Department of Public Health, Defense Health Science College, Addis Ababa, Ethiopia
Submission: August 22, 2019; Published: September 27, 2019
*Corresponding Author:Fasil Kenea Duguma, Public Health Department, Defense Health Science College, Addis Ababa, Ethiopia
How to cite this article: Fasil Kenea Duguma, Kelayu Kiros, Ibrahim Hussen, Fantahun Aderaw, et al. Assessment of Safety Equipment Utilization Rate
and Magnitude of Occupational Related Incidences Among Workers in the Ministry of Defense Construction CMC Site, Addis Ababa, Ethiopia, 2018. Civil
Eng Res J. 2019; 9(2): 555757. DOI: 10.19080/CERJ.2019.09.555757
Introduction: ILO and WHO joint Committee defined Occupational health and safety as: “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. Occupational health services are available only to 10-15% of the 3 billion workers of the world.
Method: Institutional based descriptive cross-sectional study was conducted. Large scale house construction site was selected by using purposive sampling method, based on the number of worker (n=274) and construction units. All workers were participated in the study. Data was collected in both interview and observational approaches. SPSS 20 version computer software package was used for data entry, cleaning, coding and analysis.
Result: Health and safety information access, habit of personal protective utilizations had an association with occurrence occupational injuries. Majority of the participants 167(60.9%) were male workers, the mean age was 28.92(SD±6.805); 233(85%) of workers had not safety training exposure and 83(30%) of workers involve manual handling activity like pulling, pushing, carrying, and lifting. Among these 25(15.8%) of were carrying very heavy tools greater than 50kg for an average of 4 hours and above. Most of the participant handling approach were observed as it was risky to them.
Conclusion and recommendation: Behavioral factors like sleep disturbance, lack of satisfaction, alcohol consumption, smoking cigarette, poor habit of personal protective equipment was observed as main contributing factor for occupational injury. Provision of Safety training and continuous monitoring play role in reducing occupational injury
Keywords: Construction safety; Occupational health and safety; Ethiopia; Safety equipment or material; Construction worker
Abbreviations: DUCHS: Defense University College of Health Science; EC: Ethiopian Colander; ETB: Ethiopian Birr; FDR: Federal Democratic Republic of Ethiopia; GC: Gregorian Colander; GDP: Gross Domestic Product; NCA: National Construction Authority; ILO: International Labor Organization, PI: Principal Investigator, PPE: Personal Protective Equipment’s; WHO: World Health Organization
International labor organization or World Health Organization Joint Committee defined occupational health and safety as: “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 of workers in their working section from risks adverse to their health and placement of workers in an occupational environment adapted to their physiological and psychological capabilities are also the objectives of occupational health . Occupational injury is a death, unintentional physical damage resulting from an occupational accident; it is fatal or non-fatal injury [2,3].
Occupational health services are available only to 10-15% of the 3 billion workers of the world. In industrialized countries, the coverage varies between 15 and 90% and in developing countries between a few percent and 20% [3-5].
The role of occupational health services in most developing countries has been given less attention due to inadequate knowledge, shortage of information, lack of resources and lack of political will which can impose greater burdens for occupational injuries [6,7]. The experience and practice of occupational health service in Ethiopia is very limited. Recently, the national Ministry of Labor and Social Affairs is giving emphasis and under plan to organize the service, but the baseline information on determinants
of occupational injuries especially on construction work is scarce
/absent for planning and implementing to prevent and control
it . In 2015, US bureau of labor statistic reports shows that
roughly 2.9 million non-fatal workplace injuries and illnesses,
of which 2.8 million were injuries in private industry employers,
which occurred at a rate of 3.0 cases per 100 equivalent full-time
According to Ethiopia labor statistics development program
with ILO, improving working environment and strengthening
occupational health and safety are used for enhancing work
efficiency at any industry [10,11] The majority of developing
country like Ethiopia, occupational health and safety aspect has
been given less attention and workers, who have been done in
construction industry are work- related injury occur very high.
