workplaces (Ladou& Joseph, 2006). .... Joseph and Minj (2010) in their paper entitled âRisk rating in the tea planting industry: The ...... Ladou & Joseph (2006).
KNOWLEDGE, ATTITUDES AND PRACTICES TOWARDS OCCUPATIONAL HEALTH AND SAFETY AMONG TEA PLUCKERS: A case Study of Eastern Produce Malawi- Esperanza Estate in Mulanje. AUTHOR: YOHANE VINCENT ABERO PHIRI SUPERVIRSOR: SAVE KUMWENDA CORDINATOR: DR. S. TAULO
“Submitted in partial fulfilment of the requirements for the award of a degree of Bachelor of Science in Environmental Health”
UNIVERSITY OF MALAWI THE POLYTECHNIC DEPARTMENT OF ENVIRONMENTAL HEALTH DECEMBER, 2011
DECLARATION I, Yohane Phiri, declare that this dissertation is my own original work and that it has not been presented for any other awards at the University of Malawi or any other university. Name of Candidate
:
Yohane Vincent AberoPhiri
Signature
:
_________________
Date
:
23rd December 2011
CERTIFICATION This research project of Yohane Phiri is approved by Department of Environmental Health through: _____________________________ (Supervisor)
____________________________________ (Head of Department)
DEDICATION To my Mum and Dad, Lebetina and RodrickV.A Phiri, whose contribution to my education is simply ineffable and my son Yohane Phiri Jnr. for being such a wonderful boy during my studies.
ACKNOWLEDGEMENT Firstly, manythanks to Mr. S. Kumwenda, my supervisor, and Dr. S. Taulo, the Health Systems Research Coordinator, for their invaluable comments on this project and the entire Environmental Health Department. I would also like to thank the management of Eastern Produce Malawi (EPM) Limited for accepting my request to conduct this study in one of their tea estates in Mulanje at Esperanza Tea Estate. I also appreciate for the support rendered by the management and staff of Esperanza Tea Estates. Specific vote of thanks should also go to The General Manager of Eastern Produce Malawi Limited Tea Estates- Western Division, Mr. Mayilosi and The Group Manager of Esperanza Tea Estate, Mr. Custom for direction they rendered during data collection of the research project. Finally, I extend my sincere gratitude to my fiancée, Bridget Luya, for the support she rendered during data entry and analysis of this research paper and at large her moral support. Above all, I thank the Almighty God for the gift of life and everything up to today until completion of this study.
ABSTRACT Workers in the tea plantation sector in the tea estates are exposed to several Occupational Health and Safety Hazards; of which most of these have not been adequately studied or documented. The tea planting industry being Labor intensive and workers being exposed to the vagaries of terrain and climate, in addition to exposure to chemicals in the form of pesticides and fertilizers, the possibility of safety and health hazards is very high. In the tea estates, legislation to take care of occupational safety in tea plantations is also found wanting. Accounting to the fact the tea planting industry habours a population of about 40 000 persons as labourers in Mulanje only, this study was conducted to assess “knowledge, attitude and practices” towards OHS among tea pluckers in one of the tea Estates in Mulanje namely Esperanza. The study aimed to answer questions on the participants’ knowledge, attitude and practice level in terms of conversance with OHS principles and standards in their work environment. The study was observational and descriptive. Data was collected by questionnaire, an observational checklist form during data collection visits. The results were then, analyzed using SPSS spread sheet. From the results, 48% of the participants had lower educational level. 82% of the participants had knowledge of what OHS was. On injuries, 87% of the participants had injury reports within the past one year within the work environment with a frequency range of 1-10 occurrences. On periodic checkups of the participants 82% of the participants had not undergone any periodic medical checkups as regard to requirements of OHS basic principles. It was concluded from the results that the participants have the potential to protect themselves from work hazards as they were conversant with most OHS basic operating principles but they are failing due to problems of inadequate provision of information on OHS and enforcement procedures by their employers. There is low case detection and identification of OHS related cases through recording keeping both by the supervisors in the fields and the Estate clinics documentation hence lowering levels of control of newly developing OHS problems. Finally, there is a need for an updated system in the recording of workplace injuries and education and training procedures regarding safe work procedures and prevention of accidents.
CHAPTER ONE 1.0 INTRODUCTION “Occupational Safety And Health Is Vital To The Dignity Of Work.” (Buyite, 2007) Occupation Health and Safety (OHS) is one of the major aspects of occupational medicine that is a branch of science concerned with health problems in work places. It is a cross-disciplinary area concerned with protecting the safety, health and welfare of people engaged in work or employment. The goal of all OHS programs is to foster a safe work environment.As a secondary effect, occupational health and safety may also protect co-workers, family members, employers, customers, suppliers, nearby communities, and other members of the public who are impacted by the workplace environment. It involves interactions among many subject areas, including occupational medicine, occupational (or industrial) hygiene, public health, safety engineering, chemistry, health physicsetc.(Ladou& Joseph, 2006). The seeds for safer workplaces through improving knowledge on OHS internationally were sown at the beginning of the 20th century. This began with full scale surveys of safety and health conditions in workplaces. Spanning three decades, these surveys proved useful in measuring and monitoring occupational health and safety in terms of injury frequency and severity in different workplaces (Ladou& Joseph, 2006). Work plays a central role in people’s lives since most workers spend at least 8 hours a day in the work place whether it is on an estate, factory, construction site, or in an office. Occupational health is concerned with health in its relation to work and the working environment. Occupational health implies not only health protection but also health promotion, emergency care, wide range of preventive, curative services, rehabilitative services, a concept which includes everything that can apply to promote the health and working capacity of workers (Sebastian 2002, Lam 1999). Workers constitute a large and important sector of the world’s population varying from the tea industry to other industries. The global labour force is about 2600 million with 75% of these working people in developing countries (Brindha, 2005). In Malawi, the tea industry is charged with about 8% of the total exports that are produced to the outside world of the country. This percentage seconds tobacco, which is regarded the main export product. (IBP, FF. 2010)
Malawi as a nation beginning in the early 1940s took a serious step on issues of OHS by producing statements in her constitution and other acts such as Labour Relations Act and the Employment Act. These give basic protection and a guideline of working conditions of those that are employed hence achieving OHS. In 1997 Malawi developed an act, Occupational Safety, Health and Welfare Act, to ensure that health problems in work places were properly and professionally addressed. It is therefore, through the implementation of the acts mentioned above that Malawi as a nation has made sure that companies in all the different sectors of products abide by the guidelines outlined on OHS of their employees (Loewenson, 1998). A report “Impact Briefing Paper-the Tea Industry” released by the Fair-trade Foundation; as of June 2010 the tea industry had about 40,000 to 50,000 people as work labour force especially at its peak of the seasons. As indicated the numbers may vary to as far as 60,000 individuals being employed in the rainy season when tea picking is at its peak. A report by ECAM (June 2005) entitled “Baseline Survey Report on Child Labour” comprehensively presented the figures of the size of the labour force on Mulanje District Tea Estates between July 1999 and June 2004, as shown in the table below: Table 1: Size of Labour Force on Mulanje District Tea Estates YEAR
MALE
FEMALE
TOTAL
1999/2000
36 318
15 007
51 343
2000/2001
30 526
9569
40 095
2001/2002
21 242
7624
28 866
2002/2003
22 589
6350
28 938
2003/2004
31 230
9377
40 607
As the figures show, the seasonal demands of the tea industry render employment in tea production rather temporary in nature, except for a small group of more experienced and conditioned workers. Under normal circumstances the volatility in the labour; render vulnerable social categories in the tea industry, specifically the minorities like tea pluckers extremely susceptible to exploitative employment practices. It to this fact that most of the individuals that are employed in the specified section may not be aware of OHS programmes that are supposed to be implemented in their work environment. This, hence, leads them to exposure to different nature of hazards in their work environment without the knowledge and know how in preventing and eliminating the encountered hazards (ECAM, 2010).
“Malawi Tea Research Project” a report by Malawi CARER (2007) backs up poor working conditions among tea industry labourers in Malawi by presenting the average wages for both permanent labourers and tea plucking labourers. The report states that in almost all estates as of 2007, the basic wage for time work of all daily rated employees was MK101 (Malawian Kwacha) equivalent to US$ 0.72 and plucking rate was as low as MK2.29 equivalent to US$ 0.016 per kilogram of green leaf plucked. It continues by stating that poor working environment conditions among tea peaking workers are aggravated due to lack of knowledge of what hazards they will be exposed to in the work environment. Mulanje District is one of the districts in which issues of occupational health and safety are important with regard to the operating tea estates and other industries namely coffee and fruit juice company. It is a district located in the Southern Region of Malawi, covering an area of about 2,056 km² with a population totaling about 428,322. It is also well known for its tea growing industry and Mount Mulanje which is one of the highest peaks in Southern Africa. The district is one of the major districts in Malawi that harbours a lot of industries; mostly the populations of these industries are tea and coffee producing companies. One of the major tea producing companies in the district is Esperanza Estate. Esperanza Estate is a tea producing estate under Eastern Produce Malawi Limited (EPM).EPM is a company which was first under British African Tea Estates (BATE). The change of ownership of the tea estate occurred in early 1985. EPM has ten factories in Malawi of which four are in Thyolo and six are in Mulanje. Esperanza factory is one of these ten factories. It is located in Mulanje, west of all EPM factories and currently, the tea fields that almost surround the factory cover about 330 hectares of land. Its first tea field was planted in 1902 and the first tea production at Esperanza factory took place in 1925. This was to give room to construction and installation of machinery that was required. The factory produces almost 1.2 to 1.8 million tons of made tea per year with the peak of its production in the rainy season. Approximately the estate has about 150-200 factory workers and about 200 permanent tea picking workers with an increased variation of the number during rainy season when tea picking is at its peak. The variation may go as high as 500persons/day temporarily employed in the tea picking only (Malawi CARER, 2010).
