of occupational health hazards as follows FSLC (F = 109.553 > 2.37) O‟
level (F = 95.568 > 2.37), NCE/Diploma (F = 89.282 > 2.37), First degree (F =
95.367 > 2.37) and Higher degree (F = 68.224).
13) The health care workers perceptions of occupational health hazards was dependent
on their job type. The various job types studied among health care workers are doctor
(F = 96.936 > 2.37), Nurses/midwives (F = 99.959 > 2.37), pharmacist (F = 92.293 >
2.37), scientist/technicians (F = 92.620 > 2.37), and attendants/nonprofessional (F =
82.142 > 2.37).
14) The health care workers perceptions of occupational hazards was dependent on their
gender (t-cal = 3.058 > 1.960). The dimensions of occupational health hazard
involved in the study include physical (t-cal = 3.730 > 1.960), chemical (t-cal =
3.094 > 1.960), biological (t-cal = 3.208 > 1.960), mechanical (t-cal = 2.005 >
1.960), and psychological (t-cal = 1.973 > 1.960).
15) The health care workers perceptions of occupational health hazards was dependent
on their location. The HCWs perceptions of any of the dimension of occupational
72
health hazards depend on their location of either rural or urban centres. Occupational
health hazards perceptions in respect to their location (t-cal = 7.418 > 1.960).
Discussion of Findings
In discussing the findings, it has been organized and presented under the following
headings which represent the major dimensions of hazards that were investigated. These
were health care workers perceptions of the physical, chemical, biological, mechanical and
psychological hazards and factors influencing health care workers perception of
occupational health hazards.
Health Care Workers (HCW’s) Perception of Physical Hazards
The findings of the present study reveal that health care workers perception of
physical hazards depend on their gender (t-cal = 3.730 > 1.960) at .05 level of significance
(Table 14). This finding is in agreement with the study conducted by Amunega (2002) in
Odo-Okun saw mill in Ilorin West local government area of Kwara state that saw mill
workers perceptions of physical hazard was dependent on their age and gender.
HCW’s Perception of Chemical Hazards
The findings that the HCW‟s perception of chemical hazards in their workplace was
adequate was very encouraging and favourable. That is, the HCWs were aware and could
recognize the presence of chemical hazards in their workplace. However, the perception of
the HCW‟s was found not to be that of neglect but clear awareness and recognition of the
presence of chemical hazards in their workplace. They had adequate perception of the
chemically hazardous condition which they deliberately entered (Table 2). The health care
workers perceptions of chemical hazards include allergic contact dermatitis, non-adhesive
surface and fall, all hazards including corrosive acid, inhaled chemical and delayed potential
effects of chemicals include cancer of occupational origin. The grand mean score of health
care workers perceptions of chemical health hazards was above the criterion mean score
5.0577 > 4.50.
73
HCWS’ Perception of Biological Health Hazards
The finding that the health care workers‟ perception of biological hazards in their
workplace was favourable and very encouraging. That is, the health care workers were
aware and could recognize the presence of biological hazards in their workplace (Table 3).
The health care workers aware that unhealthy environment may constitute to
biological hazards, biological agents like viruses, bacteria, fungi, parasites and animals
capable of causing pneumonia, gastroenteritis and hepatitis. Furthermore, exposure to
tuberculosis and yellow fever patient, undue exposure to blood and other body fluids may be
deleterious.
It therefore concluded that health care workers perceptions of biological hazard was
showing high positive perception of biological health hazards.
Health Care Workers Perception of Mechanical Hazards
It was established that, health care workers perceived their vulnerability to
mechanical hazards (Table 4) such as injury from sterilizer leading to burns, sharp
instrument or skin piercing instruments, needle pricks or recapping and other hospital
machines. The health care workers could recognize a mechanical hazards and they aware of
its presence in the hospital environment. The finding was in agreement with Takala (2000)
who observed that mechanization had ushered in increase in potential harm. Furthermore,
the study was also in agreement with the study conducted by Fasunloro and Owotade (2004)
on perceived occupational hazards among the clinical dental staff of the OAUTHC, Ile-Ife in
Osun state that the HCWs had good occupational hazard perception and aware of the
occupational exposure to mechanical hazards.