This is due to illiteracy, poverty, lack of health, and safety training
and information on health hazards and risks at the workplace
. Globally, about millions of working age group peoples are
work under poor and risk environments, due to the occupational
injuries and disease continue to be the leading cause of workrelated
deaths . Recently WHO/ILO report shows that every
15 seconds, a worker dies from occupational accident or disease
. Every 15 second, 153 workers and every day 6300 people
die as results of occupational accident or work-related (13).
The impact of these, the economic burden of occupational
injury that means the direct and indirect cost 1.8%-6% GDP in
average 4% of National Domestic Product in worldwide [15,16].
According to same studies, the construction industry in the
world is rapidly growing at a rate of 75.5% on average. This
reality is also experienced in the Ethiopian context, it reaches to
12% in the year 2014/15 . However, a survey was done by
international commission on occupational health member from
47 industrialized and industrializing countries; the estimated
coverage of workers with OSH services was only 18% . The
right of labor is declared with detail obligation of employers in
Ethiopian labor proclamation no 377/2003 EC. The proclamation
explains that employees must take appropriate steps of ranging
from instructing or notifying employees concerning the hazards
of their respective occupations to provide workers with protective
tools, clothing and other safety equipment. But unfortunately, this
legal document, according to the existing working environment
and situation of daily labored, seems to have been just shelved
at the ministry of social and labor affair, justice bodies and
construction companies [17,18]. Irrespective of this, the
construction industry is at its booming stage, especially in Addis
Ababa. Hence, implementation of occupational health and safety
rules had a major problem in developing country .
An occupational injury is one of the most prevalent among
construction industries reports of developing countries show
work-related injury are the most commonly reported occupational
illness and disability. Apart from personal suffering, these
conditions impose a major financial burden on the community
on employers and on individual. There is less information about
the prevalence and associated risk factor of work-related injuries
among building construction workers population in developing
countries like Ethiopia when compared to industrialized
countries. Occupational morbidity, disability and death without
use PPE in most developing countries including Ethiopia are
becoming a serious public problem. Construction industry has
been identified as one of the most hazardous industries in many
parts of the world. Especially developing country like Ethiopia
in which, development on housing construction on fast growing
are more affected. Although, evidence based occupational health
and safety services are indispensable, studies showing factors of
occupational injury in most workplaces such housing construction
are scarce in Ethiopia. Therefore, finding of this study may utilized
and provide baseline information for Defense construction
sector/bureau, help in proper usage of PPE’s to prevent workrelated
injury for employer, employee Defense construction
This study discovers the rate personal protective equipment
utilization and protecting factors in Addis Ababa Ethiopian
Defense construction industries. Different investigation reported
that low educational status, low monthly salary, low working
experience (5 years or less) on present job were common risk
factor for work-related injuries [20-22]. Most occupational
health and safety studies conducted in developing countries also
revealed that increased educational levels in factory have been
associated with decreased work-related injuries [23,24]. However,
across sectional status in Addis Ababa shows educational status
of the workers has not significantly associated with magnitude
of occupational injuries . Education is more likely to increase
workers safety and health practice that can prevent them from
occupational injuries [25,26]. Workers salary per month was
found to be significantly related to injury occurrence. Workers
with low income could have more hazardous job in which may not
use protective clothing. Workers with good salaries are usually
highly educated have supervisory jobs and have less exposure to
job hazards .
Many studies concluded hours worked per week, health and
safety information, workplace supervision health and safety
training showed a significant association with work and workrelated
injuries [21,23,28,29]. An increasing number of studies
have considered job satisfaction and regular supervision of
workplace as pervasive and influential factors in the occurrence
of work-related injuries in the work environment. Study done in
France indicated that work accidents have been associated with
alcohol consumption . Study done in our country Afar regional
state workers who were used drink alcohol were more likely to be
injured than those who do not consume alcohol but no significant
association between chat chewing and cigarette smoking with
occurrence of occupational injuries .
Also, study conducted in Gondar University among the
construction workers included that awareness among workers regarding dangers and risks at workplace use of personal
protective equipment, and good personal hygiene practice to
minimize unnecessary exposure to work site contaminants
was found to be important to decrease the occupational injury
problems and improve the health status of workers . Most
study show that the leading cause of occupational injury among
construction workers are falling ground level, struck by an object,
cutting by sharp object and slipping [21, 23, 25, 31].
