Abstract
Introduction: Occupational health and safety (OHS) plays a pivotal role in ensuring safe and healthy working conditions particularly in high-risk environments such as medical laboratories. In South Africa compliance with the Occupational Health and Safety Act 85 of 1993 is a requirement for all organisations. Compliance with legislation is an important measure of the extent to which laws and regulations are followed. Non-compliance with legislation can result in workplace injuries and diseases which can lead to death, disability, loss of income and financial loss. Assessing occupational health and safety compliance by analysing audit results can provide an important indication of the gaps in occupational health and safety management systems and highlight specific policy strategies that may need to be implemented. The study assessed the status of occupational health and safety compliance in selected National Health Laboratory Service (NHLS) medical laboratories by analysing audit results from 2016 and 2022.
Method: A quantitative, descriptive study design was used to examine secondary data consisting of audit results from the same set of 61 laboratories audited in 2016 and 2022. Audits were carried out in strict compliance with a standard operating procedure, GPS0048 which contained the audit checklist comprising of 12 categories, namely Administrative Procedures, General Housekeeping, Equipment Safety, Accident and Incident Management, Risk Assessment, Safety Training, Hazardous Chemical Agents, Emergency Procedures, Personal Protective Equipment, Engineering Controls, Hygiene Control/ Facilities, and Ergonomics. The 2016 audit checklist contained 201 questions and the 2022 checklist contained 220 questions, and results recorded as either “compliant”, “non-compliant” or “not applicable”. A total of 12261 audit results for 2016 and the 13420 audit results for 2022 recorded in the Occupational Health and Safety Information System (OHASIS) in use at the NHLS were imported into Microsoft Excel, quantified and analysed using SPSS version 30. The Shapiro-Wilk test was used to assess for normality at a significance level of 0.05. The data was found not to be normally distributed so a non-parametric Wilcoxon Signed Rank Test was used to compare 731 audit category scores and 61 final audit scores from 2016 and 2022 to determine any statistically significant difference between the results and the significance level thereof.
vi
Results: Aggregated audit category scores were all above 95% with the exception of Risk Assessment, Safety Training, and Hazardous Chemical Agents with scores of 94.85%, 92.85%, 94.80% respectively in 2016, which improved to 97.03%, 96.44%, and 96.09% respectively in 2022. The total number of non-compliances in 2016 (229) decreased by 17% in 2022 (191). The Safety Training audit category had the highest prevalence of non-compliances in 2016 (98%) and in 2022 (82%) and NC prevalence decreased by 16% between the two years. Eight of the twelve audit categories (67%) displayed a decrease in non-compliance prevalence from 2016 to 2022. These audit categories included General Housekeeping (3%), Accident and Incident Management (2%), Risk Assessment (26%), Safety Training (16%), Hazardous Chemical Agents (17%), Personal Protective Equipment (16%), Engineering Controls (5%) and Hygiene Control/Facilities (39%). The results of the Wilcoxon Signed Rank Test showed statistically significant changes in aggregated audit category scores for four of the twelve audit categories. These audit categories included Equipment Safety (p = 0.008), Safety Training (p = 0.023), Personal Protective Equipment (p = 0.002), and the Hygiene Control / Facilities (p = 0.001). In 2016 the Histology laboratory discipline had the highest prevalence (29%) of non-compliances. In 2022 the Haematology laboratory discipline had the highest prevalence (26%) of non-compliances.
Conclusion: The study found aggregated audit category scores and final audit scores to be above 95%, indicating high occupational health and safety compliance levels in the laboratories. A decrease of 17% in non-compliance prevalence from 2016 to 2022 indicated an improvement in audit outcome and OHS compliance. The Safety Training audit category had the highest prevalence of non-compliances in 2016 and 2022, however a decrease of 16% in non-compliance prevalence was noted. The results of the Wilcoxon Signed Rank Test showed statistically significant improvement in aggregated audit category scores for three of the four audit categories which included Safety Training, Personal Protective Equipment, and Hygiene Control/Facilities. The fourth audit category, Equipment Safety, showed a statistically significant decline in aggregated audit category scores. The Histology and Haematology laboratories recorded the highest prevalence of non-compliances in 2016 and 2022 respectively, highlighting discipline-specific challenges. The study concludes that while overall occupational health and safety
vii
compliance is high, targeted interventions are still necessary to address the existing safety training and equipment safety gaps and the discipline-specific risks. These findings provide important insights for enhancing occupational health and safety management systems and policy implementation in South African medical laboratories.