Assessing The Awareness On Occupational Safety and

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195]
Original Article
Assessing the awareness on occupational safety and

health hazards among nursing staff of a teaching hospital
Prajwal M. S1, Kanakavalli K. Kundury2,3, Sujay M. J2
1
Student, MBA-Hospital Administration, Department of Health System Management Studies, JSS Academy of Higher Education
& Research, Mysuru, 2Assistant Professor, Department of Health System Management Studies, JSS Academy of Higher
Education & Research, Mysuru, 3Coordinator, Special Interest Group in Patient Care Management (SIGPCM), JSS Academy of
Higher Education & Research, Mysuru, Karnataka, India
A bstract
Introduction: Occupational safety and health hazards in healthcare facilities play a significant role in the lives of care providers and
also contribute toward quality patient care. Healthcare workforce gets exposed to physical, chemical, biological, and psychological
hazards while discharging their duties, thus demanding for proper knowledge and awareness to address the same. Objectives: As
nursing staff implement the care process directed by the physicians, the current study conducted at a teaching hospital aimed at
assessing their awareness on occupational safety and health hazards. Methodology: A prospective study was conducted on a pilot
basis for a period of 3 months in various nursing areas of the hospital. The questionnaire aimed at assessing the awareness of
nursing staff on occupational safety and health hazards (5‑point scale) was administered on nursing staff (150/170]. Total scores and
percentage of responses were computed and the degree of correlation was observed as 0.4 between the participants age, educational
qualifications, and total scores. Results: Participant response rate was 88% (150/170). Awareness on occupational safety and health
hazards were shown as 43.4%‑ accidental falls at workplace, 42.7%‑ complete awareness on latex allergies, 52.7% on dermatitis and
respiratory problems, 42% complete aware on accidental fires, 39.4%‑ burns, 36.7%‑ electric shocks, 59.4%‑ complete awareness
on biological infections, 54%‑ respiratory disorders, 48.7%‑ skin allergies, awareness on usage of PPE to prevent: 67.4%‑respiratory
problems, 44%‑ accidental falls; 77.4%‑ importance of handwashing, 78% ‑ significance of Hepatitis B vaccination, 71.4% ‑ usage
of first aid kits in minor accidents, 60%‑ reporting incidents, and 58%‑ documentation system for incident reporting. Sum total
of scores revealed that 73.3% of the participants were found to be completely aware about all the components of occupational
health and safety mentioned in the questionnaire. 22.6%‑ aware, 3.3%‑ moderately aware, and < 1% were slightly aware of the same.
Conclusions: The study had highlighted the areas that require knowledge enhancement on occupational safety and health hazards
which helps in adopting the best practices at workplace.
Keywords: Hazards at workplace, nursing staff, occupational health, occupational hazards, occupational safety
Introduction of the most hazardous occupational settings.[1‑3] In addition to the

