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PREDICTORS OF COMPLIANCE TO USE OF PERSONAL PROTECTIVE EQUIPMENT IN LARGE LOGISTICS FIRM: A CASE OF SPEDAG INTERFREIGHT UGANDA LIMITED

CHAPTER ONE

INTRODUCTION

Background to the Study

According to Mashestwari (2014), the purpose of personal protective equipment is to reduce employee exposure to hazards when engineering controls and administrative controls are not feasible or effective to reduce these risks to acceptable levels. PPE is needed when there are hazards present. 

PPE does not eliminate the hazard at the source and non use may result in employees being exposed to accidents and illness if not well used. (Merchant, 2015) Any item of PPE imposes a barrier between the user and the hazardous working environment. Practices of occupational safety and health can use hazard controls and interventions to mitigate workplace hazards, which pose a threat to the safety and quality of life of workers. (Pandey, 2014) states that the hierarchy of hazard controls provides a policy framework which ranks the types of hazard controls in terms of absolute risk reduction. At the top of the hierarchy are elimination and substitution, which remove the hazard entirely or replace the hazard with a safer alternative.

According to Samuelson, (2016) Personal protective equipment (PPE) refers to protective clothing, helmets, goggles, or other garments or equipment designed to protect the wearer’s body from injury or infection. (Kakuru.2013) the hazards addressed by protective equipment include physical, electrical, heat, chemicals, biohazards, and airborne particulate matter. Protective equipment may be worn for job-related occupational safety and health purposes, as well as for sports and other recreational activities. “Protective clothing” is applied to traditional categories of clothing, and “protective gear” applies to items such as pads, guards, shields, or masks, and others.

Many scholars have discussed various compelling factors leading to the use of personal protective equipment for example In a report of study carried out in Institute of Medicine (IOM) 2008, the contributing factors were categorized into three; Individual factors such as knowledge, attitude towards the use of PPE, perception of risk, and demographics, Environmental/economic factors such as availability, accessibility, Organizational factors such as management/administrative measures, guidelines and policies, expectations and feedbacks, trainings and education programs.

According to Pandey (2012), it is amazing how easy it is to put a pair of gloves on and yet workers have a difficult time doing so. Non-compliance to use of P.P.E is an area that requires little of effort to improve compliance. A pair of qualified boots is more than enough to reduce the chance of a foot related injury. It does not take much effort to wear the appropriate PPE when working, but still, only 64% workers globally on average, constantly use and wear the correct protection (OSHA, 2007), as a result approximately 65 million dollars (ISEA, 2015) are spent on related injuries in roadway institution in U.S. According to OHSA there should 100% compliance to use of personal protective equipment, and 0% work place injuries.

However in Africa there is still low compliance, according to Nghitanwa, E. M., & Zungu, L. I. (2017) a research carried out reported that in Namibia only 10% of industries were found to be compliant in use of PPE, most industries were reported to be non compliant to OHS legislation (Ministry of Labor and, industrial relations and employment creation of Namibia, 2016.

A research carried out in Tanzania among healthcare workers in Kahama district in Tanzania, Laisser, R. M., & Ng’home, J. F. (2017), revealed that 90% of the staff had experienced work place injuries which results from non compliance to use of PPE, 81% of the workers stated that there was no existence of guidelines and protocols in regards to how to perform their duties, 26% of the staff were not reporting cases hence not identifying the issues.

According to Ndejjo et al., 2015) Uganda is still reported to have a rate of non utilization of the all the necessary PPE hence increasing the risk of biological and non biological hazards in government and private owned hospitals.

Spedag Interefreight has a compliance rate of 75% which has to be increased to 100%.

Alli, 2008 defines occupational health and safety as the science of workplace hazard anticipation, recognition, evaluation and control that may impair the health and well being of workers, work places, surrounding communities and the environment.

Employers’ legal duty to provide suitable PPE for their employees comes in the Personal Protective Equipment at Work Regulations 2012. Suitable equipment must be provided in situations where workers may be vulnerable to harm, and where it is not possible to eliminate every potential hazard. It’s up to individual companies to write their own PPE policies and decide whether and what their employees must wear, based on their risk assessments and analysis of any previous accidents or injuries (William, 2013). 

In the early 1800s, shipbuilding workers would paint their hats in tar and cure them under the sun to solidify. When they hardened they would be strong enough to protect their heads from being struck by falling objects. Nowadays, hard hats are mandatory in all the organizations, industrial and mining sites. More importantly, in Canada, all hard hats being worn in these contexts must be certified by the Canadian Safety Association (CSA). This is to ensure that PPE meets the minimum safety standard to withstand trauma to the head. Personal protective equipment (PPE) is the last line of defense in preventing workplace injuries and ill health. If you can’t control the risks in other ways, you must provide PPE and workers must use it. People sometimes refuse to wear PPE because of religious beliefs or on health grounds but, mostly, refusals stem from poor management, communication and training. If workers don’t understand why they need to wear PPE or don’t have any say in choosing it, they are more likely to refuse to use it than if they are properly trained and involved (Pandey, 2014).

Observing the above data, it can be concluded that adequate, timely and appropriate use of PPE is essential as well can contribute extensively to improving the safety performance of the industry. Hence this is an aspect that requires further insight, especially as to why an appreciable proportion of institution workers do not wear PPE. This diagnosis will be significant, in particular, towards developing strategic recommendations for improved usage of PPE in the logistics firms (Saunders, 2014).

