Abstract
Introduction: The healthcare industry, like many workplaces, has cases of employee illness, injury, and death. The prevalence of injuries experienced during employment varies from 32% to 87.8% between industries and is often worse in low- to middle-income countries. There is an unknown level of compliance with health and safety activities in the healthcare industry and their capability and willingness to develop and/or provide health and safety training to the employees. The level of compliance includes the reporting of accidents; employee health and safety training; occupational health programmes; policies and regulations adopted for compliance; and the measurement of health and safety implementation. This is especially important in laboratories in the healthcare sector where employees are often exposed to hazardous materials.
The aim: To determine the prevalence of occupation-related injuries and the knowledge, attitudes, and behaviour (KAB) of laboratory workers at National Health Laboratory Services (NHLS) towards health and safety in the workplace.
Method: A quantitative cross-sectional approach was used in this study at the NHLS' Charlotte Maxeke Johannesburg Academic Hospital Business Unit. Participants were randomly sampled. The study had a sample size of 273, and the response rate was 94%. The participants held different positions and were 18 years of age or older. A self-administered questionnaire with closed questions was used to collect primary data. The data was quantitatively analysed using SPSS version 29. Descriptive statistics included frequencies and counts to describe demographic characteristics, knowledge, attitude and behaviour as well as the occurrence of injuries of the study population. The Chi-square test was used to assess the significance in differences in characteristics among participants with injuries and those with no injuries. Logistic regression with Odds Ratios (OR) was used in bivariate and multivariate analysis to determine the relationship between level of knowledge, attitude and behaviour of staff and occurrence of injuries. The crude OR was determined and variables with a P value<0.02 were included in the final model. The P value<.005 was used as the level of significance with a 95% confidence interval in the final adjusted model.
The results: A total of 256 participants took part in the study. Most of the participants (37.9%, n=97) were between 31 and 40 years of age, followed by 26.2% (n=67) aged between 41 and
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50 years, and 24.6% (n=63) aged between 18 and 30 years. 76.6% (n=196) of the participants were female. Most of participants (57.03%, n=152) were employed as qualified laboratory workers, which includes medical technicians, technologists, and lab managers. Most of the participants (28%, n=73) had been in their current roles for six to 10 years, followed by 24.4% (n=62) who had been employed for two to five years.
The data showed that 24.6% (n=63) of participants experienced injuries, with individuals aged 41–50 (37.3%, 25/67) and females (73.1%, 143/196) having the highest injury rates. Lab assistants (34.5%, 10/29), medical professionals (pathologists and phlebotomists) (34.5%, 10/29), and the participants employed for six to 10 years (30.1%, 19/73) had a higher prevalence of injuries. Age was the only factor that was statistically significant between those who had been injured and those who had not, with a p-value of (p=0.003).
In the crude regression analyses, the following knowledge factors were significant: the knowledge of how to contact the Safety Health and Environment Officer (SHEO) (p=.007); how to contact the Health and Safety representative (p=.031); participants' knowledge of a risk assessment being conducted in the lab (p=002); awareness of health and safety as discussed in staff meetings (p=.019); training received on the subject of hand hygiene (p=.005), use of PPE (p=.016), and machine hazards (p=.035); and participants' knowledge of to whom to report an injury in the workplace (p=.009) and who is responsible for reporting workplace injuries and/or occupational diseases (p=.016). The factors that were significant for participants' attitude was their perception of how the organisation manages health and safety (p=.001) and the rating of their knowledge of workplace hazard identification (p=013). The factors that were significant for behaviour questions were a lack of knowledge of how to access the organisation's health and safety policy and standard operating procedure(SOP) (p=.050) and not knowing who was accountable and responsible for health and safety in the organisation (p=.001).
After conducting the multivariate regression (adjusted model), the following factors remained significant: participants aged 41–50 years (AOR1.16, 95% CI:1.06-1.27) and 31–40 years (AOR 1.12, 95% CI:1.02-1.24) were more prone to injuries compared to those aged 18–30 years. Participants with injuries were less likely to know how to contact the SHEO (AOR 0.76, 955 CI:0.68-0.85) compared to those who did not experience injuries. On the subject of workplace
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hazard identification knowledge, most participants with injuries were found to have no knowledge at all (AOR 1.32, 955 CI: 1.11-1.57).
Participants with injuries were more likely to respond with "not easy" (AOR 1.09, 95% CI:1.00-1.19) to get follow-up information on health and safety issues, than those who responded with "easy". The participants were more likely to respond with a "no" (AOR 1.17, 955 CI:1.02-1.34) regarding their knowledge on how to access the organisation's (NHLS) health and safety policy and standard operating procedure (SOP).
Conclusion: According to the study, there are differences in knowledge, attitude, and behaviour among laboratory staff based on age, which may contribute to a high incidence rate of injuries among those aged 31–40 and 41–50 years. While the data suggests a low rate of reported injuries (24.6%) compared to other studies, it is possible that there is underreporting of workplace injuries. To promote effective occupational health and safety, it is recommended that laboratory staff receive regular training on the subject of health and safety that is specific to a laboratory.
Keywords: knowledge, attitude, behaviour, health and safety, injuries