usual workplace related exposures, healthcare workers encounter
Healthcare workers constituting 12% of the working population diverse hazards because of their work‑related activities.[4,5]
worldwide operate in an environment that is considered to be one
Occupational health and safety is a discipline with a broad scope
Address for correspondence: Prof. Kanakavalli K. Kundury,
involving many specialized fields such as physical, psychological,
Assistant Professor, Department of Health System chemical, biological, and mechanical/electrical, which determines
Management Studies, JSS Academy of Higher Education & the health and safety of employees in a broader context.[6,7]
Research, Mysuru, Karnataka, India.
E‑mail: [email protected]
Health care workers including physicians and nurses get regularly
exposed to occupational hazards such as physical, biological,
Received: 30-05-2020 Revised: 09-09-2020
Accepted: 14-10-2020 Published: 31-12-2020 This is an open access journal, and articles are distributed under the terms of the Creative
Commons Attribution‑NonCommercial‑ShareAlike 4.0 License, which allows others to
Access this article online remix, tweak, and build upon the work non‑commercially, as long as appropriate credit is
given and the new creations are licensed under the identical terms.
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Website:
www.jfmpc.com For reprints contact: [email protected]
DOI: How to cite this article: Prajwal MS, Kundury KK, Sujay MJ. Assessing
10.4103/jfmpc.jfmpc_1025_20 the awareness on occupational safety and health hazards among nursing
staff of a teaching hospital. J Family Med Prim Care 2020;9:5961-70.
© 2020 Journal of Family Medicine and Primary Care | Published by Wolters Kluwer ‑ Medknow 5961
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Prajwal, et al.: Assessing the awareness of nursing staff on occupational safety and health hazards
chemical, and mental hazards during care delivery process.[8,9] computed. Assigning score value of 1–5 for individual items
Assessing the awareness on various hazards and imparting the under respective components had given a total score of 135
knowledge required to manage such hazards is vital for quality which is obtained as below: General awareness on occupational
patient care. As patients care delivery process is driven by nursing safety and health hazards (4 items × 5), physical hazards (3
staff as instructed by the physician, the nurse’s awareness on items × 5), chemical hazards (3 items × 5), electrical/mechanical
occupational safety and health hazards contributes to quality of hazards (3 items × 5), biological hazards (4 items × 5) and
patient care. Thus, the current study was undertaken to assess practices for hazard management (10 items × 5). A higher overall
the same among the nursing staff of the hospital. score was considered to determine complete awareness whereas
a low score represented their unawareness.
Study objective
The objective of the current study is to assess the awareness Statistical analysis
on occupational health and safety among the nursing staff of a Degree of correlation between participant’s demographics such
teaching hospital. as age and work experience; and their total scores were measured
as 0.4 which means a positive linear relationship. Cronbach’s
Materials and Methods Alpha value of 0.95 was obtained which measures the reliability
and internal consistency between various items mentioned in
Study site the tool.
A prospective study was conducted on a pilot basis for a period of
3 months from April to June 2018 at a teaching hospital located Results
in South India. Ethical committee approval was not obtained for
the current study as the study was a part of academic requirement The study had aimed at assessing the nursing staff awareness on
involving no clinical interventions. occupational safety and health hazards.
Recruitment of study participants Demographics of study participants