1.1 STATEMENT OF THE PROBLEM Joseph and Minj (2010) in their paper entitled “Risk rating in the tea planting industry: The employees' opinion”,workers in the tea plucking and planting industry are exposed to a variety of OHS hazards in southern Africa, Malawi included. Despite the exposure to such a lot of different unaddressed risks faced by these workers; their living and working conditions are described as far from ideal. The geographical and socio-economic isolation of tea plantations in countries such as Malawi is one of the factors behind the vulnerable dependency of plantation workers. Tea plucking is a notoriously tough job, and can be physically debilitating. There are a number of factors that make it so, and all of them could be better addressed by plantation management. The heavy baskets carried by workers concentrate the weight on their head and neck, leading to severe back pain for many. Studies in Kenya and Malawi and other African tea producing countries in 1997 indicate that as many as 64% of tea pluckers suffer from back pain during their employment as tea pluckers, and only 29% of these will have had a history of back pain before starting tea plucking. This means that about 35% have developed back pain solely due to occupational exposure to the musculoskeletal hazards of tea picking (Oldenziel, 2006). Awareness of the knowledge and practices of an OHS program to both administrative staff and labourers like tea pluckers helps continually remind employees to work safely using proper procedures when performing all tasks. This result in the reduction of OHS related diseases, injuries and illness. Furthermore OHS program awareness help in effective workplace health and safety programmes to save the lives of workers by reducing hazards and their consequences. Effective programmes can also have positive effects on both worker morale and productivity, and can save employers a great deal of money (Paulison, 2003). Surprisingly, data presented in a report “Malawi Tea Research Project” by Malawi CARER (2010) and “Baseline Survey on Child Labour- Tea industry in Malawi” by ECAM (2005) shows that issues regarding OHS in the tea sector in Malawi remain unaddressed and a major challenge, especially for those in the plantation sector. Though the papers do not put much emphasis on OHS, they outline some of the major OHS hazards and problems faced by mostly plantation workers specifically tea pluckers. The reports represent about 56% of all diseases of plantation workers as due to poor working conditions which is typically under the topic OHS.
Lack of capacity to exercise OHS
Low knowledge on importance of OHS among staff
Little or no practice of OHS fundamentals
Lack of specialists or experts in OHS system
Low academic levels among staff members and tea pickers
FIGURE 1: Problem analysis diagram Therefore, this study establishes the levels of knowledge, attitudes and practices among the tea pluckers on what OHS programme encompasses in their work environment. Furthermore, the study recommends some practical intervention to minimize and/or curb the prevalence of accidents, illnesses and diseases which may result from little or no practice of OHS fundamentals. 1.2 SIGNIFICANCE OF THE STUDY This study establishes an accurate picture of the levels of knowledge, attitudes and practices of all the concepts covered in OHS among workers especially among tea pluckersof Esperanza Tea Estate located in Mulanje Industrial Area. The information generated by this study, may be used at large by the estate in which the study was conducted, and other stakeholders to refresh their approach on ensuring that employees and their employers are knowledgeable enough, have a positive attitude and put into practice basic conceptsofOHS program (and not only document
them) before contracts between them are signed. The study also provides information that will assist employers in ensuring that rules and regulations regarding OHS are not only documented in their companies but rather implemented in their daily undertakings. The findings of this study have also been presented to the Group manager, with copies to productions and operations managers of EPM-Esparanza Estate to give them a clear picture of the level of knowledge, attitudes and practices of their employees, specifically tea pluckers, on OHS; this being in accordance with the assumption that the managers are knowledgeable enough on the issues of OHS. It is again in the interest of this study to act as the baseline data for further studies at national level. Finally, in addition to the above, this study was conducted in partial fulfillment for the award of a Bachelors of Science Degree in Environmental Health.
1.3OBJECTIVES OF THE STUDY 1.3.1 Broad Objective To establish the knowledge, attitudes and practices among tea picking workers on what occupational health and safety encompasses in their work environment. 1.3.2 Specific Objectives 1. To assess awareness of tea pluckers onoccupational health and safety programme. 2. To evaluate awareness of tea pluckers of the risks from hazardous materials in their work environment. 3. To determine knowledge of the methods of evaluation and identification of areas prone to OHS accidents; and necessary preventive measures and plans of safety for efficient conduct of work
4. To ascertain the attitudes and practices on the knowledge of methods developed for safety in the work place fortea plucking workers
1.4 RESEARCH QUESTIONS Basically the research was geared to establish answers for the following questions. 1) Are the workers aware of what occupational health and safety program is? 2) Are the workers familiar of what risks from hazardous material in their work environment are? 3) Do the workers know what methods of evaluation/identification of areas prone to accidents in their environment are and how they may be prevented? 4) What plans of safety are implemented as to avoid accidents or eliminate them? 1.5 HYPOTHESIS Level of knowledge and perception among tea picking workers on the importance of OHS is low. There is inadequate supervision and enforcement of OHS fundamentals by management.
CHAPTER TWO 2.0 LITERATURE REVIEW The review of literature was covered within the following headings 1. Occupational Safety and Health 2. Occupational Hazards and Injuries 3. Occupational Health Legislation 4. Occupational Safety Issues in the Tea Manufacturing Industry 5. Prevention of Occupational Injuries and Diseases. 2.1. OCCUPATIONAL SAFETY AND HEALTH ‘Occupational health’ as defined by a joint committee of WHO and ILO (1950), involves the ‘promotion and maintenance of the highest degree of physical, mental and social well-being of workers in all occupations’. This definition emphasizes the term health rather than disease, and further implies a multidisciplinary responsibility as well as a mechanism for the promotion of health services for the working population(Koh&Jeyaratnam, 2002). During the early days of the industrial revolution, occupational medicine focused attention on workers in mines and thereafter in factories, as these were situations in which workers were at obvious health risks as a consequence of their work. This led to the discipline in the early days being known as Industrial Medicine or even factory medicine (Park, 2005).The terms ‘industrial health’ and ‘industrial hygiene’ have been replaced by the modern concepts of occupational health which embrace all types of employments including mercantile and commercial enterprises, service trades, forestry and agriculture. The subjects of industrial hygiene, industrial diseases, industrial accidents and toxicology in relation to industrial hazards, industrial rehabilitation and occupational psychology- all come under the purview of occupational health (ILO, 2005).With this idea in mind, a report entitled review of“Occupational Health and Safety Act”(2000) by the Australian Federation of Employers and Industries, caught that modern OHS systems should be those that are in line with the concept of primary responsibility for doing something about levels of occupational accidents and disease lying in the hands of those who create risks and those who work with them.
The above review also fall in line with what Lord Robins did say in 1972. Though such the case it must be clearly known that it is still the duty of occupational health and safety practitioners to ensure that the protection of the health of the working population in their work environment is achieved. The study of work related diseases and illness dates back from ancient times. Minj (PhD) (2007), in her research entitled “Occupational Safety and Health Risks in Selected Estates of a Tea Planting Company” submitted in partial fulfillment for her PhD show that the existence of diseases related to work has been documented since antiquity. Imhotep (2780 BC) described cases of occupational injuries and ‘sprains of the vertebrae’ among pyramid builders. Hippocrates (460-377 BC) emphasized the importance of environmental factors in his treatise on Air, Water, and Places. Both Hippocrates and Galen (AD 130-201) described the diseases of certain occupations including metallurgists, fullers, tailors, horsemen and farmers among others. Occupational Health developed further in the middle Ages. The Italian physician Bernardo Ramazzini, often described as the Father of Occupational Medicine, described many occupational diseases that are still seen today, and furthermore described the principles for their control. 2.2. OCCUPATIONAL HAZARDS AND INJURIES Occupational injuries and diseases are largely preventable. They unnecessarily affect the health of the working population and have effects on productivity and on the economic and social wellbeing of workers, their families and society. The cost of work-related health loss and associated productivity loss may influence the total gross national product of a country (Koh&Jeyaratnam, 2002). In each OHS program it is therefore always pertinent to define OHS diseases, injuries and illnesses that may be encountered. These diseases and injuries are classified as occupational diseases and general diseases affecting work population. Basically these general diseases aremedical conditions prevalent in the community without a causal relationship with work. ILO & WHO (2002)estimated that worldwide there are at least 2 million deaths per year due to occupational diseases and injuries, with these injuries resulting in more than 300,000 deaths per year. Cullen, Rosenstock and Kjellstrom (2005) further support the findings byILO/WHO in their work entitled “Occupational and Environmental Health and Safety in Developing Countries” by outlining the fact that aabout 80% of the world’s population lives in areas that are
defined under the label ‘developing countries’. Although in most of these areas the major determinants of health remain poverty, poor sanitation and malnutrition, there is compelling evidence to show that a disproportionate amount of the world’s occupational and environmental injuries and diseases occur in these societies as well. The clinical effects of the major environmental and occupational hazards may occur anywhere, but the likelihood is higher, the consequences often more profound and the strategies for prevention and treatment more problematic in poor nations than rich. In their work, Cullen, Rosenstock and Kjellstrom (2005), further outlined that the problems in the prevention and treatment of occupational injuries and diseases may be due to some of the following factors:
Distribution of economic activity: wherein high proportion of workers are involved in high risk activity.