Health Care Workers Perception of Psychological Hazards
The finding that the health care workers of psychological hazards in their workplace
was adequate and very encouraging. That is, the health care workers were aware and could
recognize the presence of psychological hazards in their workplace (Table 5). The health
care workers considered poor remuneration, queries and retrenchment more hazardous ( =
5.0990). Above all, all the ten statement items under psychological hazard were considered
hazardous with different degree of perception. The health care workers disagreed with the
74
statement in items 44, 48 and 49 with their mean scores less than the criterion mean for the
study. Similarly, the study is in agreement with the study conducted by Enebechi (2008) on
perceived occupational health hazards among teachers in government secondary school in
Udi education zone of Enugu state.
The findings of this report were congruent with that of Ajala and Bolarinwa (2002)
who established significant difference between senior and junior staff of colleges of
education in south-western Nigeria regarding their perception of psychological health hazard
at workplace.
Factors Influencing Health Care Workers Perception of OHH
The influence of certain demographic variables as age, level of education, job type,
gender and location on the health care workers perception of occupational hazards formed
the main focus on research questions 6-10 and the five null hypotheses. Regarding the
influence of age, Table 6 contain data testing this variable. Data in the table showed that
health care workers perception of physical, chemical, biological mechanical and
psychological health hazards was dependent on their age. According to the Table, the Ho1
was rejected. In the five dimensions of occupational health hazards, age depend on health
care workers perceptions of those health hazards.
These developments agree with Borgman (1971) who stated that perception changes
with individual‟s age because there was increased susceptibility to various optical illusions
with increasing age. It then follows that optical illusion could influence hazard perception
negatively. Bergh (2003) observed that occurrence of individual accidents was associated to
such personal factor as age. He noted that accidents were more between ages 17 to 28 and
60 years and above.
In contrast, the study was not in agreement with the study conducted by Amunega
(2002) on occupational hazards in Odo-Okun sawmill in Ilorin west local government area
of Kwara state that indicated that there was no statistical difference with regard to age and
gender of sawmill workers of occupational health hazards at .05 level of significance.
Regarding the Influence of level of education, Table 7 and 10 contains data testing
this variable. Data in the tables showed that health care workers perception of physical,
chemical, biological, mechanical and psychological health hazards was dependent on level
75
of education (Table 10). According to the Table, the Ho2 was rejected. However, level of
education exerted significant influence on the health care workers perception of physical,
chemical, biological, mechanical and psychological health hazards hence, the Ho2 was
rejected. This study is in agreement with the findings of Nweke 1996 and Oji, 1994 that
occupational health hazard perceptions is dependent on level of education, job type and
years of experience.
Regarding the influence of job type, Table 8 and 13 contains data testing this
variable. Data in the tables showed that health care workers perception of physical,
chemical, biological, mechanical and psychological hazards was dependent on job type,
(Table 11). According to the Table, the Ho3 was rejected. The present study is in agreement
with Fasunloro and Owotade (2004), who conducted study on occupational hazards among
the clinical dental staff of the OAUTHC, Orji et al (2003) in UNTH, Arun Garg (2006) in
USA, and Olayemi (2005) at Aro-Abeokuta Psychiatric Hospital established the influence of
job type and location on occupational hazards perception.