A total of 170 nursing staff working in medicine wards, OBG wards, According to Table 1, out of 150 study participants, 93.3% were
pediatric wards, orthopedics wards, nephrology, neurology, and female nurses, whereas the rest were males. Mean age of the
urology wards along with various Intensive Care areas of the hospital study participants was 30.2 ± 7.2 years. Average years of work
were recruited into the study with no specific inclusion/exclusion experience was 7.6 ± 6.2 and ~63% were married.
criteria and questionnaires on assessing their awareness on occupational
safety and health hazards were distributed. 150 questionnaires General awareness on occupational safety and health
were duly filled and received resulting in 88% completion rate. hazards
Figure 1, depicting the general awareness of nursing staff
Data collection tool on occupational safety and health hazards demonstrated
The questionnaire was divided into two segments. Segment1 that 44% (66/150) of the study participants have shown
comprised demographic information of the participants, their full awareness on occupational safety and health
Segment 2 included 6 components and a total of 27 items under hazards [Figure 1a], 46% (69/150) were fully aware about
these components [Annexure 1]. occupational hazards [Figure 1b], and 48.7% (73/150) were
fully aware on various diseases resulting out of occupational
Primary and secondary outcomes
Identifying participant awareness on occupational safety and Table 1: Description of Participants Demographics
health hazards is the primary outcome of the study. The Details
secondary outcomes of the study include identifying knowledge PARTICULARS (n=150) TOTAL %
gaps in occupational health and safety, so that necessary measures GENDER MALE 10 6.7
such as increasing the workplace training or re‑orientation FEMALE 140 93.3
sessions can be suggested for filling the gaps. AGE 21‑30 85 56.7
31‑40 52 34.6
41‑50 11 7.3
Data analysis method 51‑60 2 1.3
Percentages were computed on participant’s demographic details WORK ≤1 yr 25 16.7
such as age, gender, work experience, and marital status. Mean EXPERIENCE 1‑10 yr 75 50
age of study participants was calculated along with their work 11‑20 yr 47 31.3
experience. 21‑30 yr 3 2
MARITAL STATUS Married 94 62.7
Scores were assigned to each of the responses ranging from Single 52 34.7
Others 4 2.7
1 (Not Aware) to 5 (Fully Aware) and total scores were thus
Journal of Family Medicine and Primary Care 5962 Volume 9 : Issue 12 : December 2020
a b
c d
Figure 1: General Awareness on Occupational Health and Safety
hazards [Figure 1d]. Moderate awareness was observed awareness on respiratory problems. Data analysis also showed that
in 28% (42/150) of the nursing staff on various types of 2.7%‑3.4% (4/150–5/150) [Figure 3a‑c] nursing staff were not
occupational hazards, whereas only 22.7% (34/150) were fully aware of chemical hazards.
aware on occupational hazard classifications [Figure 1c]. Less
than 1% of the study participants were not aware of occupational Electrical/mechanical hazards
safety and health hazards [Figure 1a‑c]. Working with electronic devices exposes the nursing staff to
potential electrical/mechanical hazrds.[12] In the current study,
Nursing staff awareness on various occupational according to Figure 4, among 150 nursing staff assessed,
hazards 42% (63/150) [Figure 4b] were fully aware about the accidental fires
Physical hazards at workplace, 39.4% (59/150) [Figure 4a] were fully aware about
It was found that most of the nurses get exposed to ergonomic burns and 36.7% (55/150) [Figure 4c] about electric shocks at work
hazards such as skeletal and muscular disorders, and physical place. 14–16.7% (21/150–25/150) [Figure 4b and c] were found to
hazards.[10] In the current study, according to Figure 2, there be moderately aware about electrical/mechanical hazards. Lack of
was 24‑27% (37/150–41/150) full awareness observed among awareness was observed in 4% of the nursing staff on accidental
the nursing staff with respect to accidental falls [Figure 2a], fires, 2.7% (4/150) and 4.7% (7/150) [Figure 4a‑c] nursing staff
hearing problems [Figure 2b], and headache [Figure 2c]. were unaware on accidental burns and shocks, respectively.
43.4% (65/150) of the nursing staff were aware of accidental
falls at workplace [Figure 2a], 42.7% (64/150) were aware of Biological hazards
hearing problems [Figure 2b] and 45.4% (68/150) were aware While delivering patient care, nurses might get exposed to
of headaches [Figure 2c].
blood‑borne pathogens and infectious diseases.[13‑15] In the current
study, nursing staff awareness on biological hazards was assessed in
Chemical hazards
Figure 5 as 59.4% (89/150) [Figure 5c] of the nursing staff were fully
As nurses get exposed to aerosolized medications, anesthetic
aware about infections at workplace, 54% (81/150) [Figure 5b] were
gases also gets in contact with latex materials,[11] in the current
study, nursing staff awareness on diseases because of chemical fully aware on respiratory disorders, 48.7% (73/150) [Figure 5a]
hazards was assessed. Figure 3 represents full awareness on latex about skin allergies, and 46.7% (70/150) [Figure 5d] were fully
allergies among 42.7% (64/150) [Figure 3a] of nursing staff, aware on work place stress impacting health of the individual.
52.7% (79/150) [Figure 3b and c] full awareness on dermatitis and 32.7–36.7% (49/150–55/150) [Figure 5d and a] awareness
respiratory problems as well. 41.4% (62/150) [Figure 3a] of awareness on biological hazards was identified. Moderate awareness was
was shown on latex allergies, whereas 31.4% (47/150) [Figure 3b] observed among 14.7% (22/150) [Figure 5] nursing staff on
and 34.7% [Figure 3c] awareness on dermatitis and respiratory the impact of stress on health, 8.7% (13/150) [Figure 5b] were
issues, respectively. Moderate awareness was observed in moderately aware on various respiratory disorders, whereas
11.4% (17/150) [Figure 3a and b] of nursing staff on latex allergies 2–3.4% (3/150–5/150) [Figure 5c, a and c] unawareness was
and dermatitis, respectively, and 8.7% (13/150) [Figure 3c] moderate observed in the same areas.
a b
c
Figure 2: Awareness on Physical Hazards
a b
c
Figure 3: Awareness on Chemical Hazards
Awareness on occupational safety practices and [Figure 6b]‑ PPE usage in preventing respiratory problems,
incident reporting 44% (66/150) [Figure 6c]‑ usage of PPE in accidental fall
Nursing staff should possess knowledge required to safeguard prevention, 77.4% (116/150) [Figure 6d] ‑ importance of
themselves from possible hazards by taking precautionary handwashing, 78% (117/150) [Figure 6e]‑ significance of
measures such as using PPE, handwash, incident reporting, and Hepatitis B vaccination, 71.4% (107/150) [Figure 6f]‑ usage of
documentation.[16‑18] first aid kits in minor accidents, 62.7% (94/150) [Figure 6g]‑usage
of fire extinguishers, 60% (90/150) [Figure 6i]‑ on reporting
According to Figure 6, full awareness of nursing staff incidents to higher authorities, and 58% (87/150) [Figure 6j]‑ on
was observed in 55.4% (83/150) [Figure 6a]‑ PPE usage documentation system for incident reporting. Moderate
to prevent cuts and skin abrasions, 67.4% (101/150) awareness was observed among nursing staff as 9.4–12.7%
a b
c
Figure 4: Awareness on Electrical and Mechanical Hazards
a b
c d
Figure 5: Awareness on Biological Hazards
(14/150–19/150) [Figure 6a, b, c, d, g, I, and j] in terms of PPE Participant‑wise analysis of awareness on