This study will therefore focus on the potential factors influencing the compliance to use of personal protective equipment at Spedag Interfreight limited Kampala Uganda.

SPEDAG Interfreight is a logistics company that considers health and safety of its employees as a core priority with the office in Basel, Switzerland; they are committed to comply with the highest international standards. Spedag Interfreight Uganda is certified by NEMKO for; ISO: 9001 (Quality), ISO: 14001 (Environment) and OHSAS: 18001 (Occupational health and safety). They ensure that their staffs are very healthy and equipped with knowledge regarding health.

Spedag Interfreight Uganda Limited is a leading Provider of end to end supply chain Management with offices in Kampala Uganda and branches all over Uganda. The company specializes in supply chain management, consolidation Services, Distribution Logistics, Project Logistics, Warehousing, Airfreight, Transports, Sea freight Overland and comprehensive Logistics. 

Employers in Spedag Interfreight Uganda Limited have duties concerning the provision and use of personal protective equipment (PPE) at work. Many workers at Spedag Interfreight Uganda Limited appreciate the necessity of wearing personal protective equipment (PPE) while at work. Despite the dramatic improvements in safety that have taken place in Spedag Interfreight Uganda Limited, the safety record in this company continues to be one of the poorest and the company is consistently ranked among the most dangerous occupations accounting for a disproportionately large percentage of all work-related illnesses, injuries and death.

Statement of the Problem

According to William, (2013).PPE in logistics firms is frequently described by workers as a hindrance, but this feeling can be overcome when it fits them well, is of good quality, is comfortable and does not prevent them from seeing clearly or moving freely. Such PPE used in logistics firms can make people more productive, as well as safer.

Non compliance to use of PPE refers to a situation in which workers/employees deliberately choose not to make use of the personal protective equipment at the appropriate time of use, for example wearing safety shoes where there could be a lot of nails that can prick legs, wearing gloves while handling dangerous chemicals. 

The United States government is aiming at improving the occupational safety; however the obstacle is the adopting automation systems in many industries. According to Matela, D. (2008) 89% of workers do not use personal protective equipment, 29% used the equipment on very few occasions.

Gina stated that non compliance is an exposure of staff to serious health and safety threats, as well as death. The Bureau of statistics (BLS) show that workers who sustained a variety of on-the-job injuries wear not using PPE.

Employers’ legal duty to provide suitable PPE for their employees comes in the Personal Protective Equipment at work regulations in Spedag Interfreight Uganda Limited and suitable equipments are provided in situations where workers are vulnerable to harm and where it is not possible to eliminate every potential hazard. Employers in Spedag Interfreight Uganda Limited have duties concerning the provision and use of personal protective equipment (PPE) at work. Many workers at Spedag Interfreight Uganda Limited appreciate the necessity of wearing personal protective equipment (PPE) while at work. But for every willing employee, there’s also a stubborn one who would rather gamble with their safety. Non-compliance to wear PPE or neglecting safety gear can be catastrophic for the individual and even the whole company. 

Spedag Interfreight assessment report (2017). Despite all the administrative measures and emphasis made for staff to make good of the PPE, there is still poor response from most of the staff, accounting for a disproportionately large percentage of all work-related illnesses, injuries and death. This situation still puzzles the researcher hence prompting her to conduct research on   the factors associated with compliance to use of P.P.E in large logistics firms.

Research Questions

1. What are the individual/personal factors associated with use of PPE at Spedag Interfreight.
2. What are the organizational factors related to utilization of PPE at Spedag Interfreight.
3. What is the prevalence of utilization of the PPE at Spedag Interfreight.
4. What is the influence of the personal and organizational factors on the prevalence of PPE use in Spedag Interfreight.

Research Objective

General Objective of the study

The general objective of the study is to assess the potential factors associated with compliance to use of personal protective equipment which therefore develop measures of how to ensure 100% compliance and 0% workplace injuries.

Specific objectives of the study

1. To identify the individual/personal factors associated with use of PPE at Spedag Interfreight.
2. To assess the organizational factors related to utilization of PPE at Spedag Interfreight.
3. To determine the prevalence of utilization of the PPE at Spedag Interfreight.
4. To establish whether there is a significant influence of the personal and organizational factors on the prevalence of PPE use in Spedag Interfreight.

Hypothesis of the Study

There is no significant influence of the personal and organizational factors on the prevalence of PPE use in Spedag Interfreight.

Significance of the Study

This research and the findings may be of significant importance and beneficial to various stakeholders at different capacities as presented below;

To the international and national stakeholders of occupational health and safety; the research will add on the available data and report in reference to occupational hazards and their mitigation measures.

To the ministry of Labor and Ministry of health, the results will help to identify areas in which to put much emphasis in designing and funding programs on occupational health and safety.

To the logistics industry, the results will help the logistics firms to identify the area of concern regarding the factors influencing the use of PPE and how they can address the issues.

The findings from the study will empower all the logistics firms in Uganda to understand how Personal Protective Equipment can be used in order to eliminate every potential hazard at the work place.

To the researcher The study when completed will also help to acquire knowledge on how workers should be protected and also for other researchers to carry out future research.

Scope of the Study

The study will be carried out in Uganda, Kampala at Spedag Interfreight Kampala located in Nakawa division. It will basically focus on the predictors of compliance to use of P.P.E. The subject matter will be based on the individual and organizational factors. This will range between the periods of June to July 2018. The time of data for the company records will range from (2013-2017) and report will be submitted in September 2018.