Questionnaires-based survey conducted in Ethiopia, Gondar
among construction workers show that the major occupational
problem are skin disorder 16% eye problem and headache,
15% muscular skeletal problem and harm by sharp instrument
14% . Finally, the prevalence and factors that contribute the
occurrence of injury in workplace in Ethiopia will studied. And,
the availability and utilization PPE among construction worker
are not studied. So, this study will provide baseline information
for policy makers to design strategy to give priority to prevention
and control of occupational injuries to have healthy workforce
and sound economic development by availability of PPE to
workers and regular supervision on the work site for proper
utilization of PPE, training of pre-work and after work. The result
of this research is expected to be important for practitioners
and researchers on how to deal with incorporate and identify
problems related to ergonomic aspects to assess work-related
injuries in the construction industry Figure 1.
Institutional based descriptive cross-sectional study method
Study area and period: The study was conducted in Addis
Ababa (Capital city of Ethiopia). From Feb 26 - Mar 19/2018 GC,
in “CMC” site Defense construction, which is Defense Foundation
house construction. Addis Ababa city has a total population of
3,338,569, projected from the 2015 population census (CSA 2007
EC). The city is divided into ten sub-cities. Defense construction
bureau has 29 construction Project as hole of the country, from
this the 7 large construction projects are in Addis Ababa, CMC
site is one of the largest construction project contains 17 block of
ground pulse 7 and 9. The choice of this sector was based on the
size of the project and number of worker in the project so based
on this factors CMC project site was selected as main study site.
All employees who involved in 17 block construction workers,
working as the masons, Carpenters and roofers, Plumbers and
electricians, finishing worker, Helpers and daily laborers were
included in the study to assess the rate of safety material utilization; and experienced occupational injury within the past 12 months,
and last 2 weeks workers who never experienced occupational
injury within the working site. employee as supervisors, trackers,
and other managerial working area were excluded from the study
assuming that they were less exposed for occupational injury.
The total number of workers in the selected study site were
≤2,000 out of this 800 population was calculated using formula
of a single population proportion, so the sample size was 274
considering, data was continuous and at confidence interval
95%, marginal of error 5% and considering 5% non-response
rate. There are 29 project with ≥ 20,000 workers in Defense
construction sector, from these only one site was included in our
study, (3.5%) was selected for study according to our randomly
selection, 3.5% was inadequate for analysis and reporting, but
the selected sites have uniform PPE requirements because they
had one similar experience. Our site had been registered by Addis
Ababa city and certified by NCA. In the site 274 participants was
select by the interval of 3th to participate in the study because the
number of construction workers in one site will almost the same.
Sample size (n) was calculated by using one population
proportion formulas by considering used of PPE and unused of
PPE among the construction workers. Out of 800 workers 274
workers was sample size by the interval of 3th was select by using
randomly sampling method. Project 16-01B and Project 14-01B
working department which include in the study, the total sample
was the construction site and their worker population size
was calculated based on availed participant at the observation
time. Pre-taste and structural interview questionnaire and
observational check list was used to collect the data. Finally, each
study subject was selected by using random sampling technique
on the workers work site.
Data were collected by using pre-taste and structured
Amharic questionnaire face to face interview approach. Training
was given for both the facilitators, supervisors at the time of data
collection. The training includes briefing on the general objective
of the study, discussing the content of the questionnaires and type
of information needed to be answered. The questionnaire focused
on the Socio- demographic, utilization and availability of PPE,
behavior of the workers, environmental risk factors, occupational
injury, and job stress assessment tools. We used observation check
list for cross checking mechanism for data quality. Data were
collected by six BSc public health profession or group members,
which were used to determine on prevention of occupational
injury within the construction area.
Personal Protective Equipment: -Utilization of a material
uses by worker who work in a construction worker protection
against health and safety hazard. Include items success as gloves,
safety glasses, ear plug, shoes/boots, hard hats, respiratory
or coveralls, full body suits that necessary to be worn during a
Occupational Injury: Any physically injury sustained on
worker in construction within the performance of his or her work
and absent from work four or more days from workplace .
