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Predictors of Knowledge about Health and Safety among Health
Workers
Mr. Hassan Sambo
1
, Prof. L.F. Buba
2
, Zinat Mahmood
3
, Dr. Adamu Alhaji
4
1
Department of Environmental health Sciences, Faculty of Allied Health Sciences, Federal University of Health Sciences,
Azare
2
Department of Environmental Management, Faculty of Earth and Environmental Sciences, Bayero University, Kano
3
Department of Medical Microbiology, Federal University of Health Sciences, Azare
4
Department of Nursing Sciences, Faculty of Allied Health Sciences, Federal University of Health Sciences, Azare
DOI : https://doi.org/10.51583/IJLTEMAS.2025.140400032
Received: 14 April 2025; Accepted: 18 April 2025; Published: 05 May 2025
Abstract: Health and safety are pivotal in ensuring the protection of healthcare workers (HCWs) and patients from occupational
hazards and infectious diseases. This study employed a cross-sectional design to examine the predictors of knowledge about
health and safety among HCWs at a tertiary healthcare institution in Northern Nigeria. A sample of 250 HCWs was selected using
stratified random sampling across various departments including clinical, nursing, laboratory, and support services. Data were
collected using a structured and pretested self-administered questionnaire. The questionnaire covered demographic details and
knowledge of health and safety practices. Data were analyzed using SPSS version 25. Descriptive statistics, Chi-square tests, and
logistic regression analyses were conducted. The results indicated significant associations between knowledge and factors such as
age, type of organization, position held, and years of service. Particularly, HCWs aged 30-39 demonstrated higher knowledge
levels, while those in the 40-49 age group and those employed as contractors or support staff showed poorer knowledge. The
study underscores the importance of targeted interventions and continuous professional education to enhance health and safety
knowledge among HCWs in Nigerian healthcare institutions. These findings have practical implications for policy makers,
hospital administrators, and training institutions aiming to strengthen the health and safety culture within the healthcare system.
Keywords: Health workers, safety knowledge, predictors, occupational hazards, Nigeria, healthcare safety, professional training
I. Introduction
Occupational health and safety (OHS) remain critical concerns within healthcare delivery systems, especially in developing
countries like Nigeria where health infrastructure is often inadequate. Healthcare workers (HCWs) face numerous hazards in their
daily activities, ranging from exposure to infectious diseases, hazardous chemicals, and injuries from sharp objects, to ergonomic
and psychosocial risks. According to the World Health Organization (WHO, 2020), HCWs are at a heightened risk of workplace
injuries and infections, particularly in low- and middle-income countries (LMICs).
In Nigeria, the situation is compounded by systemic challenges such as insufficient training, poor compliance with safety
standards, unavailability of personal protective equipment (PPE), and lack of institutional support (Owolabi et al., 2017). Despite
awareness campaigns and safety policies, many healthcare institutions struggle to implement sustainable health and safety
practices.
Several studies have highlighted poor knowledge and unsafe practices among HCWs regarding infection control and occupational
safety (Adejumo et al., 2019; Amoran & Onwube, 2017). However, little attention has been paid to identifying the specific
predictors of health and safety knowledge within the Nigerian healthcare context. Understanding these predictors is vital to
designing effective and context-specific interventions.
This study, therefore, aims to assess the level of knowledge about health and safety among HCWs and to identify key
sociodemographic and organizational factors that predict this knowledge. The research contributes to existing literature by
focusing on a tertiary healthcare facility in Northern Nigeria and by providing evidence-based recommendations for improving
safety education and compliance.
Objectives of the Study
1. To assess the level of knowledge about health and safety among healthcare workers.
2. To identify socio-demographic and organizational predictors of knowledge about health and safety practices among
HCWs.
3. To provide recommendations for targeted interventions to improve occupational health and safety knowledge.
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II. Literature Review
Occupational Hazards in Healthcare
Healthcare environments pose a range of occupational hazards. Common risks include biological exposures (e.g., HIV, hepatitis),
chemical hazards, physical injuries, and ergonomic stressors. Studies have shown that needlestick injuries alone account for over
3 million exposure incidents annually, with the majority occurring in LMICs (WHO, 2020). These risks are heightened by
inadequate infection control systems and overburdened facilities (Ngatu et al., 2017).