usage in the prevention of cuts, accidental falls, respiratory issues; occupational safety and health hazards
importance of handwash and incident reporting mechanisms. Considering the overall response of nursing staff, the awareness
However, the percentages were comparatively low with on occupational safety and health hazards was also analyzed
2.7% (4/150) [Figure 6e] moderate awareness in importance of component wise by individually considering various types
vaccination, 4% (6/150) [Figure 6f]‑ usage of first aid kits in minor of occupational hazards. Scores were assigned to individual
accidents, and 3.4% (5/150) [Figure 6h]‑ significance of regular responses and total scores were computed, thus determining
health checkups. It was observed that 5.4% (8/150) [Figure 6c] their awareness on individual hazard classification.
unawareness was observed on usage of PPE in prevention of
accidental falls; 1.4–2.7% (2/150–4/150) [Figure 6a, b, e, f, h, and j] Figure 7 depicts component wise analysis of nursing staff ’s
nursing staff were not aware of PPE usage in prevention of awareness on occupational safety and health hazards. More than
hazards, importance of vaccination, periodic health checkups, 50% of the study participants were found to be completely aware
and documentation process in incident reporting. Less than about fundamentals of occupational health and safety hazards,
1% (1/150) [Figure 6d, g, i] of unawareness was mentioned in whereas 40% of them were aware and negligible percent were
terms of significance of handwash, usage of fire extinguishers, unaware of fundamentals of occupational hazards [Figure 7a].
and reporting of incidents to higher authorities. Figure 7b explains that 44.6% (67/150) of the study participants
a b
c d
e
f
g h
l j
Figure 6: Awareness on Safety Practices and Incident Reporting
were aware about physical hazards at work place and more than electrical/mechanical hazards at workplace showed that more
30% (46/150) were completely aware, whereas only 4% (6/150) than 43% (65/150) were completely aware, 36% (54/150) were
were unaware of the same. 58.6% (88/150) of the nursing staff aware and only 2.6% (4/150) were unaware of possible electrical/
were found to be fully aware of possible chemical hazards at mechanical hazards [Figure 7d]. With regard to biological hazards
workplace, 32.6% (49/150) were aware of chemical hazards at workplace, 61.3% (92/150) participants were completely aware,
at workplace, whereas only 2% (3/150) were unaware of 3.3% (5/150) were moderately aware, and 1.3% (2/150) were
the same [Figure 7c]. Analysis of participants awareness on unaware of biological hazards [Figure 7e]. Analysis of participants
a b
c d
e f
Figure 7: Component wise analysis of participants awareness on occupational health and safety
According to Figure 8, 73.3% of the participants were found to