Health and Safety training: A Training gave to a worker
about health and safeties.
Occupation Health Risk: Any source of potential damage,
harm or adheres health effects on something or someone under
certain conditions at work.
Permanent employee: -Any contract of employment between
employee and employer concluded for an indefinite period .
Temporary employee: Any employment contract between
employee and employer made for define period .
Cigarette Smoker: Any employee who were smoking one
cigarette per day or occasional for at least 1 years.
Alcohol drinker: An employee who drinks alcohol at least
five drinks per week for men for at least 1 year, and two drinks pet
week for women for at least 1 year.
Data entry and the analysis were conducted by using SPSS
version 16 software package for data management and analysis.
The descriptive statistics such as frequency, percent, mean, and
median were employed for most variables.
The questionnaire was first prepared originally in English
and translated to Amharic and then back to English to verify the
consistency and content validity. Finally, Amharic version was
used. All the research team was involved in data collection after
training. The training was focused on data collection instrument,
field method inclusion-exclusion criteria and record keeping
issues. The interview questionnaire was pre-tasted on 5% 
respondents in Defense head quarter sub construction old airport,
Addis Ababa, LIDETA sub-city, to identify potential problems,
unanticipated interpretation and objection; based on the finding
of pretests some modification was done on the questionnaire
before the actual data collection.
This study was carried out after obtained ethical clearance
from Defense University collage of health science/IERC of the
college. Permission to conduct this study was secured from
Defense construction bureau and from study construction site
officially. Oral consent from each subject was obtained after
clear explanation on the purpose of the study. Participant was
also informed as they had full right to discontinue or refuses to
participate in the study. confidentiality, autonomy, privacy, total
time taken was informed and secured.
A total of 274 participants were interviewed for this study,
the total participant 167(60.9%) were male workers, under the
age of 30 years 181(66.1%) and the mean age 28.92(SD6.805),
regarding to marital status of workers majority of them were
single 155(56.6%), about educational level of worker 84(30.7%)
completed primary level Table 1, 157(57.3%) are temporary
employed workers and about 78(28.5%) were above or 3 months’
work experience, the mean of monthly salary of the workers were
3000.81(SD1824.291) Figure 2 and Figure 3.
The result showed that half of the respondents utilize PPE
on duty 192(70.1%), participant affirmed availability one or two
of the following PPE, safety boots 9(3.3%), 110(40.1%) helmet,
heavy duty gloves 27(9.9%), ear plug 6(2.2%), other equipment
respectively while the remaining (45.5%). Affirmed the availability
of among PPE utilize on duty of respondent 115(42.0%) were
Table 2 used all the time. The majority worker reason for not use
PPE were not fill comfort 50(18.2%) and lack of awareness of risk
43(15.7%). Among PPE user on duty respondent above 50% of
PPE supplied by the institution and the rest bought by workers
themselves Figure 4 and Figure 5.
The total magnitude of occupational injury in the last 12
months was 37(13.5%), above half of respondent 23(8.4%)
exposed at least once. In the last 2 weeks were 11(4.0%) were
exposed at least one times suffered form of injury and did not
used any PPE’s. Finger 20(7.3%) were the most injured body
part of respondent. the report shows that types of accident occur
in workers were hurt by struck against object 23(8.4%), struck
by object 12(4.4%) and Nile injury 8(2.9%). The main reason of
injury occurrence was due to not using PPE 11(4.0%). Among the
total injured worker 10(3.6%) were visited hospital and 6(2.2%)
of worker were absent from work for more than 12 hours because
of the injury Table 3.
About 274(100%) was worked less or equal 8 hours per
day/48hrs per week, 217(79.2%) of workers were not done
regular health and safety supervision of workplace. 233(85%)
of worker did not had safety training in connection with new
employment, equipment, or work process, and 83(30.3%) of
workers involve manual handling activity like Pulling, Pushing,
carrying, and lifting. Among those 30(12.0%) of were carrying
medium weight, 5(1.8%) were carrying very heavy (greater than
50kg) on average for 4 hours and above Table 4.