Health and Safety Knowledge among HCWs
Knowledge of safety protocols is essential for protecting both HCWs and patients. Practices such as hand hygiene, proper waste
disposal, and correct use of PPE are directly influenced by the worker's knowledge. Bello et al. (2021) found that better-informed
workers demonstrated higher adherence to hygiene practices. Nonetheless, studies from Ghana and Nigeria show widespread
knowledge gaps (Darko et al., 2022; Adejumo et al., 2019), often linked to infrequent training and inadequate institutional
commitment to safety education.
Predictors of Knowledge
Existing research identifies various predictors of safety knowledge. These include age, educational level, years of experience,
professional rank, and exposure to formal training (Adane et al., 2019; Askarian et al., 2020). Professional experience often
correlates with better knowledge retention and practical application of safety measures. However, some studies suggest that
organizational support, departmental differences, and availability of resources may outweigh individual attributes in shaping
knowledge (Garus-Pakowska et al., 2019).
III. Methodology
Study Design
This study adopted a descriptive cross-sectional design suitable for identifying the prevalence and predictors of knowledge at a
single point in time.
Study Area and Population
The study was conducted at the Federal Medical Centre, Azare, a tertiary healthcare institution in Bauchi State, North-East
Nigeria. The target population comprised all categories of HCWs including medical doctors, nurses, laboratory scientists,
pharmacists, radiographers, cleaners, and auxiliary staff.
Sample Size Determination
The required sample size of 250 was estimated using Cochran's formula: Assuming a 50% prevalence of good knowledge, a 95%
confidence level, and a 5% margin of error, the computed sample was adjusted for non-response. Stratified random sampling was
applied to ensure proportionate representation of all relevant departments and job cadres.
Instrumentation and Data Collection
Data were collected using a validated and structured self-administered questionnaire. The tool was divided into four sections:
demographic information, training exposure, knowledge assessment, and job-specific variables. The questionnaire underwent
pretesting among 20 HCWs from a different facility in the same state. It demonstrated satisfactory reliability with a Cronbach's
alpha of 0.78.
Measurement of Variables
Knowledge was measured using 15 multiple-choice items focusing on hygiene practices, PPE usage, and emergency protocols.
Responses were scored and categorized as Good (80% and above) or Poor (below 80%).
Ethical Considerations
Approval was granted by the Ethics Review Committee of Federal Medical Centre, Azare (Approval No:
FMC/AZ/REC/2024/041). Participants provided written informed consent. Confidentiality and anonymity were maintained
throughout the study.
Data Analysis
Data were coded and entered into SPSS version 25. Descriptive statistics were used to summarize demographic characteristics.
Chi-square tests examined associations between categorical variables and knowledge levels. Bivariate and multivariate logistic
regression analyses were used to determine significant predictors. Results were presented with 95% confidence intervals and p-
values <0.05 considered statistically significant.
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IV. Results
A total of 250 HCWs participated. Males constituted 59.6%, and females 40.4%. The most represented age group was 30-39
years (36.7%). Most respondents were in the civil service (68.9%), followed by contractors (14.3%). Regarding job positions,
general workers (35.3%) and middle managers (25.5%) dominated. Overall, 77.2% of respondents had good knowledge. Bivariate
analysis showed significant associations between knowledge levels and age, type of organization, job position, and years of
experience (p < 0.05).
The sociodemographic profile of the study participants is displayed in Table 1. Respondents are grouped according to their
gender, age, kind of organization, position held, and years of service. The distribution of respondents among these groups is
highlighted by the frequencies and accompanying percentages, which shed information on the characteristics of the staff members
who participated in this assessment. Understanding the viewpoints offered in the study requires knowledge of this information.
