CHAPTER ONE

INTRODUCTION

Background to the Study

Occupational hazard is the exposure of industrial workers to any harmful condition or

substances that causes accident death or injury to the health of the workers

(Scand,2019). This has been a major challenge to industrial workers worldwide in

various work places. Because some of these industrial workers have been exposed to

this agent, the physical, social, economical, emotional and physiological states of

workers in the working environment due to the continued exposure of this agent for at

least six to eight hours daily have been jeopardized.

Studies have shown that out of all industrial Workers that are exposed to

contaminated environment or substances, 53.8% developed sub acute symptom illness

such as sore throat, cough, chest tightness, breathlessness, thirst, sweating, irritability

and loss of libido.

According to ILO,(2020), over 500,000 workers die of Occupational cancer every

year, between 8-16% of all cancer are as a result of exposure to various chemicals at

work. Approximately 100,000 chemicals are used in workplace worldwide.

In developed countries, hazard from different workplace has contributed to many

injuries and death of individuals. According to the U.S Bureau of labour statistics

(2019), there were 5,333 fatal work injuries recorded in the United States.

Transportation incidents accounted for the largest share of death followed by falls,

slips and trips, exposure to harmful substances and environment, unintentional

overdose due to non-medical use of drugs or alcohol, fires and explosion( Michael

Grant, 2021)

In developing countries, it has been estimated that people are exposed to more than

80% of global occupational hazard. These hazard are associated with risk that are

likely to cause disease, injuries or even as much as fatalities to workers.While

developed countries are seen as more stringent about workplace and safety, it's

obvious that developing countries do not take safety Seriously or have insufficient

legislation to minimize these risks. Again developing countries do not have the

knowledge to effectively formulate a functional HSE legislation to help prevent

accident

In Nigeria, the health and safety profile of construction industries are very poor. The

industries alone account for 39.2% of injuries and 34.9% of death at the workplace in

Nigeria between 2014 and 2016, So knowledge of occupational hazard, prevalence

and factors associated with occupational injuries was assessed among construction

workers in Abuja.

In hospital, high incidence (about 60%) of occupational exposure to microorganisms

is observed among all HCPs although nurses form the largest group of health care

professionals and are more vulnerable to an occupational hazards (Konte,

Nikolopoulos, Raftopoulos, Pylli, Tiara, Marri &Paraskeva,2013). It has also been

reported that transmission frequently occurs during the performance of

medical procedures when these healthcare professionals fail to follow aseptic

precautions (Kosgeroglu, Ayranci, Vardareli, & Dancer, 2014).

The high frequency of about 60% of skin contact with patients' blood and needle stick

injuries as reported by (Konte et al., 2013) may reflect low practice of standard

precautions of infection control especially as it relates to use of personal protective

equipment and safe injection practices

Control of infection and prevention of hospital-associated infections is an ongoing

issue worldwide. The most effective and simple way to prevent infection in the

hospital is to follow standard precautions, which are a set of recommendations

designed to prevent or minimize exposure to infectious agents by hospital staff,

patients and their visitors (WHO,2017). Many infection control measures, such as

appropriate hand hygiene and the correct application of basic precautions during

invasive procedures are simple and of low-cost, but require staff accountability and

behavioural change, in addition to improving staff education, reporting and

surveillance systems (Bouallegue, Naija, Said, Nouria, Jaidane, Dhidah,

&Boujaafar,2013). For example, despite a clear recognition of the importance of hand

washing in reducing transmission of microorganisms, compliance by health

professionals is often poor and protective equipment is not always used appropriately

(Garner, 2013). It has also been argued that reduction in risk taking behaviour to

infection only occurs when there is a perceived risk and when efficacy is expected.

This study therefore will examine the perceived risk-taking behaviors associated with

occupational exposures to pathogens among nurse of Chukwuemeka odumegwu

ojukwu University teaching Hospital,Amaku Awka Anambra state,Nigeria.

Statement of the problem

The occupational risk of exposure to (Blood,body and fluids) BBFs and needle

stick injuries not only affects the safety and wellbeing of HCPs, but also compromises

the quality of health care delivered (Awases, Nyoni, Chatora, 2014). Healthcare

professionals in operating, delivery, and emergency rooms and in laboratories have an

enhanced risk of exposure and they experience significant fear, anxiety, and

emotional distress, which can sometimes result in occupational and

behavioral changes (Lee, Botteman xanthakos & Nicklasson, 2015). Consequently,

the occupational exposure to pathogen constitutes one of the challenges for public

health professionals. In the absence of a definite cure for some of the diseases like

HIV and HBV contracted through occupational exposure to these pathogens, positive

behaviours and prevention measures at occupational levels remain the key for

prevention of these exposures.

