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

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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)

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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

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IWORKPLi
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Kffi University of Georgia I

Self-Protective Constructs & Stages

of S-P Behavior

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

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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

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Ficililiting cHidiEiona 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)

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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

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IWORKPL;
Health Grouj

I ffi University of Georgia I