Table 1: Socio-Demographic Characteristics of Respondents
Variables
Frequency
Percentage (%)
Gender
Male
149
59.6
Female
101
40.4
Age (Years)
≤20 years
8
3.1
20 - 29 years
40
16.1
30 - 39 years
92
36.7
40 - 49 years
69
27.6
≥50 years
41
16.4
Type of Organization
Consultant
18
7.3
Civil service
172
68.9
Contractor
36
14.3
Regulators
14
5.6
Authority
10
3.8
Position Held
Top Management
27
10.8
Middle Management
64
25.5
Support Staff
37
14.7
Artisans
34
13.6
General Workers
88
35.3
Duration of service (years)
≤5 years
60
24.1
6 - 10 years
84
33.6
11 - 15 years
66
26.2
16 - 20 years
28
11.2
≥ 21 years
12
4.9
Knowledge
Good
193
77.2
Poor
57
22.8
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Bivariate statistical examination of the relationship between healthcare workers' (HCWs') sociodemographic traits and their
knowledge of health and safety is displayed in Table 2. The participants are divided into groups based on important
characteristics such as age, gender, job title, organizational type, and duration of service.
The information is carefully organized to make it easier to compare respondents' knowledge levelswhich are classified as
"Good" or "Poor"across various sociodemographic factors. There were 250 participants in the study overall, and the frequency
and percentage distributions that were obtained provide important information about the characteristics of the medical staff that
were participated
Table 2: Bivariate Statistical Exploration of Association Between Health and Safety Knowledge of the Respondents and Their
Socio-demographic Variables.
Factors
Knowledge Level
n = 250
Level
Good (%)
Total
2
(P-value)
Gender
Male
116(77.9)
149
0.8(0.765)
Female
77(76.2)
101
Total
193(77.2)
250
Age (Years)
≤20
3(37.5)
8
60.8(0.000)
20 - 29
34(85.0)
40
30 - 39
87(94.6)
92
40 - 49
33(47.8)
69
≥50
36(87.8)
41
Type of
Organization
Consultant
16(88.9)
18
107.3(0.000)
Civil service
(Medical)
155(90.1)
172
Contractor
4(11.1)
36
Regulators
11(78.6)
14
Authority
7(70.0)
10
Position Held
Top Management
23(85.2)
27
25.3(0.000)
Middle Management
57(89.1)
64
Support Staff
21(56.8)
37
Artisans
19(55.9)
34
General Workers
73(83.0)
88
Duration of
service (years)
≤5
35(58.3)
60
20.4(0.000)
6 - 10
65(77.4)
84
11 - 15
60(90.9)
66
16 - 20
24(85.7)
28
≥ 21
9(75.0)
12
Table 3 provides an extensive overview of Bivariate Logistic Regression Analysis, explaining the crude odds ratios (COR) related
to respondents' awareness of health and safety when categorized by different socio-demographic variables. When it comes to age
demographics, respondents who were between the ages of 30 and 39 had the highest level of knowledge attainment, with 94.6%
of them being classified as "Good." This was accompanied by a statistically significant odds ratio of 0.18 (p < 0.001), indicating a
notable decline in knowledge levels for older age groups, especially those who were between the ages of 40 and 49 (47.8%
"Good"). The table also illustrates organizational kinds and highlights notable differences in knowledge levels. For example, the
percentage of civil service medical workers and regulatory staff with strong knowledge was higher (90.1% and 78.6%,
respectively).