Greater susceptibility of the populations: This may lead to greater co-morbidity and multiple hazards.
Proximity of workplace and residential communities: leading to additive exposures, risk of catastrophic accidents and risk to families and children of workers.
Demographics of the population: where children may be at risk and there is a high turnover of jobs.
Climactic factors: Personal protective equipment, often designed for ambient conditions in developed countries, may also fail more readily or may not be tolerated in warm climates. Workers may also be exposed to new hazards such as parasites and animals.
Inadequate regulation and enforcement: In most developing countries, regulations are inadequate or inadequately enforced or both. The reasons for this include - lack of political will, compromises against the perceived need for rapid economic expansion, inadequate resources, few professionals to fill key technical responsibilities and corruption among others. This results in greatly increased risk of injury or disease from environmental contaminants and work.
Low educational level of managers and Occupational and Environmental Medicine (OEM) professionals and few OEM trained physicians and environmental
hygienists: to provide expert guidance and policy for government or to support practice by employers. In general, reliance is placed on physicians and engineers trained in other disciplines, with predictable suboptimal results.
Equally problematic is the low level of training and knowledge regarding occupational and environmental health and safety among managers and personnel in the workplace charged with the day to day protection of workers and the environment.
Low educational level of population: puts a higher burden on employers to engineer out risks to the extent possible, and to train workers in matters including those of hygiene and safety.
Higher proportion of migrant work: leads to social instability and increased risk of sexually transmitted diseases (STDs).
Extent of informal sector work: where work may be undocumented and unregulated.
Resource limitations: Machinery and technology proven to reduce exposure are unfeasible economically, as are substitutions from dangerous to safer chemicals. The cost of appropriate safety equipment may be prohibitive, as may even its availability. At the government level, expenditure on environmental health and safety must be balanced against other health priorities.
Of interest to note is that the above mentioned challenges are also the major influencers of consequences that the tea industry in Malawi is also faced with. 2.3. OCCUPATIONAL HEALTH LEGISLATION Legislation of OHS is another important fact that Malawi has done intimately in line with different Acts such Factories Act, Occupational Health, Welfare and Safety Act, and Employment Act. Legislation of OHS is also associated with regulatory bodies such Ministry of Labour in Malawi. In other countries specific bodies such as Occupational Safety and Health Administration (OSHA) in the United States are those responsible for the OHS legislation and regulation of OHS systems of industries (Cullen and Rosenstock, 2006). Principally, it is a challenge in Malawi as we do not have such a body as OSHA in the USA. One of the most effective ways in ensuring that notification of OHS diseases and injuries is through having well established regulatory bodies as it is with the case of OSHA in USA
(ILO,2002). ILO outlines the requirement for notification of OHS diseases and injuries by stating that competent authority shall, by laws or regulations or any other method consistent with national conditions and practice, and in consultation with the most representative organizations of employers and workers, establish and periodically review requirements and procedures for: a. The recording of occupational accidents, occupational diseases, dangerous occurrences, incidents, commuting accidents and, as appropriate, suspected cases of occupational diseases; and b. the notification of: i.
Occupational accidents, occupational diseases and dangerous occurrences; and
ii.
As appropriate, commuting accidents and suspected cases of occupational diseases
In its outline ILO further made it simpler by classifying and documenting samples which may be adopted in developing a list of most common occupational diseases and injuries at national level for purposes of recording, notification and compensation. Table 2 below shows the documented list as produced by ILO. Table 2: Classification of OHS diseases and injuries by ILO
1. Diseases caused by agents
1.1. Diseases caused by chemical agents 1.2. Diseases caused by physical agents 1.3. Biological agents
2.
Diseases
by
target 2.1. Occupational respiratory diseases
organ systems
2.2. Occupational skin diseases 2.3. Occupational muscular-skeletal disorders
3.Occupational cancer
-
4. Others
-
2.4. OCCUPATIONAL SAFETY ISSUES IN THE TEA MANUFACTURING INDUSTRY The process of tea manufacturing exposes workers to several hazards including those due to extremes of climate, uneven terrain at high altitudes under wet weather conditions, besides those hazards that a worker faces while working in a factory. Like in any other employment sector, workers in the tea plantations run the risk of being injured as a result of the kind of work they do. The main risks posed are from unguarded machinery in the factory, exposure to fertilizers, pesticides and other agro chemicals, and accidents as a result of the uneven terrain in the fields (ILO/EFC 1998). A report produced by the Employers’ Federation of Ceylon (EFC),Sri Lanka in July 1998 states that there were 2,391 accidents reported from 161 Sri Lankan estates during the year 1996. This included 478 accidents that occurred in the factory premises and 1,913 accidents that occurred in the field. The commonest injuries to occur in the tea estates surveyed were sprains, fractures and dislocations which occurred as a result of persons falling in the fields due to uneven and rough terrain. These were followed, in decreasing order of severity, by bruises and cuts, poisoning due to snake bites, occupational dermatitis, amputations, burns, chemical hazards/exposures, internal injuries, respiratory injuries, injuries to the nervous system and noise related injuries. The prominent causes of accidents, illness and diseases in the tea industry include falls from the same level, falls from heights, mechanical injuries, injuries due to striking against stationery or moving object, motor accidents on estate roads, muscular stress related injuries, improper manual handling of loads, improper use of tools, injuries due to repetitive movements of the limbs and torso, electrocution, fires and explosions, exposure to chemical hazards, environmental pollution, snake bites and insect bites. The specific hazards facing plantation workers vary from one plantation to another. In Uganda the main areas of concern included injuries from machinery and equipment, unsafe handling of chemicals, and injuries from the crops themselves. Other common hazards include physically strenuous work, falls, insect and snake bites and adverse weather conditions including harsh sunshine, heavy rains, morning dew and cold. Occupational injuries in the plantations were found to be quite severe (56%) and long lasting (45%)(ILO/EFC, 1998). The workplace and the environment have always contained risks. Traditionally, accidents have been the most important risks that need to be assessed. Certain jobs have been considered more
hazardous than others based on risks that are clearly visible. The risks associated with exposure to chemicals, however, are often hidden. (Chase &Whysner, 1988). A ‘hazard’ is a substance, agent, or physical situation with a potential for harm in terms of damage to property, damage to the environment or a combination of these. Hazards can be physical, chemical, biologic, ergonomic or psychosocial in nature. A ‘Risk’ relates to the likelihood of the harm or undesired event occurring, and the consequence of its occurrence. It is the probability that a substance or agent will cause adverse effects under the condition of use and/or exposure, and the possible extent of harm. It is thus a function of both exposure to the hazard and the likelihood of harm from the hazard. Extent of risk covers the population that might be affected by the risk, the numbers exposed, and consequences (Koh & Jeyaratnam, 2002). 5. PREVENTION OF OCCUPATIONAL INJURIES AND DISEASES. Knowledge of the risks in one’s workplace environment is one of the basic prerequisites of OHS. This knowledge may help in the prevention of accidents, illness and diseases that may result from little or no practice of OHS fundamentals. The various measures for the prevention of occupational diseases may be classified as medical, engineering and statutory or legislative measures. (Park 2005). Successful prevention of occupational disease could be achieved by controlling exposure to harmful agents to what are considered as safe and permissible limits. There are several mechanisms for this which include: (Koh & Jeyaratnam, 2002).
Total elimination of the hazard: This method eliminates the health risk completely, and has been used for substances that are carcinogenic such as asbestos, benzene, or those that can cause serious health effects, such as cadmium.
Substitution of the hazard: with a less toxic alternative is another feasible option. For example use of a less toxic solvent such as 1, 1, 1-trichloroethane can be used instead of the more toxic trichloroethylene or tetrachloroethane. Another method could be the substitution of the hazard to a form that reduces the risk of exposure.