Limitations to the Study

I intend to use the cross sectional study design which cannot establish the cause and effect relationship; it cannot determine the behavior over a period of time, it is also prone to recall bias as a respondent may not be able to recall exactly what happened at a certain time T. This study as well being a triangulated one, not a lot of concentration may be given to either of the qualitative and quantitative data to be collected. These will be managed by requesting the respondents to be give every truthful information they have.

Theoretical framework

The study is underpinned to Side-Bet theory which holds that practices of occupational safety and health can use hazard controls and interventions to mitigate workplace hazards, which pose a threat to the safety and quality of life of workers. The theory adds that employers’ legal duty to provide suitable PPE for their employees comes in the Personal Protective Equipment at work regulations in the company and suitable equipments are provided in situations where workers are vulnerable to harm and where it is not possible to eliminate every potential hazard.

Demographic transition theory has been used as a framework through which the drastic changes in family and family related behaviors, age, household size, and marital status can cause Non-compliance to use of P.P.E in logistics firms.

In logistics firms there is a collective set of rules or norms that tell people how they ought to conduct various aspects of their lives. Recent data reveals fundamental shifts in values, attitudes and norms which also can cause non-compliance to use of P.P.E in logistics firms.

The changing economic status of the employers reflected in rising labor force participation rates and earnings, is most likely to be responsible for causing non-compliance to use of P.P.E in logistics firms.

The theory of reason action also will guide the study, Ajzen and Fisbein formulated this theory in 1980 based on the fact that a person’s behavior is determined by their intention to perform the behavior in question of which the intention is determined by their attitude towards the behavior, the intention is looked at as the persons readiness to perform which is determined by attitude, subjective norms and perceived behavioral control.

Conceptual Framework

The conceptual frame work has been development based on the studies done by various scholars; it explains how the independent variables influence the dependent variable at different levels. The use of personal protective equipment is the dependent variable which looks at the compliance and non compliance to use of PPE. The independent variables are individual factors such age, attitude, knowledge among others and the organizational factors such as availability, economic situation of the origination, guidelines and policies among others which may have an influence of PPE use.

Independent Variables             Dependent Variable

Figure 1: Conceptual Framework 

Operational Definition of Terms

Gender; In this study will refer to the state of being either male or female and will be categorized as 1=Male and 2=Female.

Age; In this study will refer to old in years an individual is and this will be measured numerically 1, 2, 3…nth.

Level of education; refers to the respondents level of formal education which will be categorized as 1=high school, 2=certificate, 3=diploma, 4=degree, 5= masters.

House hold size; in this study will refer to number of people living the individuals home and this will be measured numerically 1, 2, 3 …nth.

Marital status; In this study refers to state of being either married or not married. This will be categorized in to 1=married, 2=Not married, 3=divorced.

Ethnicity; in this study will refer to the cultural beliefs and practices and extent to which they influence the use of PPE, and will be measured by 1=Yes and 2=No.

Individual attitude; In the study refers to the behavior and attitude towards the use of PPE, this will be categorized into the positive and negative.

Peer Influence; refers to extent to which the staff utilizes the PPE because their workmates are also utilizing, whether they are influenced by their colleagues or not. This will determined by 1=yes and 2=No.

Availability; Refers to number of PPE available visa-vie the number of staff, this is to determine if some of the staff do not utilize the PPE simply because they are not available. This information will be availed by key informants measured by 1=More than enough, 2=adequate, 3=Not enough, 4= very few, as well as responding to an open ended question.

Accessibility; in this study refers to the situation in which the staff are actually able to access the PPE for use. This will be measured by 1=yes and 2=no.

Economic situation of the organization; In this study refers to the financial potential of the company to procure more than enough PPE for the different categories of staff that need to use the PPE. This will as well require a key informant to respond to an open ended question.

Guidelines and policies; In the study refers to whether the organization has guidelines and policies in reference to PPE availed to the staff and if they are observed by the staff. This will be measured by a 1=yes and 2=No.

Knowledge of the staff about use of PPE; In this study refers to the training received by the staff and sub-contractors about the use of PPE. This will measured by 1=yes and 2=no.

P.P.E: refers to protective clothing, helmets, goggles, or other garment designed to protect the wearer’s body or clothing from injury by electrical hazards, heat, chemicals, and infection, for job-related occupational safety and health purposes.

A health hazard: is property damage, loss of livelihood and services, social, environmental and economic disruption caused by a dangerous phenomenon, substance, human activity or condition.

Hazard: The inherent potential of a material or a situation to cause injury or to damage people’s health, or to result in loss of property.

Occupational health hazard: is a dangerous phenomenon, substance, human activity or condition that may cause loss of life, injury, or other health impacts at the workplace.

Occupational health: is defined as 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 ill-health caused by their social cultural factors and the protection of workers in their employment from risks resulting from factors adverse to health.

CHAPTER TWO

LITERATURE REVIEW

Introduction

This chapter reviews literature related to the research problem and objectives of the study. It reviews the theories on which this study is based and the key concepts of the study. It then shows how this research relates to the existing body of knowledge and it identifies the gaps existing in the current study.

Individual factors and use of personal protective equipment

This literature is reviewed under each variable including the gender, level of education, age, household size, marital status, and ethnicity.