Among the total respondent 41(15%) workers were not
satisfied on the job/works. 93(33.9%) of respondent s were
said as they had hurry and excessive work load, 90(32.8%) of
worker were consider work situation as danger, 179(65.3%) of
respondent consider the job as it was dangers for their life, and
274(100.0%) of respondent stated that hazard sign was not
displayed at work site Table 6.
Regarding to observational result of this study all most all
environmental health and safety factors in construction area
such as personal protective equipment are not in the store,
no enough supply, put in correct place, no sign of warning and
safety rule, there was clinic in the site but had not enough supply
first aid equipment, no electrical panel knockout in place, there
was no training of workers, supervision of work place by safety
professionals, hammers kept free of splinters, covered wall and
floor opening and portable circular saws equipped with protective
guard were not fulfilled within the working site, the employees are
not use the necessary personal protective equipment/ worker not
match with proper personal protective equipment, are not proper
utilization of personal protective equipment, the ladders are safe
and inspected as appropriate place, more of them use equipment
lifter manual than ladder, the operating lifts are trained on the
The study result showed that overall utilization level of
personal protective equipment 192(70.1%) participant affirmed
availability of one or two of the PPE, from 192(70.1%) 115(42.0%)
were used all the time. The majority workers reason for not used
PPE, 50(18.2%) were not fill comfort, and 44(16.1%) were not
think aware of risk. Among PPE user on duty respondent above
140(51.1%) of PPE Supplied by the institution and the rest bought
by workers themselves.
The availability of PPE’s was not online with the type of
work and hazards one was exposed at any time. In this study
construction workers reported to be using the following PPE’s
safety boots; helmet; heavy duty glove; dust mask; ear mask;
goggles; safety harness/belt but had not full supply. Participant
have knowledge each PPE’s is used for a different work in the
construction sites, that safety boots are used to protect foot from
injuries, goggle are used to protect eyes from strong light during
welding and dust; overalls are used to protect one’s clothing from
getting dirty, helmets are used against head injuries; ear muffs are
used to protect ears against excessive noise in the construction
sites; safety harness/belt are used to protect workers from falling
from heights. Some workers are provided with PPE and yet
they were not using them especially goggles and face masks as
observed in this study.
Reasons for not utilization PPE’s were given by the respondent
varied reasons why they did not use the available PPE’s in their
workplace. This study showed that some participants did not had
them because they did not see any importance of them; other did
not have the equipment; observation showed that some workers
had PPE’s, but they were not using PPE hence it influenced
the increase in the use of PPE in work place. Due to these the
prevalence of occupational injury in the last 12 months and 2
months un used PPE was 37(13.5%), above half of respondent
23(8.4%) frequency of occurrence of injury in the last 12 months
where one times, similar to this injury in the last 2 weeks were
11(4.0%) frequency of occurrence where one times, suffered
some form of injury, did not have any used PPE’s despite used
PPE’s participant. Among those injured workers 15(5.5%) of
them did work behavior, finger 20(7.3%) were the most injured
body part of respondent. the report shows that types of accident
occur in workers were hurt by struck against object 23(8.4%),
struck by object 12(4.4%) and Nile injury 8(2.9%).
The main reason of injury occurrence was due to not using
PPE 11(4.0%). Among the total injured worker 10(3.6%) were
visited hospital and 6(2.2%) of worker were greater than 12
hours absent from work because of injury. When we compare
with different study, like Study done in Gondar 38.7%  and
Addis Ababa 38.3%,84.7%  higher prevalence reported. So,
this discrepancy may be because of our study area only one level
one general contractor firm whereas study done in Addis Ababa
include one to five level contractor firm and study done in Gondar
nothing has been mentioned about level of contractor. And,
another reason for higher prevalence sample size deference and
sample population. In this study, a minimum of a year experience
in construction worker is mandatory to be recruited as study
participants, whereas nothing has been mentioned in both studies.
In contrary study done India 22.9%  and Egypt 18.4% 
have lower prevalence reported than our study. This difference
may be safety concern; awareness and education of workers in
these countries are greater than ours regarding this sector. Also,
the study area also in these studies were done in big construction
companies, not included small ounces, that give concern for health
and safety for their workers.