Engineering controls: Automation, enclosure or segregation of a work process, the use of dampeners or mufflers to reduce vibration or noise have been some of the successful measures used.
Redesign of the workplace or process: to reduce unnecessary and repetitive bending or to prevent excessive stretching to the limit of the range of movement of the workers can minimize ergonomic hazards.
Administrative controls: This could take the form of job enlargement or job rotation, restriction of hours of work at a hazardous occupation, or even temporary job reassignment.
Education of workers: the training of workers in how to recognize work hazards, how to work safely and what to do in the event of an emergency or when occupational diseases occur is another important aspect of prevention.
Use of personal protective devices: The use of PPE is often widely practiced. It has its merits, the major one being its relative in expense, and is especially useful for situations of short term or occasional exposure to occupational hazards. However, protective devices have to be properly selected to be effective against specific hazards. Workers have to be trained to use the equipment correctly and to ensure that it is working correctly. Worker compliance in the use of these devices has to be high or its protective effects may be less than desired. Protective devices have to be properly maintained and replaced when necessary.
Occupational Health Services can save companies of costly injuries, valuable time, and can help businesses comply with state and central regulations through various screenings, programs, and training. Though such the case, except few major reputed public and private industries, other industrialists are not sensitized to the importance of industrial safety (Agnihotram, 2005).There is a tremendous potential for large scale epidemiological research to determine the exposure to occupational risks. Hence, we need more focus on epidemiological data for decision making and setting priorities on research. It is also necessary to generate a pool of human resources in occupational health researchers.
CHAPTER THREE METHODOLOGY 3.1 STUDY TYPE The study was both observational and descriptive. Qualitative and quantitative methods of data collection were used. Questionnaires and checklists were used to collect the data. 3.2 STUDY AREA The research was done in Mulanje District, within the confines of Esperanza Tea Estate. Mulanje, a district in the Region of Malawi, covers an area of about 2,056 km² with a population totaling about 428,322. It is one of the major districts in Malawi that harbours a lot of industries; mostly the populations of these industries are tea and coffee producing companies. Esperanza Estate is one of the major teas producing estate in the district under Eastern Produce Malawi Limited (EPM). EPM has ten factories in Malawi of which four are in Thyolo and six are in Mulanje. Esperanza factory is one of these ten factories, located in Mulanje, west of all EPM factories. Currently, the tea fields that almost surround the factory cover about 330 hectares of land. The factory produces almost 1.2 to 1.8 million tons of made tea per year with the peak of its production in the rainy season. Approximately the estate has about 150-200 factory workers and about 200 permanent tea pluckers with an increased variation of the number during rainy season when tea plucking is at its peak. 3.3 STUDY POPULATION The study was done among tea plucking workers at Esperanza Estate specifically among those that are employed as permanent workers and those that are employed on temporary basis (in short a sample of the population of tea pluckers staying around the tea company). Despite concentration to the tea picking workers information on the verification of training of the workers and other data was taken from the relevant employers. 3.4 SAMPLE SIZE The study size in this study was composed of 100 study units from a total population of 300 in which 200 were permanently employed and 100 were those who were once employed in the estate as tea pluckers.
The study size was arrived at using multistage random sampling method. In the first stage the tea pluckers were divided into their strata basing on whether they are permanently or have ever been temporarily employed at the estate. Then, the two strata were further divided basing on the sex of the pluckers, thus male or female. Finally a sample from the strata was selected using simple random method in which individual selection was done upon considering the final proportion of the two strata individuals. For sample size Calculation of the research project see annex 1 3.5 DATA COLLECTION, MANAGEMENT AND QUALITY CONTROL Data was collected inform of individual interviews using questionnaires to both strata of the study. A checklist of OHS fundamentals practice was also used among the study group during the days of interviews. The questionnaire encompassed knowledge, attitude and practices questions on OHS program in the Estate. A pre-test of the questionnaire was done on a similar population as the study population in Mulanje at one of the tea estates of EPM Limited. The purpose of the pre-test was to assess the questions in terms of clarity, simplicity and specificity. The pre-test was also assessing the questions whether they are answerable by all respondents or will provide useful information and if worded to provide the desired information. Data collected was stored in a spread sheet created by SPSS package. 3.6 DATA PROCESSING AND ANALYSIS In order to ensure quality data, tools for data collection were checked right in the field where data was collected for completeness. Analysis of data was done manually and summarized on a data master sheet. Data was also analysed using a computer Microsoft Excel Package and SPSS. 3.7 DISSEMINATION OF THE STUDY RESULTS Upon thorough completion and compilation of the study, the report has been submitted to the following: o The university of Malawi, The Polytechnic, Department of Environmental Health in partial fulfillment of the award of a Bachelors of Science Degree in Environmental Health.
o Esperanza Tea Estate Manager and the Occupational Health and Safety Officers of the Estate. 3.8 ETHICAL CONSIDERATIONS Before conducting the study, consent was first sought from Esperanza Tea Estate Management, through the General Manager for the west division of all Eastern Produce Malawi Limited Tea Estates. Consent was also sought from the respective respondents before interviews and the administration of questionnaires. The researcher also recognized the respondents’ rights to either divulge or withhold information. The interviewers, therefore, were also asked for an arrangement of a convenient time during which to conduct the interviews with the respondents. The respondents were also assured of confidentiality and anonymity and were well informed that no personal identity was to be used for the publication of the report. For this reason, no name was required on the questionnaire. 3.9. LIMITATIONS Lack of statistically documented data on issues of OHS in the tea industry and in Malawi in general, with regards to OHS injuries, diseases and accidents, was one of the challenges faced during the research project. Malawi Tea Research Project” by CARER Malawi (2007), falls in line with the above statement as it comments that despite the tea industry contributing up to 70000 people in the employment sector no statistical information is available on issues of OHS and other relevantly important information on the employees. It is this fact therefore, that makes it almost impossible to establish levels of different variables of the tea plantation populations. Though the case we cannot just ignore such most important industries as with the same case as the tea industry. The other major challenge was that of limited time for the researcher. Though such the case, this was taken into consideration and appropriate measures employed as to ensure that the results are free of such interference and any bias.
3.10 STUDY VARIABLES The table below presents study variables in line with the objectives of the research project. Table 3: Study Variables. VARIABLES
INDICATORS
TOOL
Level of knowledge
Percentage of respondents able to remember Questionnaire key points on OHS Program given.
Level of attitude towards OHS Percentage of respondents able to show why Questionnaire OHS is vital (Untrained) Percentage of respondents to remember key Questionnaire points on why OHS is Vital given (Trained) Level of injury, disease and Percentage of respondents able to give out Estate Clinic record accidents occurrence.
number of times of OHS related injuries
Forms (if available) Questionnaire
Level of OHS fundamentals Percentage of respondents able to remember Observation checklist practice
key points on OHS practice given. Percentage of respondents in use of PPE during data collection exercise
form questionnaire
and
CHAPTER FOUR 4.0 FINDINGS OF THE STUDY 4.1 GENERAL INFORMATION There were 100 study units in the study. The study units had tea pluckers permanently and temporarily or once temporarily employed. The table below summarizes the information on sex and categorical classification of the study units. Table 4: Sex of respondents and categories of respondents CATEGORIES OF STUDY POPULATION SEX
PERMANENTLY
ONCE
EMPLOYED
TEMPORARILY
TOTAL
EMPLOYED MALE
48 (72%)
23 (70%)
71
FEMALE
19 (28%)
10(30%)
29
TOTAL
67 (100%)
33(100%)
100
4.2 RESPONDENTS CHARACTERISTICS The characteristics of the respondents were in relation to age, education and work experience, as listed in table below. The tables 5- 8 show the breakdown of the characteristics with respect to categories of either permanent or temporary employment.
Table 5: Age, Education and Work Experience respondent characteristic n =100 RESPONDENT
FREQUENCY (n)
PERCENTAGE
56
15
15
Totals
100
100
Primary Std 1-4
48
48
Std 5-8
42
42
JCE (Form 1-2)
8
8
MSCE (Form 3-4)
2
2
Totals
100
100
10 years
15
15
CHARACTERISTIC AGE
EDUCATION
WORK EXPERIENCE
Table 6: Relative respondent distribution of age, between temporarily and permanently employed
RESPONDENTS AGE
AGE
PERMANENTLY
ONCE
EMPLOYED
TEMPORARILY
TOTALS
EMPLOYED
(YEARS)
46
10 (15%)
5 (16%)
15
Totals
67 (100%)
33 (100%)
100
Level of education is important as it also plays an important part in the knowledge levels of the people. This being as it positively or negatively influences understanding of different concepts. From the table below, on average, about 48% of both the permanent and temporary employees indicated not to have up to senior levels of free primary education.