Gender and Use of Personal Protective Equipment

Schenker eta l in a study carried out California, it was concluded that being young and a male was greatly associated with use of PPE, in his study the male respondents constituted 91%, however this is argued by Bosompem and Mensah who found that some elderly male cocoa farmers in Ghana had low compliance to use of hand gloves 35.6%, wearing masks 37.5%, and protective clothes 35.4%. However in Nigeria Olowogbon found that 35% of the famers were wearing PPE, Okoffo etal found that 35% of farmers in Ghana were wearing PPE in full set comprising of the helmet, gloves, boots, goggles. Wearing boots had the highest percentage of 66%. This study found that the factors associated with use of PPE were affiliated to educational level, experience of working, the size of the farm and age of the farmers, agricultural extension of contracts, presence of agrochemical shops, however they did not put into consideration the female farmers and factors contributed by the farms administrators. 

Level of education and use of personal protective equipment

Studies have shown variance in the relation between level of formal education and use of personal protective equipment; it is conceived that the higher level of education would make it much easier for health and safety to be observed. However (Faremi et al., 2014) in a study on the awareness of occupational hazards and post exposure prophylaxis for human immune deficiency virus among hospital cleaners reported that the majority of the cleaners had only attained secondary education and they lacked formal training, tools and information. They are poorly educated middle aged and married women; they therefore concluded that on job training about the risks and precautions was the best way to encourage use of PPE.

Odonggkara, Mulongo and Mwetale (2012) in their study on the prevalence of occupational exposure to HIV also concluded that there was no significant relation between education and health and safety practices; therefore the need for further investigation.

Age and use of personal protective equipment

Baksh etal 2007, in their cross sectional study found that the young pickers easily adopted the use of PPE as compared to the elderly pickers and they concluded that the PPE use was influenced by age, perception of temporary health impact, level of education, however they did not specify the exact ages of the respondents. 

In a similar study carried out by Oyekale A S, 2018 he found that the people not complying to use of PPE were of 57 years and above which was not good and called for interventions since they were the majority. However the ages in these studies are not clear enough, earlier studies found the young men are more exposed, there is need to specify the ages.

House hold size and use of personal protective equipment 

Oyekale. A. S. 2018 in a study at west Cameroon found that household sizes centre and south west Cameroon were significantly different and they contributed to health hazards in their families due to chemical residues in food obtained from the plantations which is brought to the house by the farmers. 

Reichler et al., 2018 in the study of  household transmission of ebola virus considered isolation of the household members from the victim due to the quick transmission. However in both scholars did not put into consideration the fact that some of the workers do not make use of the PPE simply because they do not have a family to care for, therefore it wouldn’t matter if they were safe and healthy or not.

Marital status and use of personal protective equipment

Oyekale a.s 2018 further discussed that in their study, 71% of the farmers in the centre were married and 70% were married in the south west region, 12% and 5% of the farmers were divorced.

Gebretsadik. M. Kumie A & Gebremichael G 2017 in their study about magnitude of occupational injury, did not consider marital status as a factor and yet it is very evident that a married person would careful protect him or herself from injuries that may occur so as keep their families running, as compared to one who is not married and does not care what the outcome would be.

Ethnicity and use of personal protective equipment

Cultural practices of various ethnic groups may influence the use of personal protective equipment, Logistics firms being diverse and employing people from different cultural and traditional backgrounds, therefore it is expected that people will have different attributed the use and some traditions may not have any offense. Scholars have carried out studies in relation to how ethnicity influences the use of PPE, however no clear information is given regarding the same, and this has to be brought out clearly in this study.

Individual attitude and use of personal protective equipment;

Carpenter, W.S Lee et al 2002 in their study about use of PPE among farmers concluded that with the exception of the welding masks, there was still very low compliance rate, the PPE were readily availed however the decision to make use of the PPE was entirely personal and very minimal influence was made by outside parties.

Occupational health hazard such as stress include dealing with life-threatening illnesses, injuries, demanding employers, being overworked, understaffing, difficult schedules, the availability of specialized equipment, the hierarchy of authority, lack of control, participation in planning and decision making, and employee deaths affects the attitude of staff and compliance to protection. According to Lewy (2011), in many organizations the nurse may feel isolated, fatigued, angry and powerless due to a sense of depersonalization created by large bureaucratic system. Stress-related symptoms can lead to an increase in the use of cigarettes, alcohol and drugs. The health worker’s behavior and attitude may be adversely affected, leading to decreased job performance and increased absenteeism (Lewy, 2011).

They did not put into consideration the policies and guidelines which have to observed and the administrators/managers must ensure they are observed at all times, therefore the use of PPE must be fully managed by the organization leaders.

Knowledge of PPE use and use of personal protective equipment

For efficient compliance to use of P.P.E is important to educate employees on potential of accidents, how to prevent accidents and potential hazards involved in their jobs. Hence, training and education programs play a significant role in enhancement of safety in construction and important to increase safety awareness (Ghani, 2010) and change behavior of employees (Wong et al., 2010). 

According to study conducted by McDonald (2013) to 18 construction site in Ireland stating that safety training is carried out without systematic schedule which primarily to “cover themselves” and protect company if something goes wrong with little expectation that it would influence the knowledge and behavior of employees. Insufficient safety training between the employees are general root cause of accidents in the construction sites because they did not have the knowledge, education and skills to recognize potential hazards at site (Toole, 2012).