Gender, was another demographic variable considered while investigating the
subjects on their perception of hazards in their workplace. Data showing the result were
presented in Tables 9 and 14. Investigation reveals that there was significant difference
between male and female health care workers regarding their perception of physical,
chemical, biological, mechanical and psychological hazards (Tables 9 and 14). The
corresponding tables showed that the null hypothesis (Ho4) was rejected at .05 level of
significance. Therefore, the health care workers perceptions of occupational heath hazards is
dependent on their gender. The study disagree with Sorenson, Malm and Forehand (1971)
who asserted that the perception of occupational health hazards is not dependent on their
gender but the study is strongly agree with Ajala and Bolarinwa (2002) who found out
disparity between male and female staff of colleges of education in south-western Nigeria
regarding their perception of occupational hazards in their workplace. The study further
agree with Bergh (2003) that occupational health hazard is dependent on their gender and
age as earlier mentioned. This result was not unexpected against the background of available
literature. The investigator has expected the female gender to show different perception of
hazards. This is because the female gender has been known to show more cautions
behaviour than their male counterparts who are culturally known to engage in risky
76
behaviours. This is understandable as Hattingh (2003) revealed that, in some cultures, risky
behaviours were viewed as brave or adventuresome in contrast with too cautions behaviours
which was viewed as dull or cowardly. However, gender was not culturally considered in
the present study, and incidentally the result is in line with what is obtainable naturally and
culturally.
Last but not the least, location of the respondents was considered while investigating
the subjects on their perceptions of occupational hazards in their workplace. Data showing
the result were presented in Table 10 and 15. The mean score ( = 4.51) of the rural
respondents is above the criterion mean score of 4.0 with high variability (SD = 13.4) as
compared with urban respondents (SD = 12.9). While the mean score ( = 2.91) of the
urban health care workers is less than the criterion mean score. The rural health care workers
had most favourable perceptions of the occupational health hazard and the urban health care
workers had most unfavourable occupational health hazard perception.
Further statistic in Table 15 reveals that the health care workers perceptions is
dependent on their location at .05 level of significance, therefore the null hypothesis (Ho5)
was rejected. The health care workers perceptions of occupational health hazards were
dependent on their location. The overall health care workers perception of occupational
hazard with regard to their location (t-cal = 7.418 > 1.960) at .05 level of significance is
dependent on the location of the respondents. This is in agreement with the result of the
studies conducted by Fasunloro and Owotade (2004) on occupational hazard among the
clinical dental staff of the OAUTHC, Orji et al (2003) in UNTH, Arun Garg (2006) in USA
and Olayemi (2005) at Aro-Abeokuta Psychiatric Hospital who established the influence of
location on occupational hazard perceptions. Similarly, Amunega (2002) established a
significant influence of location on sawmill workers perception of occupational hazard when
conducting a study at Odo-Okun sawmill, Ilorin Kwara state.
So, from the findings in the study, there is every need to re-orientate the health care
workers towards adequate and accurate perceptions of occupational health hazards in their
workplace. Inaccurate perceptions may be very detrimental to the safety of the perceiver
because of the potentiality of leading to accidents, injuries or death. The findings so far
agree with the submission of Igwe (1998), that there were those who know about the danger
77
but may not be aware of its presence; could recognize a hazard but are not thinking about it;
deliberately enter a hazardous situation after appraising the danger and deciding that odds of
not being injured favour them and know about the danger in a hazard but believe they are
personally not vulnerable to danger. The health care workers could recognize, appraise and
aware of hazards in their workplace but there is incessant report of needle stick injuries,
cross infection, conflicts and transmission of various deadly diseases among others in their
workplace.
78
CHAPTER FIVE
Summary, Conclusion and Recommendation
Summary of the Study
The present study was purposely aimed to identify the perceived occupational
health hazards among health care workers in government hospitals in Ondo state. To achieve
this, ten research questions were posed and five null hypotheses (Ho) postulated.
The cross sectional survey design was utilized to collect data from a sample of 1071
health care workers drawn from eighteen local government area of the state. The sample cut
across all categories of health care workers, older and young as well as male and female
health care workers in both urban and rural areas of the state. Data generated were analyzed
item-by-item using mean and standard deviation to answer ten research questions. The
ANOVA statistic was employed to test the first three null hypotheses (Ho1 – Ho3) and t-test
statistic was employed to test the last two hypotheses (Ho4 and Ho5) at .05 level of
significance.