Table 7: Relative respondent distribution of education level, between temporarily and permanently employed
RESPONDENTS EDUCATIONAL LEVEL
CLASS
PERMANENTLY
ONCE
EMPLOYED
TEMPORARILY
LEVEL
TOTALS
EMPLOYED
Std 1-4
32 (48%)
16 (49%)
48
Std 5-8
33(49%)
9 (27%)
42
Form 1-2
2(3%)
6 (18%)
8
Form 3-4
0 (0%)
2 (6%)
2
Totals
67 (100%)
33 (100%)
100
Table 8: Respondent work experience, between temporarily and permanently employed
RESPONDENTS WORK EXPERIENCE YEARS
OF PERMANENTLY
EXPERIENCE
EMPLOYED
ONCE
TOTALS
TEMPORARILY EMPLOYED
10
14 (21%)
1(3%)
15
It is vital knowing the duration of one’s stay within the work premises as this may have an influence on the attitude and levels of knowledge of different OHS essentials being practiced. 4.3 LEVEL OF KNOWLEDGE OF EMPLOYEES ON BASIC OHS PROGRAM CONCEPTS The data presents a correlation between knowledge of OHS by the employees and basic components of OHS principles. 4.3.1 Information on Knowledge of OHS Definition and Knowledge The bar graph below shows the percentage of the respondents comparatively between those permanently and temporarily employed as regards to ability to define OHS and knowledge of what it encompasses in their work environment.
90
84%
79%
80
70 60 50 40 30
16%
21%
20 10 0
OHS definition and Knowledge PERMANENTLY EMPLOYED
Inability to define OHS ONCE/ TEMPORARILY EMPLOYED
FIGURE 2: Bar graph showing percentage distribution of OHS Definition and Knowledge
4.3.2 Information on knowledge of OHS illnesses, diseases and accidents with their mode of prevention. Knowledge of OHS illnesses, accidents and diseases and methods of knowledge of prevention will assist decreasing levels of injury occurrence amongst employees’ hence better health and
safety in their work environment. Figure 3 below is a pie chart representing the findings in the study relating to the above mentioned factors in section 4.3.2.
% knowledge on OHS problems prevention measures 13.42%
Knowledge of OHS problems and prevention measure 86.58%
Lack of Knowledge of OHS problems and prevention measure
FIGURE 3: Pie chart showing percentage of level of knowledge on OHS illnesses, diseases and accidents and their prevention methods. 4.3.3 Level of knowledge of stakeholders as to whom OHS program is Vital The bar graph (figure 4) below shows level of knowledge of stakeholders as to whom OHS is vital. The question of interest was to know/rather identify if the both groups of the study are aware of stakeholders as to who OHS is vital: employers, employees, the government, and NGOs. To determine the level of knowledge of the respondents on who do they think OHS is vital among the above mention groups a key was used as follows: Low Level of Knowledge
= those that were not sure on who OHS is vital
Medium level of knowledge = those that indicted at least two of the above as on who OHS is vital Highlevel of knowledge OHS is vital
= those that indicated all the above mentioned as on who
Of the 67 permanently employed 40 (57.58%) had a high level of knowledge, 25 (37.31%) had a medium level knowledge and 2 (2.99%) were not sure and hence a low level of knowledge as on whom OHS is vital. Similarly, of the 33 temporarily employed;19 (57.58%), 10 (30.30%) and 4 (12.12%) had high, medium and low levels of knowledge as on whom OHS is vital respectively. The above information represents that 59%, 35% and 6% of the total combined study sample had respectively high, medium and low levels of knowledge as on who is OHS is vital. 59.7%
57.58%
60 50 40
37.31%
High 30.3%
Medium
30
Low
20
12.12%
10
2.99%
0 PERMANENT EMPLOYMENT
TEMPORARY EMPLOYMENT
FIGURE 4: Bar graph showing percentages of level of knowledge among tea pluckers as on who OHS is vital.
4.4ATTITUDE OF EMPLOYEES TOWARDS OHS Respondents in this section were asked as whether they once received training on OHS in their work environment; and if they did indicated if they find it useful in their daily work life. If not trained, indicate if they find OHS knowledge beneficial or not in the work environment. Additionally, both groups were asked to indicate if they may agree or not to a proposal of penalties/punishment on those not following OHS principles during work and why would they agree or not. This was to establish levels of attitudes among the workers (both temporary and
permanently employed) towards OHS program. This being an important concept as may influence adoption of OHS practices, such as use of PPE. The KEY below presents how the level of attitude towards OHS amongst the workers (pluckers) in their work environment was assessed and established. This was among the workers of both strata of the study. Low
= < 40% correct responses
Medium
=40-70% correct responses
High
= 70% > correct responses
Using the above key the data was coded into SPSS spread sheet and transferred to excel to come up with the frequencies tables below: Table 9: Level of attitude towards OHS among permanent workers
LEVEL OF ATTITUDE
FREQUENCY
PERCENT
Low
14
20.9
Medium
23
34.3
High
30
44.8
TOTAL
67
100.0
Table 10: Level of attitude towards OHS among temporary workers
LEVELS
OF FREQUENCY
PERCENT
ATTITUDE Low
7
21.2
Medium
15
45.5
High
11
33.3
TOTAL
33
100.0
4.5 OHS PROGRAM BASIC PRINCIPLES PRACTICE 4.5.1 Injury occurrence and severity The detection of the level of injury in the workplace of the pluckers was gathered through questions as to whether the participants had injury occurrence recently (defined as past one year), its classification as minor/major and frequency of occurrence. Level of injury among the participants is vital as it will entail the degree at which OHS principles are practiced. Below is a bar chartshowing numbers of measure of injury/disease/accident among the participants and classification on whether the injury was major or minor. INJURY PRESENCE AND SEVERITY AMONG PARTICIPANTS FOR 5 times
18
5
23
2
8
About 10times 6 >10 times
12
8
20
Not sure
3
6
9
TOTALS
60
27
87
4.5.2 Reporting, Recording and Treatment of injury This was done as to come up with the level of practice in terms of OHS injury, disease and accidents case detection. This being a role for both the workers and employees, using the checklist information was sort as regards to recording of OHS accidents and injuries from the estate clinic and through the questionnaire from the participants. Of the 60 permanent workers who reported experiencing either major or minor injuries within the past one year, 54 (95%) indicated to have reported the injuries whilst 6 (5%) did not. Amongst the temporarily employed, of the 27 who had injuries within the past 12months 23 (85.19%) indicated to have reported the injuries whilst 4 (14.81%) did not. The table below presents the authorities to whom the injury cases were reported, the period taken to present the report of the injury and form of treatment given. Table 12: Level of OHS practice in terms of injury case reporting (authority & time taken to report) and form of treatment INJURY REPORT Authority
No.
RECORDING/DOCUMENTATION TREATMENT of Period take before No.
of Type
of No. of
workers
reporting Injury
workers
treatment
Workers
Colleague
26
Within Six Hour
30
First Aid
40
Supervisor
34
Six hours to 1day
36
Dispensary
30
MO/Nurse
27
After Several days
12
Major H/T
6
Didn’t
9
Not sure
9
Referred
2
TOTALS
87
87
78
Key: In the table above MO = Medical Officer and H/T = Hospital Treatment Apart from the above information, data was also sought with regards to record keeping of the reported cases of injuries for the purpose of development of measures to minimize or otherwise eliminate occurrence.
Of the total participants who reported to have had cases of injuries (n=87), only 6(6.897%) said to have seen the authorities to whom they reported put into writing their problems of which they assumed was recorded; 13 (14.943%) were sure that did not see the officer to whom they reported to taking any notes apart from giving them first aid or sending them to the dispensary, finally 68 (78.160%) said to know nothing of recording of the injuries. The estate clinic when visited for the records and/ documentation of cases of injuries for the past one year, only provided documented reports of periodic medical checkups of the employees. 4.5.3 Personal Protective Equipment (PPE) use.
60
55
50 PPE PROVIDED
40 30
25
23 19 15
20 10 0
CURRENTLY USING PPE
FREQUENTLY USE/USED PPE
0 PERMANENTLY EMPLOYED
TEMPORARLY EMPLOYED
FIGURE 6: Bar graph showing number of participants using PPEcomparatively between permanent and temporary employees. The above graph shows that about 82.09% (n=55) of the permanently employed workers are provided with PPE while the remaining percentage 17.91% (n=12). Of those provided with PPE, 45.45% (n=25) were using PPE at the time of the interview while only 34.55% (n=19) were identified to use PPE frequently. Amongst the once temporarily employed, 69.697% (n=23) were once provided with PPE during the time they worked, while the remaining percentage 30.303% (n=10) were not. Of the 23 (69.69%) who were once provided with PPE during their temporary employment only 15 (65.217%) claimed to have used PPE frequently. It was impossible to come up with the
percentage of those using PPE at the time of interview since these were not working when being interviewed. 4.5.4 First Aid Kit at the Work place Table 13:
First Aid Kit at the Work place, comparatively between permanently and
temporarily employed
FIRST AID KIT/BOX PERMANENTL Y EMPLOYED
Awareness of the
TEMPORARIL Y EMPLOYED
TOTALS
n=67
n=33
n=100
61 (91.045%)
28 (84.85%)
89%
61 (91.045%)
28 (84.85%)
89%
44 (65.672%)
22 (66.667%)
66%
availability of a first aid kit Availability of personnel trained in usage of first aid First aid kit checked/updated regularly
About 91.045% of the permanently employed and 84.85% of the temporarily employed workers (89% of all workers interviewed) said that a first aid kit was available within their workplace, in the field. All of these responded that there was someone trained in the usage of the first aid kit at their workplace. Of those who responded that first aid kits were available at the workplace 44 of the 61Permanent workers (65.672%) and 22 of the 28temporary workers (66.667%) were aware that the first aid kit available at their workplace is checked and updated regularly
4.5.5 Periodic Medical Diagnostic Checkups The participants in this section were asked whether they underwent any medical checkups for the past one year in the detection of OHS related cases and the frequency of the checkups.