Different studies report shows that male workers were
significantly associated with occupational injury [23,30] which
alien with this study. The odds of occupational injury for male
2.85 times more likely injured than those of female workers
(P-less than 0.5%). This is may be construction work more done
by male; male workers were more expose substance abuse like
alcohol and chat and female workers could take their health
and safety responsibility, use PPE than males. Based on our
findings temporary workers were 2.92 times more likely injured
than those of permanent workers (p <0.05). This is supported
by studies conducted in Iran and Ethiopia may be explained as
higher injuries reported on temporary workers were because of
temporary workers do not get a chance to work for a whole year
like the permanent, health and safety awareness of temporary
workers was less than those of permanent workers lack
experience on specific tasks and lack of job security can play an
important role in occurring accidents for such workers.
This study finds out that the odds of injuries among employees
who have less or equal to 4 months up to 5 years work experience
were 137(50%) less compared to those who have more than ≥
5 years’ work experience. The possible explanation for this may
be that those employees who have greater than 5 years’ work
experience could be accustomed to the work environment and
developed false consciousness of safety which drive them not
to obey with safety precautions including proper use of PPE. It
might also because lack of safety awareness programs in the
workplaces. This study supported by different study done Addis
Ababa and Gondar . Another important finding of this study
was the odds of injuries among employees who earning monthly
salary 960-2000 ETB were 159(58%) less compared to those who
earning ≥ 5001 ETB. This may be explained as higher payment
is related with high experience, and higher educational status,
although this factor was significant in this study and workers
with lower experience and educational status are usually placed
in working sections involving manual contact with machines
and others. According to study result showed that severities of
occupational injury were among 56 injured workers 10(3.6%)
visited hospitalized. Because of this 3(1.1%) of participant had
lost greater than 1 month of work (1440 hours work absent). This
result supported by study done in Gondar and Addis Ababa. It
might also be due to construction industry is one of the hazardous
and working behavior of construction industry.
I. Among the participant 192(70.1%) were using only one
or two of the right PPE. The extent of PPE uses especially the
right ones was wanting since it was below 50% because the
participate used only one type on PPE from the 110(40.1%)
user of helmet additionally 9(3.3%) used safety boots.
More than 82(29.9%) of worker did not have any personal
protective equipment. Most/more than 56(20.4%) workers,
who suffered some forms of injury did not have any protective
II. About 203(74.1%) before engaged to the work and
207(75.5%) after engaged the work of participant had not
been trained on PPE use and any other safety training.
III. The use of personal protective equipment in all time was
found to be important factor to decrease occupational injury
IV. Awareness and education is needed to male, higher
income, higher work experience, and temporary workers
because showed significant association on the occurrences of
occupational injury with community group.
V. Most environmental health and safety factors in
construction area such as protective equipment, sign warning
and safety rule, first aid equipment, electrical panel knockout
in place, training of workers, supervision of work place by
safety professionals, hummers kept free of splinters were not
fulfilled within the working site that may play an important
role in reducing occupational injury.
VII. Constant awareness of all hazards, injuries, and illness
associated with construction should be maintained. All sort of
injuries to workers should as much as possible be minimized
while on duties by using PPE.
VIII. All workers should need to use safety boots, helmet,
overalls and heavy-duty gloves alongside dust masks, ear
masks, goggles, safety harness/belt, and while on duty
whenever necessary to minimize injuries and illness
associated with construction work.
IX. The ministry of health, Addis Ababa health bureau,
ministry of social affairs should assign occupational health
and safety professionals for monitor working site to reinforce
and remind the basic health and safety matters fulfillments.
X. The supervision/boss of the construction area tries to
identify the needs of workers to make them satisfied by their
XI. The management of construction site should regularly
conduct helpful safety training on a construction sites and
give workers brief before commencing any work on their daily
XII. NCA to contact regular monitoring of contractors to
ensure safety need of workers.
My heart-felt gratitude goes to the Defense University College
of Health Science of Public Health at College of Health Science
library staff. We would like to extend our appreciation also
for School of Public Health administrative staff, and the study
participants for their cooperation and provision of valuable
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