At the end, the following findings were made, the health care workers
(1) were aware of the dangers in a physical hazard;
(2) perceived entering physically hazardous conditions as worthwhile because of their
belief of withstanding effect of the injury;
(3) perceived their vulnerability to physical hazards;
(4) were aware of, and could recognize chemical hazard in their workplace;
(5) perceived harm in deliberately entering chemical hazardous situations;
(6) perceived their vulnerability to the dangers of chemical hazard;
(7) were aware of the long term effect of chemical hazards like cancer of occupational
hazards;
(8) were aware of, and could recognize biological hazards in their workplace. They also
perceived their vulnerability to biological hazards;
(9) perceived risk of the biological hazards like transfer of infection, undue exposure to
blood and other body fluids;
68
79
(10) were aware of the presence and increased mechanical hazards in the hospital
ranging from the burns from sterilizer, skin piercing equipment, sharp objects,
needle stick injury and needle recapping hazards;
(11) perceived vulnerability to mechanical hazards;
(12) were aware of the dangers in a psychological hazards;
(13) were aware and could recognize psychological hazards like emotional trauma,
imbalance, stress and family conflict as a result of shift duties among health care
workers;
(14) perceived vulnerability to psychological hazards. The study further showed that at
.05 level of significance;
(15) health care workers (hcw‟s) perceptions of occupational health hazards dependent
on their age;
(16) hcw‟s perceptions of occupational health hazards (OHH) dependent on their level of
education;
(17) hcw‟s perceptions of OHH dependent on their job type;
(18) hcw‟s perceptions of OHH dependent on their gender; and
(19) hcw‟s perceptions of OHH dependent on their location.
Conclusions
Based on the findings of the study, the following conclusions were made
1. Health care workers in Ondo state government hospitals showed positive perception
of physical health hazards. This answer research question one.
2. Health care workers in Ondo state government hospitals showed positive perception
of chemical hazards. This answer research question two.
3. The perception of health care workers was positive and significant regarding
biological hazard with much emphasis on unhealthy environment that capable of
causing biological hazard. This is followed by undue exposure to blood that could
cause deadly disease. This answer research questions three.
4. The health care workers perceived mechanical hazards positively with much
emphasis on injury from burns and sharp instrument. This answer research questions
four.
80
5. Health care workers in Ondo state government hospitals showed positive perception
of psychological health hazards. This answer research questions five.
6. The health care workers perception of occupational health hazard is dependent on
their age. The age bracket 42-49 had the highest influence on healthcare workers
perception of occupational health hazard. While the age bracket 18-25 had the least
influence on their perceptions of occupational health hazards.
7. The health care workers perceptions of occupational health hazards are dependent on
their level of education. This verifies the null hypothesis (Ho2).
8. Job type is dependent on health care workers perception of occupational health
hazards. This verifies null hypothesis three (Ho3).
9. Health care workers perceptions of occupational health hazards are dependent on
their gender. This verifies null hypothesis four (Ho4).
10. Location has a significant influence on health care workers perceptions of
occupational health hazards. On other hand, HCW perceptions of occupational
health hazards are dependent on their location.
Recommendations
The following recommendations were made, based on the finding of the study and
conclusion drawn:
1. The hospitals management board, Akure and board of directors FMC, Owo, should
encourage safety education/seminar/workshop among the health care workers. This
can be done by making a lecture on safety education mandatory during health
workers forum in the ministry of health and social development monthly interactive
session.
2. Ministry of health and social development Ondo state can partner with the
millennium goals providers (UNICEF, PATHS) to train counselors and health
educators on safety education, hazard prevention and management.
3. Organization of health and safety week should be mandatory in hospitals like Nurses
and Doctors week celebrations.