be completely aware about all the components of occupational
health and safety mentioned in the questionnaire. 22.6% were
aware, 3.3% were moderately aware, and less than 1% were slightly
aware of the same. Interestingly none of the participants have
shown unawareness about occupational safety and health hazards.
There was a positive linear correlation of 0.4 observed when total

scores were correlated with participants age and work experience.
Figure 8: Percentage wise analysis of nursing staff’s awareness on
occupational safety and health hazards Discussion
knowledge on management of occupational hazards have revealed In the current study, 44% of the nursing staff were fully aware
that 77.3% (116/150) were completely aware, 20% (30/150) on occupational safety and health hazards, 46% were completely
were aware, and less than 1% were unaware about managing aware of the occupational hazards and diseases resulting
occupational hazards in terms of usage of PPE and reporting out of occupational hazards was observed in ~ 49% of the
systems [Figure 7f]. participants. Research conducted by Robert Kaba et al. (2018) on
296 participants from two hospitals, which is almost double the
Total scores were computed by assessing the overall responses sample size in the current study, showed 87% general awareness
of individual participants and percentages were calculated. on occupational hazards at workplace.[19]
Regarding the participant awareness on physical hazards at significance of vaccination. Study by Karki Sabita et al. (2018)
workplace, in the current study 24–27% were found to be fully showed that 86.4% participants were fully aware on hand washing
aware of accidental falls and ~44% were completely aware practices.[20]
about hearing problems and headache. Robert Kaba Alhassan
et al. (2018) had mentioned about 53% of the nursing staff As mentioned by A. B. de Castro (2009), underreporting of
were aware on physical health hazards in their research study.[19] work‑related injuries and illnesses has also been noted as a
Karki Sabita et al. (2018) showed 92% of the nurses were aware significant problem among nurses in the United States.[23]
about the physical hazards in their study.[19] The current study However, in the current study, full awareness was observed
had conducted a sub component analysis of physical hazards on in 60% of the nursing staff on incident reporting to higher
a 5‑point scale, which could be a reason for lower percentage authorities and 58% awareness on documentation system for
in results. reporting the incidents.
Data analysis in the current study showed full awareness on latex Summary
allergies among 42.7% of nursing staff, 52.7% on dermatitis and
respiratory problems as well. Research conducted by Mahadeo Current study has observed complete awareness among 73.3%
Shinde et al. (2015) showed that 22.9% of the participants of nursing staff on all the components of occupational health
completely agreed about dermatitis as a chemical hazard at and safety mentioned in the questionnaire. This demonstrate
workplace when research was conducted on 105 nursing staff.[20] that approximate to 3/4th nursing staff in the current study were
Karki Sabita et al. (2018) found that 91% of the nurses have aware about occupational safety and health hazards. Analyzing
knowledge regarding the chemical hazards at workplace in their individual data had revealed that very few individuals were lacking
study.[18] As the assessment on participant analysis was done the necessary knowledge required to understand the concepts
on a 5‑point scale, combined awareness (Moderate‑Complete of occupational health, possible hazards, safety precautions, and
awareness) would yield similar results. incident management. The results demonstrated the prevalence
of occupational safety climate within the hospital yet identified
The current study found 42% of the nursing staff were fully minor gaps for improvement.
aware about the accidental fires at workplace, 39.4% were fully
aware about burns, and 36.7% about electric shocks at work place. Conclusion
In Mahadeo Shinde et al. (2015) study conducted on 105 nurses,
46.7% strongly agreed that nurses are prone to have burn injuries The study had highlighted the areas that require knowledge
while handling hot sterile equipment’s.[21] Thus, being consistent enhancement on occupational safety and health hazards.
with the current results. Addressing the identified gap areas and staff orientation towards
the same would create a comprehensive safety environment in
It was found that 59.4% of the nursing staff were fully aware the healthcare facility.
about infections at workplace, 54% were fully aware on respiratory
disorders, 48.7% on skin allergies, and 46.7% were fully aware on Financial support and sponsorship
work place stress impacting health of the individual. Study conducted Nil.
by Robert Kaba Alhassan (2018) had observed 20% awareness
among nursing staff on biological hazards.[19] Study conducted by
Conflicts of interest
Mahadeo Shinde et al. (2015) found that 44.8% strongly agreed and
46.7% agreed that many medical diseases are acquired by nurses from There are no conflicts of interest.
patients.[21] Robert Kaba Alhassan (2018) stated that 20% of their
study participants experienced biological hazards at workplace.[19] References
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Annexure 1
ASSESSING THE AWARENESS ON OCCUPATIONAL SAFETY AMONG NURSES IN THE HOSPITAL
GENDER: � MALE � FEMALE
AGE: ...............................................................................................................................
MARITAL STATUS: � SINGLE � MARRIED � OTHERS
DESIGNATION: ...............................................................................................................
AREA OF WORK: .............................................................................................................
TOTAL EXPERIENCE: .......................................................................................................
ORIENTATION GIVEN: � YES � NO
PERIODIC EDUCATION (CNE): � YES � NO
KINDLY CIRCLE / TICK THE QUESTIONS
Survey component Ratings
Not Aware <‑‑‑‑‑‑‑‑‑‑‑‑‑‑‑‑‑‑‑‑‑‑‑‑‑‑‑‑‑‑‑‑‑‑‑>Fully Aware
How Aware are you of occupational health and safety 1 2 3 4 5