Schenker etal found that attainment of formal education was very high 97% in a research conducted at California as such most of the farmers earned their living from farming. However this study he did not have an in depth study on the formal education obtained by the employees before starting to work in the sites where they could have obtained basic knowledge about health and safety.

Peer influence and use of personal protective equipment

Work relationships are potential stressors among the workers in the organizations. Two sources of stress in this field are the conflicts with co-workers and the lack of staff support (WHO, 2015). Another assessment showed that lack of social support from colleagues and superiors and less satisfaction with the head nurses contributed significantly to the appearance of stress, while the Health and Safety Executive identify the negative effect of lack of understanding and support from their managers, on workers’ stress (Moustaka and Constantinids, 2010).

Inadequate staffing is another risk factor that increases the potential for non-compliance to use of P.P.E amongst health workers. Often stressful tasks such as transferring employees from a bed to a chair or vice versa may be done alone and manually due to lack of staff and equipment. Several studies have examined the association between nursing staff levels and workplace injuries and illness (Lipscomb et al., 2014; Kingma, 2016). These studies analyzed the staffing variables which included the ratio of service provider to employees, the availability of nursing aides to assist in employee transfers, and the reported worker injuries. High injury rates were reported in areas with low staffing levels. Working for more hours is also a result of inadequate staffing. This causes increased exposure to physical demands and reduced recovery time between work shifts, resulting in increased non-compliance to use of P.P.E (Lipscomb et al., 2012).

Organizational Factors and use of Personal Protective Equipment

Studies indicate that, in addition to nursing itself, organizational and management characteristics influence the occurrence of non-compliance to use of P.P.E among the workers (Moustaka and Constantinids, 2010). With regard to previous research, a large part of potential sources of stress for health workers appear to be organizational in nature including stress-generating nursing work situations, which can be of physical, psychological or social nature. Besides responses to employees’ physical and psychological status, increased job demands, because of the use of sophisticated technologies, competition among organizations, shortage of workers, work overload, and lack of task autonomy and feedback, as well as reduced advancement opportunities, appear to be major determinants of emotional exhaustion among workers (Moustaka and Constantinids, 2010).

Availability and use of personal protective equipment

Frank Harris and Ronald Mc Caffer (2014), employer must provide protective personal equipment to the workers, especially for those that work in construction sites to reduce the death of the worker if they wear personal protective equipment. 

Duff et al., 1993 in the study of construction industry in the United Kingdom found percentages of non-compliance with specific categories in six construction sites ranging from 22-38% of noncompliance in housekeeping, from 12-43% of noncompliance in scaffolding, from 20-26% of noncompliance in access-to-heights, and from 21-65% of non-compliance in using PPE. 

Robertson et al., (2016) in the study at United Kingdom found that non-compliance was around 19% for housekeeping, 16% for scaffolding, 15% for access to height and 21% for PPE. The employer also has to supervise employee from time to time to ensure they will always follow the  rules to wear safety tools to keep their safety is always a priority when perform jobs at construction sites.

In a study conducted by Monteiro and Londero (2012) on non-compliance to use of P.P.E and diseases related to the practice of anesthesiology the findings showed that, lack of equipments and tools for protection among workers while executing their duties are among the social cultural factors that contributed to non-compliance to use of P.P.E. This is also mentioned in the study conducted by (Nicholau and Arnold, 2010) on environmental safety including chemical dependency in the United States that revealed that lack of adequate equipment and tools for protection in the health facilities contributed to non-compliance to use of P.P.E among the workers. 

However is no further discussion on the possibility of availing the equipments and the workers choosing not to utilize them.

Accessibility and use of personal protective equipment

The requirement of safety and health officer is clearly stated in the occupational, safety and health (safety and health officer) regulation 1997 where the employer of the following class or description of industries shall employ a suitable, knowledge, experience and skills safety and health officer for the specific performance of the specific work. It is agreed that safety and health officer is highly empowered to change or improve the company’s safety performance. 

A study by McDonald (2013) to construction sites recommend that all site should have the safety and health offices which demonstrate potentially strong role of safety and health officer can influence both behavior and compliance of employees with safety requirements. He added, the strongest relationship with safety compliance is the presence of safety and health officer with better safety management performance for example response to audits and reporting the hazard to ensure it leads to better safety compliance on site in future. Hence, the role of safety and health officer should be strengthened and their function should be reinforced as part of the safety management system. 

The health and safety officer responsibility of ensuring accessibility of the equipment is not demonstrated, this has to be brought it clearly as he/she must ensure workers are able to access the equipment at times of need. The possibility of workers accessing the equipment and taking them to their homes is not considered.

Policies and guidelines and use of personal protective equipment

Compliance with safety requirements can help the work to be done both efficiently and safely. One very promising line of enquiry concerning the behavioral antecedents of accidents concerns the relationship among these procedural instructions governing work and the way in which work is done (Che Hassan, 2007). Thus, much could be improved with enough room for improvement towards behavioral safety compliance through strong effort to comply with safety requirements by both employers and employees. The main social economic factors in incident and accident occurrence are noncompliance to safety Requirements in a wide range of industries as agreed by occupational literatures. Occupational, safety and health requirements such as OSHA 1994 is an example of government commitment towards regulatory compliance and being realized as a key defense against hazards in the construction industry.