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Table 3: Bivariate Logistic Regression Analysis Summary (Crude Odds Ratios) of the Health and Safety Knowledge of the
Respondents and Their Socio-demographic Variables
Factors
Knowledge Level
Level
Good (%)
Poor (%)
COR (95% CL)
P-value
Gender
Male
116(77.9)
33(22.1)
1
Female
77(76.2)
24(23.8)
0.28(0.19-0.42)
Age (Years)
≤20
3(37.5)
5(62.5)
1
20 - 29
34(85.0)
6(15.0)
1.67(0.40-6.97)
0.484
30 - 39
87(94.6)
5(5.4)
0.18(0.07-0.42)
0.000
40 - 49
33(47.8)
36(52.2)
0.06(0.02-0.14)
0.000
≥50
36(87.8)
5(12.2)
1.09(0.68-1.75)
0.718
Type of
Organization
Consultant
16(88.9)
2(11.1)
1
Civil service (Medical)
155(90.1)
17(9.9)
0.13(0.03-0.54)
0.006
Contractor
4(11.1)
32(88.9)
0.11(0.07-0.18)
0.000
Regulators
11(78.6)
3(21.4)
8.00(2.83-22.6)
0.000
Authority
7(70.0)
3(30.0)
0.27(0.08-0.98)
0.046
Position
Held
Top Management
23(85.2)
4(14.8)
1
Middle Management
57(89.1)
7(10.9)
0.17(0.06-0.50)
0.001
Support Staff
21(56.8)
16(43.2)
0.12(0.06-0.27)
0.000
Artisans
19(55.9)
15(44.1)
0.76(0.40-1.46)
0.413
General Workers
73(83.0)
15(17.0)
0.79(0.40-1.55)
0.494
Duration of
service
(years)
≤5
35(58.3)
25(41.1)
1
6 - 10
65(77.4)
19(22.6)
0.71(0.43-1.19)
0.199
11 - 15
60(90.9)
6(9.1)
0.29(0.18-0.49)
0.000
16 - 20
24(85.7)
4(14.3)
0.10(0.04-0.23)
0.000
≥ 21
9(75.0)
3(25.0)
0.17(0.06-0.48)
0.001
A summary of multivariate logistic regression analysis is shown in Table 4, which includes adjusted odds ratios (AOR) based on
several socio-demographic variables that correspond to the degree of knowledge that healthcare personnel have about health and
safety standards. The results shown in this table demonstrate the relationship between demographic characteristics and knowledge
level, which are divided into two categories: "Good" and "Poor."
The results indicate that workers in the contractor category had significantly lower health and safety knowledge, with an AOR of
0.04 (p = 0.001). On the other hand, employees in the civil service had strong knowledge, with 90.1% being classified as good,
but their AOR of 0.13 was not statistically significant (p = 0.181). The positions in top management served as the benchmark for
comparison. AORs were seen for other categories as well, such as support personnel (0.28, p = 0.182) and middle management
(0.23, p = 0.261), none of which reached statistical significance but suggest noteworthy trends. The group serving 610 years
approached significance (AOR = 10.78, p = 0.054), but other durations showed AORs indicating lower knowledge levels without
reaching significance, especially for those serving 5 years or less. The term of service also showed varied odds ratios.
Table 4: Multivariate Logistic Regression Analysis Summary (Adjusted Odds Ratios) of the Health and Safety Knowledge of the
Respondents and Their Socio-demographic Variables.
Factors
Knowledge Level
Level
Good (%)
Poor (%)
AOR (95% CL)
P-value
Gender
Male
116(77.9)
33(22.1)
1
Female
77(76.2)
24(23.8)
0.61(0.19-1.92)
0.400
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Age (Years)
≤20
3(37.5)
5(62.5)
1
20 - 29
34(85.0)
6(15.0)
1.22(0.07-21.9)
0.894
30 - 39
87(94.6)
5(5.4)
0.16(0.01-1.70)
0.127
40 - 49
33(47.8)
36(52.2)
0.00(0.00-0,00)
0.992
≥50
36(87.8)
5(12.2)
7.99(1.56-41.0)
0.013
Type of
Organization
Consultant
16(88.9)
2(11.1)
1
Civil service (Medical)
155(90.1)
17(9.9)
0.13(0.01-2.54)
0.181
Contractor
4(11.1)
32(88.9)
0.04(0.00-0.27)
0.001
Regulators
11(78.6)
3(21.4)
0.05(0.00-0.00)
0.992
Authority
7(70.0)
3(30.0)
0.41(0.03-5.35)
0.498
Position
Held
Top Management
23(85.2)
4(14.8)
1
Middle Management
57(89.1)
7(10.9)
0.23(0.02-2.96)
0.261
Support Staff
21(56.8)
16(43.2)
0.28(0.04-1.81)
0.182
Artisans
19(55.9)
15(44.1)
1.87(0.40-8.73)
0.426
General Workers
73(83.0)
15(17.0)
0.58(0.11-3.05)
0.517
Duration of
service
(years)
≤5
35(58.3)
25(41.1)
1
6 - 10
65(77.4)
19(22.6)
10.78(0.96-121)
0.054
11 - 15
60(90.9)
6(9.1)
4.55(0.48-43.0)
0.187
16 - 20
24(85.7)
4(14.3)
0.28(0.03-2.55)
0.256
≥ 21
9(75.0)
3(25.0)
3.49(0.16-76.6)
0.428
V. Discussion
The analysis indicates that previous research has identified several factors influencing healthcare workers' (HCWs')
comprehension of health and safety protocols. Important factors include age, gender, years of work experience, educational