81
4. Government should mobilize every hospital to establish a hazard control
organization/unit in their various hospitals. In addition, crisis intervention workers
should also be employed and adequately equipped.
5. Seminars and workshops on hazards would help to update the health care workers
knowledge on the subject matter.
6. The use of standard/universal precaution should be entrenched in all hospitals
among health care workers.
7. Regular in training for all health workers should be encouraged by the government
to acquaint with the latest technology in the health care sector.
Limitations of the Study
1. The researcher was limited to Ondo state government hospitals health care workers
by financial constraints and time for the study.
Suggestions for Further Research
The researcher suggest thus:
1. Similar study can be carried out on Ondo state comprises both private and
government hospitals.
2. A study to correlate the health care workers perception with their occupational health
practices should be carried out.
Similar studies should be conducted on regional or national scale to examine the socio-
demographic variables on health care worker perception of occupational health hazards.
82
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Appendix 1
University of Nigeria,
Health and Physical Education Department,
Nsukka.
4th December, 2008.
Dear Respondent,
This questionnaire is designed to study the perceived occupational health hazards
among health care workers in government hospitals in Ondo State requires your full
cooperation for the successful completion of the study. You are kindly required to respond
to the items of the questionnaire as they apply to you. Therefore, feel free to express your
candid opinion on each of the items.
It is divided into two sections. Section A seeks information on personal data while
section B seek information on perceived occupational health hazards among health care
workers. Each statement is followed by 7-point Bi-polar Adjective Scale. Bi-polar Adjective
Scale is a scale made up of two opposite adjectives are separated by 7 points which increase
towards the favourable side and decrease towards the unfavourable side.
The scale is scored as follows:
Increase Decrease
7 .6 . 5 . 4. 3 . 2 .1
favourable adjective unfavourable adjective
7=MostfavourableAdjective,6=Morefavourable,5=Favourableadjective,4=Neutral,3=Unfavo
urable adjective,2=More unfavourable, and 1=Most unfavourable adjective.
An example is given below to guide you .Please circle the score that most applies to you on
the 7 points Bi-polar Adjective Scale:
1. Needle prick may be part of physical health hazard.7 (.6 ).5 .4 . 3 .2 .1 .
2 Needle prick may be part of physical health hazard.7 .6 .5 .(4 ). 3 .2 .1 .
3 Needle prick may be part of physical health hazard.7 .6 .5 .4 . 3 .2 .(1)
Explanation:
1. The first respondent considers needle prick more hazardous .He circles the score 6.
2. The second respondent considers needle prick neither hazardous nor non hazardous. He
circles the score 4 (Neutral)
3. The third respondent considers needle prick most unhazardous. He therefore circles the
score 1.
Please tick () against the response that is suitable for you. Your genuine response is
required and will be treated as confidential.
Thanks for your cooperation.
Yours sincerely,
Obalase,Stephen.B.
(Researcher).
89
SECTION A
SOCIO-DEMOGRAPHIC DATA
1. Gender A. Male B. Female
2. Location A. Urban B. Rural
3. Job type A. Doctor B. Nurses/Midwives C. Pharmacist
D. Scientist/Technicians E. Attendants/Non professional
4. Level of Education A. FSLC B. O‟Level C. NCE/Diploma
D. First degree E. Higher degree
5. Age A. 18-25 B. 26-33 C. 34-41 D. 42-49 E. 50 and above.
SECTION B
INSTRUCTION – Indicate your degree of agreement with each of the following statements about
perceived occupational health hazards by circling the score that most applies to you on the 7-point
Bi-polar Adjective Scale
1. Assault may lead to physical weakness of the body 7.6.5.4.3.2.1
2. Sharp objects could be dangerous and capable of causing discomfort to ones life
7.6.5.4.3.2.1
3. Exposure to ionizing radiation e.g. X-ray may damage tissue and be life-threatening
7.6.5.4.3.2.1
4. Noise from hospital machine may cause hearing disability or deafness. 7.6.5.4.3.2.1.
5. Poor ventilation as a result of overcrowding may lead to suffocation 7.6.5.4.3.2.1.
6. Extreme cold or hot weather may lead to physical health hazard and altered body thermo
regulation 7.6.5.4.3.2.1.