The occupational, safety and health act(OSHA) 1994 is an example of safety guidelines and regulation which provides legislative framework to promote and encourage high standards of safety and health at work thus the primary aim of the act is to promote safety and health awareness and to instill safety culture among all Malaysian workforces (Ismail, 2010). Besides, employee’s poor perception on employer compliance to safety requirements could lead to negative behavior and correlate with poor safety performance which carries enormous negative consequences to the individual and the Organization where they work (Jamal Khan, 2013). According to study conducted by McDonald (2013) to 18 construction sites in Ireland stating that level of safety compliance to safety requirements was quite variable and the was much could be improved in most site. 

Social cultural factors have a strong impact on workers’ health. A non-supportive working environment can cause harm if not controlled, and can lead to non-compliance to use of P.P.E (WHO, 2009). Organizations are moderate health-risk industries as they provide health services to people with diverse illnesses (Maier, 2009). Huanggz and Guox, (2011) found that sharp injuries remain the commonest cause of exposure to blood-borne diseases for health care workers. This shows that non-compliance to use of P.P.E remain a challenge for health professionals in the workplace.

Availability and use of PPE

Factors such as the poor ventilation in the unit, lighting and the inadequate temperature levels are among the potential work-related stresses (Moustaka and Constantinids, 2010).Difficulties in coping with stress combined with psychological or emotional instability could lead to violence and there are several studies supporting that the healthcare workers specifically health workers are especially affected by the risk of physical violence-particularly in the operating rooms which is a source of stress (Moustaka and Constantinids, 2010).

Economic situation of the organisationa and use of personal protective equipment

It is important the organization procures all the various protection equipment, Kingma, (2016) argued that when it comes to compliance with PPE use protocols, eye protection is the “most challenging” PPE category, according to 42 percent of respondents, a disturbing though not unexpected finding considering that nearly three out of five workers who experienced eye injuries were found not to be wearing eye protection at the time of the accident, or were wearing the wrong kind of eye protection for the job.  Add to this the facts that about 2,000 U.S. workers each day have a job-related eye injury that requires medical treatment, and that thousands are blinded each year from work-related eye injuries that could have been prevented and the magnitude of the problem becomes clear. However it is not clearly stated why the use if poor, this is likely because the eye goggles are not procured and calls for further research.

The research conducted by Moustaka and Constantinids (2010) reveal that when safety professionals were asked about their visions for the future of PPE, fit, comfort, and style took precedence. 42% percent of respondents said they would like to see PPE that automatically adjusts to fit different body types, hands, heads, faces, etc. Next was PPE with customizable style and design options, so that workers could select PPE based on their own individual tastes and safety requirements, this calls for procuring various sizes.

 Safety professionals were also asked about another area of concern – the potential health and safety issues for workers posed by oil, grease, heavy metal residues, or toxic elements on re-usable Rental Shop Towels. 60% said they were disturbed by these hazards, with 20 percent of these respondents reporting they were “very concerned.”    Worries about the risks to workers from “toxic towels” were the chief reason why safety professionals said they would switch to disposable wiping solutions from re-usable rental shop towels. A closed-loop solution that converts used disposable wipers to energy and diverts them from landfills (Lewy, 2011). However the question would be if this solution is cost effective and calls for further investigation.

Increasingly high noncompliance with PPE protocols is an alarming trend and a serious threat to worker health and safety,” said Gina Tsiropoulos, manufacturing segment marketing manager for Kimberly-Clark Professional. “Whether this is a result of economic conditions, a flawed approach to safety programs, younger workers who are more inclined to take greater risks, or some other reason, it’s essential that workers wear PPE when it is required.  PPE protects workers against injury, but it will not work if workers fail to use it and use it properly”(Moustaka and Constantinids, 2010).

Summary of Reviewed Literature and Identified Research Gap

There is still high rate of non compliance to use of personal protective equipment. Tam et al., 2014 stated that due to the non compliance to OHS international or national requirements, which leads to non compliance to use of PPE.

There has been less emphasis placed on women in the use of PPE and male are more referred to, the ages in the literature were not clearly stated but rather categorized, this has to be much more specific.

In this study a relatively higher PPE utilization rate is observed compared to other studies in developing countries. However, by the fact that zero injury is expected at work places, there should 100% compliance, therefore, there is need for further strengthening the safety programs as there are significant proportions of the workers who still do not use all the necessary PPE during work. Interventions to promote PPE utilization should focus on areas, such as service duration, availability of PPE, presence of shift work, and control of substance abuse.

Gaps were also identified in the influence of household size to use of PPE, which was not cleared stated, the influence of ethnicity and the impact of formal education to the compliance in use of PPE. 

In conclusion a number of factors have been considered to be influencing the use of personal protective equipment; some of the literature is reporting positive impact while others report negative impact, it is therefore important to carry out this research so as to fill up the gaps by studying the predictors of compliance to use of PPE in Spedag Interferfreight.

CHAPTER THREE

METHODOLOGY

Introduction

This chapter contains explains the procedure that will be applied in conducting the study to achieve the set objectives. It includes; research design, locale of the study, population of the study, sample size, sample size, sampling procedure, research instruments,  methods of assessing validity and reliability of the instrument, data collection procedures and data analysis and procedure.

Research Design 

The study will adopt both qualitative and quantitative research approaches. The specific research design of the study will be descriptive cross sectional and correlational research design. The descriptive research design will help in describing the phenomenon. Cross sectional because it will be carried out at one point in time from various sample elements in the population. Correlation research design will be concerned with explaining the relationships in the study.