achievement, and exposure to health and safety training. According to studies, health and safety professionals with greater
education tend to be better knowledgeable about safety protocols. This implies that education is essential for improving HCWs'
comprehension of and adherence to safety regulations (Adane et al., 2019). Regular health and safety training increase the
likelihood that participants will remember safety precautions and apply them successfully in their work (Askarian et al., 2020).
Professional experience is also a key predictor of health and safety knowledge. HCWs with more experience demonstrate a
greater level of awareness and knowledge about safety measures than their less experienced peers. This finding lends credence to
the idea that spending more time in medical environments fosters better learning and safety procedure adaptation (Babatunde et
al., 2022). Given that different age groups have differing levels of knowledge, research suggests that age may also play a part.
Younger workers could not have received the same exposure or training as more seasoned workers, which could account for
knowledge gaps (Garus-Pakowska et al., 2019).
Depending on the specific healthcare setting, predictors' impact may vary. Formal education or training alone may not be as
crucial for knowledge application and retention as departmental environment and resource availability, according to some study.
This emphasizes how important it is to tailor interventions to specific contexts in order to meet unique needs (Garus-Pakowska et
al., 2019). Although gender is taken into account as a variable in the study, previous research has produced contradictory findings
about its influence on knowledge of safety and health. The differences in other studies suggest that further research is necessary to
discover any gender-related patterns in training and knowledge transfer, even if the percentage of male respondents with good
knowledge was somewhat higher in this study than in others.
VI. Conclusion
The study's conclusion emphasizes how crucial it is to comprehend the factors that influence healthcare workers' (HCWs')
knowledge of health and safety at the Federal Medical Centre in Azare. The results show that a number of demographic
characteristics, such as years of service, position held, age, and organization type, have a substantial impact on HCWs'
understanding of health and safety procedures. In particular, lower knowledge levels were shown by younger age groups and
support professionals, indicating the need for focused educational interventions. According to the report, in order to increase
adherence to health and safety regulations, improved training programs customized for various staff categories are required.
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Addressing the observed gaps in knowledge could decrease occupational dangers and produce a safer healthcare environment for
both staff and patients. These results can guide the development of effective training resources, ensuring that all staff, particularly
those in vulnerable roles, receive the necessary information and education on health and safety standards. Ultimately, improving
health and safety knowledge among HCWs is vital for cultivating a culture of safety and enhancing overall workplace conditions
in healthcare settings in Nigeria.
The study concludes that age, employment type, and job cadre significantly influence HCWs' knowledge of occupational health
and safety. While knowledge levels were generally high, disparities exist that require tailored interventions. Enhancing
institutional policies and training frameworks is key to promoting safety culture.
VII. Recommendations
1. Improve access to health and safety education across all staff categories.
2. Mandate periodic refresher courses and certifications.
3. Prioritize inclusion of contract and support staff in safety initiatives.
4. Establish departmental safety officers to monitor compliance.
5. Foster a safety-first workplace culture through leadership commitment.
6. Integrate feedback mechanisms for continuous improvement.
7. Partner with regulatory bodies to ensure compliance with national standards.
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