12% 27%
Permanent with Checkups Permanent without Checkups Temporary with Checkup Temporary without Checkups
6.00%
55%
FIGURE 7: Pie Chart showing distribution of participants who underwent Checkups comparatively between permanent and temporary employees. About 18% the total number of participants reported to have gone for medical checkups within the past one year. This consisted of 17.91% (n=12) of the permanently employed participants and 18.18% (n=6) of the temporarily employed participants. A total of 82% of those participants who reported not to have undergone any medical checkups, 55% of them were permanently employed and the other 27% were not permanently employed. The 55% represents n=55 (82.09%) of the permanently employed and the 27% represents n=27 (81.82%) of those temporarily employed. Additionally of the 18% (n=18) of those reported to have undergone medical checkups only 16.67% (n=3) indicated to have gone for checks more than once while the other percentage, 83.33% (n=15) reported to have undergone medical checkups just once within the past twelve months.
Interestingly the results obtained from the nurse in charge of the clinic on documentation of medical checkups for all employees indicated that; of the 45 available documented forms on medical checkups between March and October 2011 only 1(2.2%) of the medical checkup forms of all employees represented a tea plucker. The rest of the forms 97.8% (n=44) were for other employees from different departments thus included sprayers, sorting department and drying department. This only shows that medical checkups are concentrated to those who are direct contact food handlers.
98.2% 100
82%
90 80
% of checkups recorded
70
60 50
Checkups Done
40
Checkups not Done 18%
30 20 10
2.2%
0 Estate Clinic Record on Checkups
Participant Checkup Status
FIGURE 8: Bar graph showinga comparison of percentagedistribution of participants who underwent Checkups and percentage of those tea pluckers, Estate Clinic recorded to have underwent checkups (March to October 2011).
CHAPTER FIVE 5.0 DISCUSSION OF THE RESULTS BY OBJECTIVES The discussion of the results has been covered under the following topics: 5.1
DEMOGRAPHIC DETAILS OF THE STUDY POPULATION
5.2
OHS KNOWLEDGE
5.2.1
Details of participants (tea pluckers) level of knowledge of OHS programme
5.2.2
Factors related to injuries in the work place
5.2.3
Details of pertaining to work environment in the field
5.2.4
Factors related to OHSresponsibilities in ensuring safe work environment
5.3
OHS ATTITUDES
5.3.1
Details of participants level of training
5.3.2
Factor pertaining to participants’ general attitude towards OHS
5.4
OHS PRACTICE
5.4.1 OHS Injury, illness and accidents occurrence, reporting, treatment and recording/documentation 5.4.2
Safety and First Aid
5.4.3
Details pertaining asymptomatic OHS related cases identification and treatment
5.1
DEMOGRAPHIC DETAILS OF THE STUDY POPULATION
The demographic data surveyed from the study population showed that out the 100 study units of both permanent and temporary tea plucking employees involved, 29% (n=29) of the study sample were females while 71% (n=79) were males(Table 4). In general most of the participants were in the age range of 16-35 (n=56), with a minor representation from the age ranges of 36 above. The data from the survey also showed that about 90%of the study units had only attended education up to either junior primary section (48%) or attended some classes in the senior primary section of PSLCE level (42%). In addition to the above information gathered, the survey further established that 76% of the participants in the study had been either temporary employed or permanently employed for a period of a year or above. (Table 5) The most interesting feature in the above data is that; though most research work in different tea producing countries shows that women are a majority in tea plantation section employed as tea pluckers(Minj 2007); per the data presented above, such is not the case at Esperanza Estate. The data obtained above show that a bulk of men are those employed as tea pluckers for the estate. According to Fashoyin et.al (2007) the change in the trends is due to the fact that most men in the tea industry may do a varied number of activities if need arises as compared to the women. Men employed as tea pluckers may be temporarily taken and allocated in other departments such as drying, sorting, fermentation etc., if needed, of which some of the above mentioned activities may not be given to women. This hence explains the large number of men employed as pluckers as compare to women. Education is a key to a basic understanding of different principles. The survey showed that in general the study units had a lower level of education. Level of education is a significant ingredient in the understanding of general principles including those of OHS program. A lower level of education is likely to affect individual’s knowledge, perception and practice of such basic principles.
Workers experience at a given position may also be considered of great value as it may contribute/contributes to the levels of knowledge, attitude and practices of any given rules and regulations in their work environment.
5.2
OHS KNOWLEDGE
5.2.1 Details of participants (tea pluckers) level of knowledge of OHS programme The participants in the study showed that they were knowledgeable enough of OHS programme by showing an ability to define what OHS encompasses in their work environment. The respondents showed that they were aware of OHS program through clearly indicating some of the illnesses, injuries and disease that may rise in the work environment as pluckers such as backaches and sprains and fractures (Figure 3). About 86.58% (n=71) of those aware of what OHS was had knowledge of the problems that may be faced in their work environment and methods of prevention that may be used as prevent their occurrence. Furthermore, 94% (n=94) of the study sample indicated at least to have knowledge with regards to who OHS is vital (Figure 4). Such a high Level of knowledge as to whom OHS is vital, isas beneficial as it will have an impact in the adoption of workplace safety rules and regulations being enforced. Garcia et.al (2004)outlines that the basic objective of the knowledge of OHS is to assure as far as possible that every working man and woman in the nation has a safe and health working environment as to preserve human resources. Though this objective has been to a great extent in the developed countries, developing countries still have far to go in satisfying this requirement. One of the main reasons for this is the lack of studies on workers engaged in both organized and unorganized sectors with referenceto the health and safety measures. 5.2.2 Factors related to injuries in the work place Knowledge of what OHS accidents and their methods of prevention is a vital tool in achieving a safe and healthy working environment. Lord Robens (1972) in his report, from a Committee on Health and Safety at Work, outlines that the primary responsibility for doing something about the present levels of occupational accidents and disease lies with those who create risks and those who work with them, hence their knowledge significant.
In the results obtained during the survey, a greater percentage of the participants showed that they were knowledgeable enough of how OHS accidents; illness and injuries may be encountered in their work environment including the methods of prevention (Figure 3). Of the total 82% aware of OHS program basic principles, 86.58% (n=71) were aware of OHS problems and relevant prevention measures. Despite these results, further results obtained in the same survey identifying the level of OHS principles practices by the participants revealed a high incidence of injuries in the work place. The results fall in line with current reports by ILO (2008) which indicate that OHS injuries are currently estimated at 250million every year worldwide with 335,000 of the accidents being fatal (resulting into death). It is further indicated that, since most countries do not have accuratekeeping and reporting mechanisms, it may be assumed that the real figures are much higher than the above mentioned projection. Of the above mentioned occurrence of accidents worldwide, the number of fatal accidents is much higher in Developing countries, such as Malawi, with the tea industries contributing a significant level of percentage of them. The difference is primarily due to better health and safety programmes, improved first-aid and medical facilities in the industrialized countries, and active participation of workers in the decision-making process on health and safety issues. 5.2.3 Details pertaining to work environment in the field The physical aspects of a workplace environment can have a direct impact on the productivity, health and safety, comfort, concentration, job satisfaction and morale of the people within it (Pheasant, 1991). This goes hand in hand with the knowledge of different concepts related to work safety and health as those discussed above. The data obtained and represented above shows that most of the participants were aware of the problems in their work environment hence presumption of an ability to make their workplace furthermore safe. Though such the case, further results on work related injuries recorded from the participants shows that there is a high prevalence of injuries in their workplace. The results therefore suggest, for a critical analysis for the factors that may be contributing to the high prevalence of the injuries. In the survey these factors were closely looked at in section 5.4.1of the discussion of the results. 5.2.4 Factors related to OHS responsibilities in ensuring safe work environment
The results obtained in the survey show that a larger percentage of the participants were able to know that OHS is vital for both the Employer and Employees. The participants further indicated that in a nation the Government, NGOs and other stakeholders play a vital responsibility as regards to OHS regulations and enforcement (Figure 4). The data represented that 59% had higher level knowledge as to who OHS is vital. The knowledge in the participants that OHS is vital for everyone is important in the enhancement of basic understanding that will help adoption of OHS principles in their workplace. This will help participants take their primary responsibility in the implementation of OHS principles and hence play a role in the prevention of OHS problems that may arise as due to negligence of such responsibilities. Despite the fact that Inspectors also have a role in verifying compliance by visiting workplaces, performing inspections and monitoring hazardous activities.The overall approach of ensuring work safety and health is intended to be constructive and supportive in the provision of preventative information and advice, and yet rigorous in the enforcement of sanctions where necessary (Grandjean, 1985). This further conforms to some literature most often used from a report by Lord Robens (1972), Committee on Health and Safety at Work in which he states that the primary responsibility for doing something on the present levels of OHS accidents and diseases lies with those who create the risks and those who work with them. In simple terms Robins was referring to both employers and employees. 5.3
OHS ATTITUDES
5.3.1 Details of participants level of training and their perception of its importance The results from the study show that most of the participants had once received training in the issues of OHS and perceived the training they had as important in their work environment. Perception on usefulness of training received on OHS is vital, as it may have an impact on the nature of general attitude towards the adoption of OHS principles in the work environment hence fostering workplace safety. Grantham (1992)in his work entitled “Occupational Health and Hygiene Guidebook for WHSO”describes that safety in workplaces is a matter of the day to day attitudes and reactions of the individuals. He continues by outlining that individuals experience is not in the normal course conducive to safety awareness, but rather positive attitude of safety awareness must be deliberately fostered by as many specific methods as can be devised of which include training.