Location

The Research study will be carried out at Spedag Interfreight Uganda Limited, Nakawa Division, Kampala district, Uganda. Spedag Interfreight Uganda Limited is a leading Provider of end to end supply chain Management with offices in Kampala Uganda and branches all over Uganda. The company specializes in supply chain management, consolidation Services, Distribution Logistics, Project Logistics, Warehousing, Airfreight, Transports, Sea freight Overland and comprehensive Logistics. 

Study Population 

The study population (230) will include all the Staff members working at Spedag Interfreight Uganda Limited. These will be composed of both male and female respondents. 

Table 1: Population of the study

Source: Human resource department, Spedag Interfreight Uganda Limited (2018)

As part of the inclusion criteria, all full time staff members and support staff and have been in the organization for the past than 6months at the time of collecting data and are willing to consent will be selected for the study.

As part of the exclusion criteria, non-staff members will be excluded, staff members who have been at the organization for less than 6months at the time of collecting data as well as have not signed the consent form will be excluded from the study.

Sample size

The sample size of the study will be 171 full time staff members as respondents, taken to be the appropriate sample size to answer whether there is a significant influence of the personal and organizational factors on the prevalence of PPE use in Spedag Interfreight, because smaller sample sizes are not reliable enough to answer a given research hypothesis or question (Amin, 2005).

The sample size will be arrived at by using the predetermined sample size table by Krejcie and Morgan (1970) formula for obtaining a proportionate sample allocation. According to Krejcie and Morgan’s (1970) table for determining sample size for a given population of 230, the appropriate sample size is 171 (see attached, Appendix IV). The table will be chosen because it presents the sample size against the population and taking the next highest value to the population in case the exact population does not appear which makes it easy.

The formula is given below;

S = X2NP1-Pd2N-1+ X2P1-P

Where;

S = required sample size

X2= the table value of chi-square for one degree of freedom at the desired confidence level (0.05)

N = the population size

P= the population proportion (assumed to be 0.50 since this would provide the maximum sample size)

d = the degree of accuracy expressed as a proportion (0.05)

Sampling procedure 

The study will employ both purposive and simple random sampling strategies to identify respondents. The purposive sampling will be used to select the departments and key informants basing on the researcher’s judgment and objectives of the study. After identifying the departments, full time employees who have worked at the organization for more than 6months will be randomly selected from the constructed sampling frame. The sampling frame will be constructed with the help of officials from the organization using lottery methods where written on with letters ‘A’ and ‘B’ will be distributed in the sampled departments, full time employees will be required to pick one letter. The full time employees who will chose letter A will become the respondents. The technique is preferred because it is simple to use and convenient. 

The number of respondents in each department will be determined by using Kothari (2004) proportionate sample simple allocation (Table 2).

Table 2: Study population and sample size

Source: Human resource department, Spedag Interfreight Uganda Limited (2018)

Research Instruments

In the study, two (2) instruments will be employed. They will include questionnaire and key interview guide (KIIG). Triangulation of the two study instruments will be employed where analysed data will be thematically incorporated within the corresponding qualitative and quantitative data to allow the researcher draw clear conclusions using related responses as one theme basing on the findings corresponding inform of short interlinked phases with key questions.

Questionnaire

Data will be collected using a researcher administered standard semi-structured questionnaire. Included in the questionnaire will be; Section A which will capture data on individual factors like gender, level of education, age, marital status, individual, peer influence and knowledge of use of PPE. Section B will capture data on organization factors like availability of PPE, accessibility of PPE, while section C will include the use of personal protective equipment such as compliance to use of PPE and non-compliance to use of PPE. This will give an opportunity to full time employees to be asked the same questions in order to solicit scientific findings.

Key Informant Interview guide (KIIG)

The KIIG will be used with top managers and supervisors as the key informants on the account of their knowledge and experience. KIIG will have questions on guidelines/policies in place and training availed for staff. In the study, a face to face interview with key informants will be preferred, since it will allow the researcher to probe some of the open ended questions that will require in-depth qualitative information as backup to the statistical information that will be generated during structured interviews.

Validity and reliability

The research instrument will be pretested to determine the suitability, appropriateness to ensure clarity and relevancy of the data collection instrument. 

Validity 

To ensure validity, the research instrument will be given to three supervisors who will proofread and check the relevance of each question in providing answers to the study objectives and appropriate modifications will be made. After which, a content validity index C.V.I will be computed using the formula;

C.V.I = Number of relevant items in the instrumentTotal number of items in the questionnaire   =   2833

After compilation, the instrument will be considered valid because the CVI will be 0.85, that is greater than 0.6 as recommended by Amin (2005).

Reliability

A pilot study will be done on 15 respondents in the different departments at Spedag Interfreight. Respondents who will be used during the pilot study will not be used during the real data collection.  This will aim at obtaining responses that will be similar to those expected from the participants in the final study.

A number of full time employees will be identified and each will be asked to fill a basing on the content of the questionnaire. While completing the questionnaire, each will be asked to think out loud. They will be asked what comes to their mind on each particular question. They will be asked whether they understand the questions, whether they find the next question and section easily, also which questions can attract uncomfortable responses and will be asked to provide the options. Thereafter, changes in the question phrasing and structuring will be done. 