How Aware are you of Occupational hazard 1 2 3 4 5
How Aware are you of Types of occupational hazards 1 2 3 4 5
How Aware are you of Diseases occurring due to profession 1 2 3 4 5
Awareness on following hazards
1.Physical hazards due to
Fall 1 2 3 4 5
Hearing problems 1 2 3 4 5
Headache 1 2 3 4 5
2.chemical hazards due to
Latex allergy 1 2 3 4 5
Dermatitis 1 2 3 4 5
Respiratory problems 1 2 3 4 5
3.Electrical/mechanical hazards due to
Burns 1 2 3 4 5
Fire 1 2 3 4 5
Shock 1 2 3 4 5
4.biological hazards due to
Skin allergy 1 2 3 4 5
Respiratory problems 1 2 3 4 5
Infections 1 2 3 4 5
Inspection done on Linen for sutures, needles and the like stress in the working environment 1 2 3 4 5
5.PPE used to
Prevent cuts, skin abrasions 1 2 3 4 5
Prevent respiratory problems 1 2 3 4 5
Prevent falls 1 2 3 4 5
Importance of hand washing 1 2 3 4 5
Hepatitis B vaccination 1 2 3 4 5
First aid kit used in minor accidents 1 2 3 4 5
How to handle a fire extinguisher 1 2 3 4 5
Importance of regular health check‑ups 1 2 3 4 5
Occupational hazard reported to higher authority 1 2 3 4 5
Record system regarding occupational hazards 1 2 3 4 5

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[Downloaded free from http://www.jfmpc.com on Saturday, February 20, 2021, IP: 82.26.231.

Assessing the awareness on occupational safety and

Introduction of the most hazardous occupational settings.[1‑3] In addition to the

Recruitment of study participants Demographics of study participants

(14/150–19/150) [Figure 6a, b, c, d, g, I, and j] in terms of PPE Participant‑wise analysis of awareness on

According to Figure 8, 73.3% of the participants were found to

There was a positive linear correlation of 0.4 observed when total

How Aware are you of occupational health and safety 1 2 3 4 5

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