5.3.2 Factor pertaining to participants’ general attitude towards OHS In general, most of the participants had a positive attitude towards OHS principles. About 41% and 38% of all the participants had presented to have a general positive either high or medium level attitude towards OHS respectively. As already alluded to earlier on, positive attitude towards OHS principles is a positive ingredient in the achievement of workplace that is safe. When people are working in situations that suit their physical and mental abilities, the correct fit between the person and the work task is accomplished. People are then in the optimum situation for learning, working and achieving, without adverse health consequences, e.g. injury, illness(ICMR Report 2002-2003) and all this a result of positive attitude towards OHS within the people. 5.4
OHS PRACTICE
5.4.1 OHS Injury, illness and accidents occurrence, reporting, treatment
and
recording/documentation Under this section the study established a wide range of factors related to OHS injury, illnesses and diseases. These factors highly contributed incoming up with the level of practice of OHS principles for both the employees and employers. In this case employers OHS practice was determined through observation of basic OHS principles which require their hand if they are to be practiced by their employees. The most prominent factors consider in this section of the discussion of the results of the survey include: Incidence of injuries, Nature of injuries, Reporting and recording of injuries, Association between employment status and workplace injuries, Treatment provided to injured workers and Use of Personal Protective Equipment (PPE) by workers. Incidence of injuries Of the 87% (n=87) (Figure 5)participants who had experienced injuries within the past one year, 17 of the interviewed workers had suffered an injury at least once, and most had suffered injuries on multiple occasions (Table 11), with some to as far greater than ten times. More of the permanently employed worker had been injured as compared to temporary/once temporary workers (Table 11).
The total number of injuries among the workers interviewed was 87 in the past year. The overall incidence of workplace injuries among workers interviewed was 870 per 1000 workers or 87 per 100 workers per year (this was within the past one year). Literature from other studies in India and Sri Lanka show that OHS injury incidences are high in the tea industry with about 17million non-fatal and 45000 fatal injuries representing about 17% and 45% of the world’s incidence of OHS injury each year (National Program for Control and Treatment of Occupational Diseases, 2007).In Malawi, no data is available pertaining to occupational injuries in the tea plantation. Despite this unavailability of data, an incidence of 87 per year as that obtained at Esperanza Estate among tea pluckers, in comparison to other countries such as India who have incidence of about 36 per year, certainly warrants some attention. In true sense such a large incidence of injury only shows some faults that may be existent in the enforcement of OHS principles and administrative role and responsibilities by the management. Nature of injuries Most of the workers had suffered an injury which was minor in nature requiring only first aid or minor treatment (Figure 5). This is easily explained by the fact that most workers carry out their tasks in the field walking barefoot over a rough terrain and are prone to injuries with stones, thorns. Slipping and falling also accounted for such injuries. Literature further shows that most of the injuries that occur in tea estates amongst tea pluckers are those affecting the toes and feet. The reasons cited for these were: improper manual use of tools and equipment, slips and falls, reptile and insect bites, and wounds caused due to non-use of footwear (ILO/EFC, 2003, 1998). Some of the most common injuries that affect the toes and feet among the tea pluckers include cuts and abrasions. In Sri Lanka the reasons for the cuts and abrasions include the improper use of sharp cutting devises such as knives and shears, and also the non-use of protective footwear. The above literature typically goes in line with the most of the accidents that are so faced in Tea industries of Malawi. Reporting and recording of injuries The fact that a large proportion of injured workers had reported their injuries (and most of them within six hours) points to a well-established protocol for management of injuries aimed at
reducing morbidity due to work-related hazards. Most of these workers also responded that they were not sure if their injuries had been recorded soon after reporting. This suggesting that appropriate actions need to be taken when a worker report his/her injury. Most workers reported their injury to a competent authority (usually a supervisor/medical officer or Nurse). (Table 12) Research has shown the under-reporting of accidents, injuries and illness appears to be a worldwide phenomenon, with confirmatory studies conducted in a wide range of countries. As would be expected, trends in accident rates and reporting accuracy vary from country to country, reflecting cultural differences, as well as variation in reporting systems and legislation. Ironically safety incentive programmes, which offer rewards for reductions in the number of workplace accidents and incidents, have been widely introduced in industrial settings with the aim of improving safety records and cutting safety-related costs may also be increasingly responsible for under reporting. Literature also shows that work-related musculoskeletal disorders and eye injuries are heavily under reported (Daniels & Marlow, 2005). Association between employment status and workplace injuries It was found out that although a greater proportion of permanently employed workers had been injured at the workplace, and the injury rate of 89.55 per 100 per year there was no significant association between permanent and temporary status of employment. This being due to the fact the injury rate amongst temporary employers was also higher to as far as 81.82 per 100 per year. Despite the above result data form different research papers has shown that seasonal demands of the tea industry render employment in tea production rather temporary in nature, except for a small group of more experienced and conditioned workers. Under normal circumstances the volatility in the Labour; render vulnerable social categories in the tea industry, specifically the minorities like tea pluckers extremely susceptible to exploitative employment practices. It to this fact that most of the individuals that are employed in the specified section may not be aware of OHS program principles that are supposed to be implemented in their work environment. This leads them to exposure to different nature of hazards in their work environment without the knowledge and know how in preventing and eliminating the encountered hazards hence increased incidence of injuries (ECAM, 2010).“Malawi Tea Research Project” a report by Malawi CARER (2007) backs up the poor working conditions among tea industry labourers, of which include tea pluckers. Treatment provided to injured workers
Most workers had suffered injuries which required a minor form of treatment. Table 12indicates that most of the workers with injuries, about 40 of the total 78 who reported their injuries were treated in the first aid stage, 30 sent to the dispensary for further treatment and the remaining 8 either treated at a major hospital or referred.
Basically the treatment accessed from the
dispensary include: general procedures at dispensary such as cleaning and dressing of wounds, suturing and application of plaster cast. This was confirmed in the oral general discussions with the chief nursing officer of the clinic at the estate during a visit to collect and gather information regarding OHS injury documentation. Also, most injuries that occurred in a year were minor cuts and bruises, and these can usually be managed without major treatment or referral. Use of Personal Protective Equipment (PPE) by workers Most of the workers stated that they had received personal protective equipment such as rain coats, masks, boots and work suits (natively Maovolosi). Further discussions with the participants revealed that boots and work suits were in limited number while rain coats were in abundance being used often in the rain season when tea plucking is at its peak. The participants did not have protective devices worn over the thumbs and fingers while plucking, most of them used bare hand in the plucking exercise with others improvising through the use plastics. Mechanically hand used tea cutters during the plucking exercise were only with very few individuals. While 82.09% (n=55) of the permanently employed workers are provided with PPE the remaining percentage 17.91% (n=12) responded not to have had them. Of those provided with PPE, 45.45% (n=25) were using PPE at the time of the interview while only 34.55% (n=19) were identified to use PPE frequently. (Frequency of use was determined by how many times was participant found wearing the PPE during the visits to the estate during data correction) Amongst the once temporarily employed, 69.697% (n=23) were once provided with PPE during the time they worked, while the remaining percentage 30.303% (n=10) were not. Of the 23 (69.69%) who were once provided with PPE during their temporary employment only 15 (65.217%) claimed to have used PPE frequently. It was impossible to come up with the percentage of those using PPE at the time of interview since these were not working when being interviewed as it was off peak tea plucking season. These findings point towards a need for continuous education of the workers on the advantages of using PPE and then, if required, regular inspections by supervisory staff. The reasons for inadequate usage of PPE also need to be looked into. One cause may be that PPE are often designed for ambient conditions in developed countries, and consequently, may fail more readily or may not be tolerated in warm climates
(Cullen et.al, 2006). Unsafe equipment and conditions, inadequate training, and limited availability and use of personal protective equipment all contribute to the incidence of occupational injuries in developing countries (Cole, 2006).