Data Collection Procedure

Ethical approval will be obtained from Bugema University Research and Ethics Committee, the administrators of Spedag Interfreight. Two Research assistants will be employed to help in data collection. They will be trained by the researcher in data collection techniques, rapport, accurate recording of data and use of various research tools. They will work under direct supervision of the researcher daily.

The study will employ both qualitative and quantitative data with the use of researcher administered semi-structured questionnaire and KIIG. Written and verbal consent obtained from the respondents after explaining the objectives of the study. Confidentiality of information obtained from the respondents will be ensured and study codes will be used instead of names.

  Face to face interviews will be used to obtain information from 12 key informants (top managers and supervisors) because it will allow the researcher to probe further and it will also require in-depth qualitative information as back up to the statistical information that will be generated with the structured questionnaire. Filled questionnaires will be cross checked by the researcher at the end of the day for completeness and the responses will be recorded for quality assurance purposes.

Data analysis

In this study, quantitative raw data obtained using a questionnaire will be sorted, edited, cleaned and fed into computer and analysed using statistical packages for social sciences (SPSS) version 16.0 for windows. Both descriptive and inferential statistical methods will be used.

For objective one, two and three, descriptive analysis will be performed to generate frequencies, percentages, means and standard deviations.

Objective four will be analysed using Chi-square (x2) technique. Factors that are significant will then be subjected to logistic linear regression to derive crude odds ratios (COR) and corresponding 95% confidence intervals (CI) to establish the relationship between the factors and compliance to use of PPE. The significant variables in Logistic linear regression analysis will later be subjected to multivariate analysis to derive Adjusted Odds Ratios (AOR) and corresponding 95% CI.

To test for hypothesis, significant levels or p = 0.05 will be used. For p-values less than 0.05, the findings will be taken as statistically significant. For p-values greater than 0.05 it will mean that the findings will not be statistically significant.

Qualitative data will be organized into coherent categories to summarize the data, and then analysed by the use of coherent analysis for find meaningful information to this study.

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APPENDICES

Appendix 1: Work Plan

Appendix I1: Research Questionnaire for the Staff Members

Dear respondent, am Ayikoru Mildred, a graduate student at Bugema University pursuing a Master’s Degree in Public Health. This research is intended to find out the factors causing non-compliance to use of P.P.E in large logistics firms. The questionnaire should not take more than 15 minutes to complete. There is no wrong or correct answers of these questions and your submitted responses will be anonymous, so please be as honest as you can. Your information will be treated with high level of confidentiality.  Kindly provide answers to the following questions by ticking (√) against the most suitable alternative or giving narrative responses in the spaces provided.

Section A: Individual factors associated with the use of PPE 

1. Gender

1. What is your gender?

Male ( )             Female ( ) 

1. Level of education

1. What is your level of education?

High school                               ( ) Certificate   ( )

Diploma                                     ( ) Degree                                       ( ) 

Masters                                      ( ) Others specify …………………….

III. Age bracket 

1. What is your age bracket?

 20 – 25 years                           ( ) 26– 30 years                             ( ) 

31 – 40 years                            ( ) Over 40 years                           ( ) 

1. Marital status

1. What is your marital status

Single                         ( ) Married                         ( ) 

Cohabiting                               ( ) Divorced                                  ( ) 

Widow                                     ( ) Others specify ……………………..

1. Individual attitude

1. What is your attitude towards to the use of PPE?

Positive                                ( ) Negative                                  ( ) 

1. Peer influence

1. Do your colleagues influence your use of PPE?

Yes                               ( ) No                         ( ) 

VII. Knowledge of use of PPE

1. Does knowledge of the PPE influence your compliance to it

Yes                               ( ) No                         ( ) 

Section B: Organizational factors associated with the use of PPE

VIII. Availability of PPE

1. Are you provided with PPEs like gloves, overalls, gumboots, masks during handling work period?

Yes                               ( ) No                         ( )

1. Are there enough PPEs at the organization?

More than enough                   ( ) Adequate                         ( ) 

Not enough                             ( ) Very few                                  ( ) 

1. Accessibility of PPE

1. Do staff members in this organisation have access to PPEs?

Yes                               ( ) No                         ( ) 

1. If yes, how often do you access them?

During work period only    ( ) Distributed to all workers ( )

1. Guidelines/policies

1. Does the company have a clear set guidelines and policies regarding staff use of PPE?

Yes                               ( ) No                         ( ) 

1. Training

1. Have you ever received any specific training on the awareness and use of PPE?

Yes                               ( ) No                         ( ) 

1. If yes to the above, when did you receive the training?

Before recruitment       ( ) Periodically after recruitment  ( )

Section C: Prevalence of use of PPE

1. Do you use PPE daily?

Yes                               ( ) No                         ( ) 

1. If yes, what makes you to use them? ………………………………………………
2. Do you receive any complaints on the work hazards as a result of non-compliance to use of PPE?

Yes                               ( ) No                         ( ) 

1. If yes, what has the organization done to eliminate such hazards?

……………………………………………………………………………………………..

Thank you for your cooperation

Key Informants Interview guide (KIIG)

For top managers and supervisors

1. What is your job title?
2. What exactly do you do?
3. What is the maximum qualification do you consider while recruiting?
4. Do you have guidelines and policies in connection to PPE?
5. What topics are covered under those policies/guidelines?
6. Do you think, the nature of your work exposes you to hazards?
7. What has been done to control this?
8. What are your recommendations to the organization to improve compliance to use of PPE?