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Full text of "Why Don't Workers Use PPE? March 2 - 3, 2010"

Why Don't Workers 

Use PPE? 



David M. Dejoy, Ph.D. 

Workplace Health Group 

College of Public Health 

University of Georgia 



Kffi University of Georgia I 



The Problem 



Compliance with PPE is frequently poor or 
inconsistent 

In-use levels of effectiveness often fall short of 
theoretical effectiveness 

PPE compliance depends on human reliability 

PPE are at the bottom of the hazard control hierarchy 
for some valid reasons 



In some situations, PPE may be the only control 
immediately available to reduce exposures 



IWUKKFLAUJ 

Health Grou] 

Kffi University of Georgia I 



Overview 



PPE compliance is not as simple as we might think 

PPE usage is not just a worker issue 

Compliance needs to be examined as a multi- 
component, behavioral process 

Training is important to compliance, but it is not the 
whole story 



Reinforcement/ feedback (behavior-based) strategies 
can be useful in some situations 

Safety climate is important but our knowledge base is 
incomplete 



Unpacking the Compliance Process 



4 sets of factors or components need to 
be analyzed for any PPE application 



User 



Device Task Context 



Attributes of each component can 
facilitate or impede compliance; in many 
instances, compliance is only as good as 
the weakest component 



Kffi University of Georgia I 



Factors Influencing Compliance 



User 



knowledge 

attitudes /beliefs 

skill 

risk perceptions 

tolerance/sensitivity 



Task 



complexity/ variability 
ha2ard frequency 
equipment interoperability 



communication 



dvnamice 



physical/psychological demands 



Device 



comfort 

complexity of use 
protective efficacy 



Context 



resources/equipment availability 

work setting/ environment 

social/organi2ational 
characteristics (micro/ macro) 



|WORKPLAC] 
Health Grou] 

Kffi University of Georgia I 



Factors: Traditional View 



knowledge 

attitudes /beliefs 

skill 

risk perceptions 

tolerance/sensitivity 



Task 



complexity/ variability 
ha2ard frequency 
equipment interoperability 



al/ communication 



dynamics 
physical/psychological demands 



comfort 

complexity of use 
Protective efficacy 



Context 



resources/equipment availability 

work setting/ environment 

social/organi2ational 
characteristics (macro /micro) 



Kffi University of Georgia I 



Factors: Expanded View 



Task 



knowledge 

attitudes /beliefs 

skill 

risk perceptions 

tolerance/sensitivity 



complexity/ variability 

ha2ard frequency 

equipment interoperability 

Interpersonal/ communication 
dynamics 

physical/psychological demands 



comfort 
complexity 



DLcacv 



Context 



resources/equipment availability 

work setting/ environment 

social/organi2ational 
characteristics (micro/ macro) 



IWURKPLi 
Health Grou] 

Kffi University of Georgia I 



Factors: Interactive Perspective 



User 



knowledge 

attitudes /beliefs 

skill 

risk perceptions 

tolerance/sensitivity 



Task 



complexity/ variability 
ha2ard frequency 
equipment interoperability 



communication 



dvnamice 



physical/psychological demands 



comfort 
complexity of use 



e erncacv 



Context 



resources/equipment availability 

work setting/ environment 

social/organi2ational 
characteristics (micro/ macro) 



Stage or Sequential Model of Self- 
Protective Behavior 




Appraisal 



Yea 



Dttriidan- 
Mukiog 



Yes 



No 



1 



Initiation 



No 



i 



Yes 



Adherent 



No 



1 



No 



i 



Exposure to injury/illness 



DeJ oy (1996) 



\ctive process, 2) Personal judgments of risk, 3) Stages of compliance 



r 



IWORKPLi 
Health Grou] 

Kffi University of Georgia I 



Self-Protective Constructs & Stages 

of S-P Behavior 



ConiVUCl 



Knznrd Apprvsal 



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Rptyaiiu 4'flacr 

yHrtlrfHLV .,.■■ i l i i ■ i r ■ 

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5tfeiy ttmrt? 



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NDti: P«prinBrti^OfIflrtc». 5r5^™iirv importance 



DeJ oy (1996) 



Decuiar -milling 



■iMinliar 



v 



5 



Adherens 



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Different constructs important at different stages 
Conditions and climate important to transfer of training 



|WORKPLAC] 
Health Grou] 

Kffi University of Georgia I 



Training and PPE Compliance 




Training necessary but usually not sufficient 

Correlation between # training hours and compliance is 
often surprisingly weak 



Knowledge-based 

knowledge and skill development (behavioral capability) 

Behavioral modeling, practice, and dialogue (2-way 
communication) (knowledge, skill, & motivation) 



Kffi University of Georgia I 



Self-Protective Constructs & Stages 

of S-P Behavior 



ConftAJCl Knurd Apprjual 


Dccuiar -milling 


Inhiartinn 


Adherence 


riYHE-nlllftl DHL P 

RtWnHflHiERr in p 


S 
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S 
G 

P 


s 
s 
s 
p 


Srti-pii^atif . . . i l i l 1 1 . i l 1 1 ■ 1 1 

Ficililiting cHidiEiona 5 


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Stfeiycfamfto 5 


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Knowledge-based Training Best P ractice-based Training 



Compliance 

Reinforcing compliance can boost rates of 
compliance, as can providing feedback on 
performance 

Works best for simple, discrete, frequently 
repeated behaviors 

Compliance diminishes with withdrawal of 
reinforcer 

Approach may be susceptible to "gaming" 



I WORKPLACE 
Health Grow 



) University of Georgia I 



Safety Climate 

Shared perceptions of employees about the 

r r / . i i 



Shapes behavior-outcome expectations 

Management commitment 

Enacted policies and procedures (actions > 
words) 

Social exchange 

Leading indicator of safety performance 



I ffi University of Georgia I 



Safety Climate: Knowledge Base 



Uni-dimensional or Multi-dimensional concept 

i No universal agreement on key dimensions of 
safety climate 

i Limited understanding of safety climate 
antecedents 



Very limited research on safety climate 
interventions 



I ffi University of Georgia I 



Safety Climate: Multi-leve 

Perspective 



Macro- 
Organizational 
Factors 




Workgroup 

Compliance 

Behavior 



Micro- 
Organizational 
Factors 



(e.g., Hofmann etal,1995; Neal & Griffin, 2004; Simard 
&Marchand,1997) 



r 



Kffi University of Georgia I 



Micro-Macro Organizational Factors 



Macro Organizational Factors 

■ Top management support 



HR and management practices 
■ Structure/technological complexity 
Firm competitive position 



etc. 



Micro-organizational Factors 

■ Work processes/risks 

■ Workgroup characteristics 
~i Communication/involvement 

i Supervisor characteristics 



etc. 



I ffi University of Georgia I 



Conclusions 



PPE should be considered as part of a comprehensive hazard 
control strategy 

PPE compliance is a multi-component, behavioral process 

Workers actively make judgments of personal risk 

Different factors are important at different stages of compliance 
— These are potential leverage points 

Training is important but it needs to go beyond basic knowledge 

Facilitating (enabling) conditions and workplace climate enhance 
transfer of training, and are key to day-to-day, ongoing 
compliance 

Micro-organizational factors may be initial priority for climate- 
related intervention 

Participatory/involvement strategies may be more effective than 
formal/ organizational policy statements 




Dave Dejoy 
dmde j oy@uga.edu 



r 



IWORKPL; 
Health Grouj 

I ffi University of Georgia I