5.4.2 Safety and First Aid Training in safety/first aid Almost all of the workers interviewed and responded to have knowledge of the availability of a first aid kit/box, in their work environment, thus about 89%, showed that at least personnel trained in safety and safe work procedures during the course of their employment were available (Table 13). Formal training in safe work procedures is likely to influence the behaviour of the worker at the workplace such as more frequent use of PPE, and thereby help reduce occupational injuries (Avory & Coggon, 2003). Training in first aid would enable workers to administer the same for the injured at their place of work itself, thereby compensating for the time lost on transport from the field/factory to the medical care facility/clinic. First aid kit at workplace As already indicated above, of the 89% who were aware of the first aid kit in their work environment and reported that some personnel amongst them had training in safety and safe work procedures, only 66% of the total interviewed sample reported that the first aid box were checked and updated regularly (Table 13). Lack of awareness regarding availability of a first aid kit probably results from the fact that not all workers are trained in first aid. This is the case due to seasonal and temporal nature of the work in the tea industry specifically the plantation sector. 5.4.3 Details pertaining asymptomatic OHS related cases identification and treatment The sole purpose of medical checkups of employees pertains the identification of asymptomatic OHS related case detection and treatment and coming up with remedial actions as to either eliminate or reduce the OHS problems hence a safe work environment. A medical checkup is not an examination in which one undergoes after reporting for example an injury. It is the employers’ responsibility to ensure that periodically all employees undergo a medical checkup.
In this study, it was established that: out of the total number of participants interviewed 18% reported to have gone for a periodic checkup. This consisted of 17.91% (n=12) and 18.18% (n=6) of permanent and temporarily/once temporarily employed workers respectively (Figure7). In total 82% reported not to have undergone yet, if at all, the medical checkups. “If at all” has been used as to represent the doubt by most of the permanently employed workers of a medical checkup who claimed that checkups are only done for those working in the factory in direct contact with food processing procedures. The claim by the employees is affirmative, as shown by results of the forms that were collected from the estate clinic, through the chief nursing officer, of documentation of all employees medical checkup status; a sample 45 forms in the year 2011 produced. A thorough analysis of the form yielded results showing that 97.8% (n=44) were employees who underwent checkups within the past one year from different departments of the tea estate including sorting and drying. Only one form (2.2%) was that of a tea plucker whose checkup was done in early March of the 2011 (Figure 8). A forced assumption may be made as think that even those participants who reported to have undergone checkups within the past one year were referring to medical examination after report of an injury of which does not qualify a checkup. Or in other words the disparity could be because of several reasons. Firstly, there may be a possibility of over reporting by the respondents due to the individual administration of the interview schedule. There may also be the possibility of recording of only those injuries which were severe in nature and warranted immediate attention. Medical checkups of employees are beneficial as they may help in the identification of health problems that associate positively with the working conditions and may require immediate action. Literature shows that a survey of the health problems among tea workers in Assam has revealed high magnitude of under nutrition and infectious diseases. Nutritional problems like underweight among children (59.9%), thinness among adults (69.8%) and micronutrient deficiency disorders like anaemia (72%) were widespread. Common infectious diseases were worm infestation (65.4%), respiratory problems (6.7%), diarrhoea (1.7%), skin infections, filariasis (0.6%) and pulmonary tuberculosis (1.17%). The study also registered a significant burden of NCDs (non communicable diseases) like hypertension (45.9%), senile cataract (25.3%), back-pain (8.7%) and epilepsy (0.73%) (Meghi et.al, 200
CHAPTER SIX 6.0 CONCLUSION 6.1 Demographic details of the study sample Demographically we may conclude that the estate (Esperanza) comprises of a large percentage of men as compared to women with the percentage distribution being 71% men and 29% female. Further it may be concluded that a mass of the population of the estate in the tea plucking section has a lower level of education comprising of about 90% with PSLCE. 6.2 Levels of OHS knowledge About 82% of permanent and temporary aware of OHS with an ability of definition of related OHS problems and necessary remedial strategies. 59% of both groups of employees interviewed are aware as to who OHS is vital. Primary responsibility for doing something on present levels of occupational accidents and disease lies with those who create risks and those who work with them. Better understanding of the OHS therefore significant. It should be everyone’s responsibility in ensuring OHS problem free environment. NGOs, Government, Workers and employers with appositive responsibility in this. Most of the employees were able to show that it is everyone’s responsibility. The physical aspects of a workplace environment can have a direct impact on the productivity, health and safety, comfort, concentration, job satisfaction and morale of the people within it, hence significant to have knowledge of your environment in ensuring OHS. 6.3 Attitude towards OHS About 79% had a medium to a high positive range of attitude of OHS as vital for health. Most of the participants had once received training in the issues of OHS and perceived the training they had as important in their work environment. Positive perception on usefulness of training received on OHS vital, as it may have an impact on the nature of general attitude towards the adoption of OHS principles in the work environment hence fostering workplace safety.
6.4 Incidence of workplace injuries in tea estate workers Around 89.55% of the permanent workers and 81.82% of the temporary workers had suffered a work-related injury in the year prior to the survey. Overall around 87% of the workers had suffered a work-related injury at least once in the past year. Most had suffered an injury only once during the same period. Most of the workers had suffered an injury which was minor in nature and the workers reported their injuries immediately to the field staff concerned of which most of workers were also not aware if their injuries were recorded after reporting. Those with severe injuries were the ones who were either sent to major hospital or referred for further treatment. 6.5 Factors related to injury at the workplace The frequency of injuries was both high among the temporarily and permanently employed personnel. Minor treatment (such as minor surgeries and procedures at the dispensary or hospital cleaning and dressing of wounds, suturing and application of plaster cast) was the kind of case management provided for a majority of the injured workers. A large percentage of both the permanent and temporary workers about 78% responded that they were provided with PPE by the employers. However only about 43.59% (n=34) with PPEs, frequently used the PPEs. PPEs provided are rain coats, masks, boots and work suits (natively Maovolosi). Insufficiency of work suits (Maovolosi) and boots a prominent problem. 6.6 Safety and first aid A greater proportion of both permanent and temporary workers (89%) commented personnel amongst them had received some form of training in safety and safe work procedures and first aid. These were also knowledgeable enough of the availability of first aid kit in their work environment. First aid kits were inspected by the supervisors in most of the field at the time of the survey, checking and updating them. Only about 66% of workers were aware that a first aid kits were checked and updated regularly. This could be because of the fact that not all workers are trained in first aid.
6.7 Asymptomatic OHS related cases identification and treatment 82% reported not record and documentation of checkups. Documentation from the clinic conclusive of inefficiency in documentation and case identification of OHS related cases amongst workers. The disparity basically due several reasons namely: a possibility of over reporting by the respondents due to the individual administration of the interview schedule and the possibility of recording of only those injuries which were severe in nature and warranted immediate attention.
CHAPTER SEVEN 7.0 RECOMMENDATIONS 7.1 Sustained efforts for the prevention of occupational injuries in the estate
The questionnaire and checklist interviews administered, the course of this study point towards the fact that prevention of occupational injuries and dealing with work-related diseases are given due importance by the management and the workers. In the other words the primary objective in the prevention of occupational injuries is a responsibility of those who create risks and work with the risks in the work environment. The safety conditions both in the field and factories have shown improvement over the course of the years, mostly owing to the establishment of safety committees and intervention by NGOs. These efforts need to be sustained and inputs from the working staff need to be considered while making future plans for further improvement of safety conditions, keeping in view the high incidence of injuries reported from these estates.
The usage of PPE should be emphasized from time to time and regular inspections to ensure adequate usage need to be undertaken. Continued motivation, surprise checks and penalization of defaulting workers are some of the steps that could be followed regularly.
7.2 Education and training regarding safe work procedures and preventions of accidents The education and training procedures regarding safe work procedures and prevention of accidents should address:
Training of more workers in first aid procedures. Although the incidence of injuries sustained at the workplace was high, most of the injuries were minor and simple in nature and can be managed by minor form of treatment, through the training provided to the workers.
Workers should be encouraged and educated on the use of protective footwear and general PPE while working, as most injuries in the estates among tea pluckers are cuts and abrasions.
Sustained education on the need, benefits and maintenance of PPE is important to ensure regular usage of the equipment provided.
Material Safety Data Sheets should be available in languages that workers can follow, but for those workers who cannot read, education could be provided by the field officers/ supervisors or even by the other workers themselves.
7.3 Maintenance of records of workplace injuries
The system of recording of workplace injuries needs to be updated. Every injury that is brought to the notice of health care providers should be recorded, whether compensable or not. This would also enable future research on the trends of occupational injuries and more importantly help in planning for safety management in these estates.
Regular monitoring of the humidity and temperature in the factories would enable the management to take corrective steps, if indicated
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