7. Trauma arising from unsafe environments within hospital may be injurious and life threatening
7.6.5.4.3.2.1.
8. Hospital machine may produce noise capable of causing nervousness and fatigue
7.6.5.4.3.2.1.
9. Exposure to vibration may also produce injuries of the joints of the hand, elbows and
shoulders. 7.6.5.4.3.2.1.
10. Radiation hazards may cause sterility, genetic changes and malformation.
7.6.5.4.3.2.1.
11. Drugs may constitute poison if not well administered and lead to chemical hazard.
7.6.5.4.3.2.1.
12. Disinfectant may be corrosive. 7.6.5.4.3.2.1.
13. Allergic contact dermatitis may lead to skin infection. 7.6.5.4.3.2.1.
14. All chemicals like formalin used in laboratories and anaesthetic agents may cause heart
failure and other health related problems. 7.6.5.4.3.2.1.
15. Delayed potential effects of chemicals include cancer. 7.6.5.4.3.2.1.
16. Chemical agents may act by local action, inhalation and ingestion and cause disorientation.
7.6.5.4.3.2.1.
17. Inhaled chemicals from hospital may cause blood circulatory problems. 7.6.5.4.3.2.1.
18. Chemical agents may constitute respiratory tract infection. 7.6.5.4.3.2.1.
19. Non adhesive surface floor can lead to fall and fracture of bone . 7.6.5.4.3.2.1.
20. Dilapidated building structure may harbour rodents to constitute life-threatening
hazard.7.6.5.4.3.2.1.
21. Exposure to blood could cause deadly disease and shorting life. 7.6.5.4.3.2.1.
22. Body fluids from patient may be deleterious and lead to transfer of infection.
7.6.5.4.3.2.1.
23. Exposure to tuberculosis and yellow fever patients may lead to air and blood borne infection
.7.6.5.4.3.2.1.
90
24. Exposure to infectious patients weaken ones immunity. 7.6.5.4.3.2.1.
25. Lack or inadequate of waste disposal facilities may cause biological hazards.
7.6.5.4.3.2.1.
26. Untidy environment may harbour and support the growth of mosquito leading to malaria
attack. 7.6.5.4.3.2.1.
27. Irregular hand washing after attending to patients may constitute biological hazards.
7.6.5.4.3.2.1.
28. Unhealthy environment may constitute to biological hazards. 7.6.5.4.3.2.1.
29. Biological agents like viruses, bacteria, fungi, parasites and animals may cause health hazard
like pneumonia, gastroenteritis and hepatitis. 7.6.5.4.3.2.1.
30. Overcrowding is capable of causing suffocation . 7.6.5.4.3.2.1.
31. Needle pricks can constitute mechanical injury. 7.6.5.4.3.2.1.
32. Injury from burns may lead to shock and loss of body electrolyte. 7.6.5.4.3.2.1.
33. Injury from sterilizer or auto calve machine may be harmful and cause sudden death.
7.6.5.4.3.2.1.
34. Injury from other equipment like scissors and forceps may be tasking. 7.6.5.4.3.2.1.
35. Hospital machines are capable of causing body aches, fatigues and anxiety.
7.6.5.4.3.2.1.
36. Sharp instruments or skin-piercing instrument should be well kept after use otherwise it can
harbour infection. 7.6.5.4.3.2.1.
37. Needle recapping can lead to transfer of deadly disease like HIV/AIDS. 7.6.5.4.3.2.1.
38. Indiscriminate disposal of syringe and needle may lead to needle stick injury.
7.6.5.4.3.2.1.
39. Passing of instrument to doctor / Nurse carelessly may be life threatening by causing injury
to the care giver. 7.6.5.4.3.2.1.
40. Lifting of heavy patient may cause back ache and fatigue. 7.6.5.4.3.2.1.
41. Rape may cause emotional imbalance. 7.6.5.4.3.2.1.
42. Stress from work causes boredom. 7.6.5.4.3.2.1.
43. Shift duties may lead to breakdown, untrust and psychosocial problems among families.
7.6.5.4.3.2.1.
44. Strained relationship among staff could constitute to emotional breakdown.
7.6.5.4.3.2.1.
45. Sexual harassment may occur in workplace among staff to staff or from staff to patient and
lead to emotional imbalance. 7.6.5.4.3.2.1.
46. Repetitive work may cause boredom and hazardous to health. 7.6.5.4.3.2.1.
47 Unrealistic personal expectations and unattainable aspirations may cause chronic stress,
fatigue and burnout. 7.6.5.4.3.2.1.
48. Work that conflicts with personal values may create tremendous stress for employees.
7.6.5.4.3.2.1.
49. Frustration and aggression within work place may cause psychosocial hazard.
7.6.5.4.3.2.1.
50. Poor remuneration, queries and retrenchment to workers may ruin workers career and be life
threatening. 7.6.5.4.3.2.1.
91
Appendix 11
POPULATION OF HEALTH WORKERS IN GOVERNMENT HOSPITALS IN
ONDO STATE AS AT 30th
AUGUST, 2008.
S/N SENATORIAL DIST NAME OF HOSPITAL POPULATION
1. ONDO NORTH S.S.H.IKARE 412
2. ,, G.H.IWARO 171
3. ,, G.H.IPE 74
4. ,, G.H.IRUN 84
5. ,, G.H.OWO 145
6. ,, G.H.IDOANI 137
7. ONDO CENTRAL S.S.AKURE 931
8. ,, N.P.H.AKURE 190
9. ,, S.S.H.ONDO 814
10. ,, G.H.IGBARA-OKE 92
11. ,, G.H.ILE-OLUJI 109
12. ,, G.H.IDANRE 82
13. ,, G.H.IJU/ITAOGBOLU 104
14. ONDO SOUTH S.S.H.OKITIPUPA 392
15. ,, G.H.IGBOKODA 99
16. ,, G.H.ORE 148
17. ,, G.H.ODE -IRELE 69
18. ,, G.H.IGBEKEBO 39
19. ,, G.H.ESEODO 58
20. ONDO NORTH
FED. MED.CENT,OWO
1179
TOTAL=5329
Source: HMB and FMC office of statistic and personnel management.
92
Appendix III
TITLE: TWO DAYS TRAINING PROGRAMMES FOR RESEARCH ASSISTANTS
Introduction: The training programme is to provide information for administration of
questionnaire to respondents on the topic, perceived occupational health hazards among
health care workers in government hospitals in Ondo State.
The purpose is to ensure that adequate information is provided to enable the researcher
to get a better result of his findings. To also enable him make possible selection of the best
research assistants for the study. The training programme will involve eight research
assistants to be familiar with the contents of the questionnaire, manner of approach and the
location of the hospitals. The training will last for two days after which an examination will
be conducted to select the best four among them.
93
94
Appendix V
Questions:
Instruction: Answer all questions
Time allowed: 10 minutes
1. What is the duty of research assistant?
2. Mention three qualities of a good research assistant.
3. List two factors that can hinder the effectiveness of a research assistant.
4. Enumerate three reasons while the research assistant should know the location of the
research area. 25 Marks each.
ANSWERS:
1. The research assistant will help to distribute, monitor, supervise and collect the
questionnaire from the respondents.
2. Smart, efficient, knowledgeable, trustworthy, diligent, vigilant and responsible (any
three)
3. Poor communication skill and manner of approach
4. For easy accessibility, efficient service delivery and maximum utilization and
cooperation of the respondent