Ideally, in medical practice it is assumed that the blood and body substances of all

patients are potential sources of infection, regardless of the diagnosis, or presumed

infectious status (WHO,2017). Published work indicates that positive behaviours of

standard precautions are effective in preventing both occupational exposure to BBFs

and their associated infections (Redecki, Abbott & Eloi, 2018; Canadian Center for

Occupational Health and Safety, 2015). In both developed and developing countries,

occupational surveillance to assess and monitor the health hazards of HCPs and their

inclination to risk taking behaviours are used to prevent and control occupational and

nosocomial infections (Canadian Center for Occupational Health and Safety, 2015).
Following the outcome of a study carried out by Owolabi, Alabi, Ajayi, Daniel,

Ogundira & Akande, (2016)at the University of Abuja Teaching Hospital in Nigeria,

the study found that 30.9% of their participants (nurses) had occupational exposures

to pathogensin the past three years. The main circumstances of exposure included;

monitoring intra-venous (IV) lines, recapping needles, during delivery

and patient care giving. This study sees the need to examine the perceived risk-taking

behaviours associated with occupational exposure to pathogens among nurses

of Chukwuemeka Odumegwu Ojukwu teaching hospital Amaku Awka ,Anambra

state,Nigeria.

Objectives of the study

The aim of the study was to assess the perceived risk-taking behaviours associated

with occupational hazards to pathogens among nurses in Chukwuemeka Odumegwu

Ojukwu teaching hospital Amaku Awka, Anambra state, Nigeria.. The specific

objectives are:

 To assess the perceived risk-taking behaviours (such as needle recapping,

improper use of gloves, improper disposal of sharps, improper hand washing, not

using personal protective equipment) associated with occupational hazards to

pathogens among nurses in Chukwuemeka Odumegwu Ojukwu teaching hospital,

Amaku Awka, Anambra state. Nigeria.

 To identify the post-exposure behaviours of nurses associated with

occupational hazards to pathogens among nurses in Chukwuemeka Odumegwu

Ojukwu teaching hospital, Amaku Akwa, Anambra state. Nigeria.

 To identify the factors that influence risk-taking behaviors associated with

occupational hazards to pathogens among nurses in Chukwuemeka Odumegwu

Ojukwu university teaching hospital, Amaku Awka, Anambra state. Nigeria.

 To determine the preventive measures against occupational health hazards among

nurses in Chukwuemeka Odumegwu Ojukwu university teaching hospital

Amaku ,Awka Anambra state.Nigeria .

Research Questions

In line with the stated objectives, the following research questions were used to

guide the investigation.

 What were the perceived risk-taking behaviours associated with occupational

hazard among nurses in Chukwuemeka Odumegwu Ojukwu university teaching

hospital, Amaku Awka, Anambra state. Nigeria?

 What were the post-exposure behaviours of nurses associated with occupational

hazard among nurses in Chukwuemeka. Odumegwu Ojukwu university teaching

hospital, Amaku Awka, Anambra state. Nigeria?

 What are the factors that influence risk-taking behaviours associated with

occupational hazard among nurses in Chukwuemeka Odumegwu Ojukwu

university teaching hospital, Amaku Awka, Anambra state. Nigeria?

 What are the preventive measures against occupational hazards among nurses in

Chukwuemeka Odumegwu Ojukwu university teaching hospital Amaku Awka ,

Anambra state , Nigeria?

Significance of the study

The outcome of this study on the perceived risk-taking behaviours associated with

occupational hazard among nurses in Chukwuemeka Odumegwu Ojukwu University

Teaching Hospital, Amaku. Awka, Anambra state will be of immense benefit to:

 HealthCare Providers and the hospital management. Its findings will create a

needed safety consciousness among nurses and help the hospital management

overhaul its safety policies.

 Researchers ,It will also aid scholars who might want to research more

on risk-taking behaviours associated with occupational hazards among nurses

in Chukwuemeka Odumegwu Ojukwu University Teaching Hospital, Amaku

Awka, Anambra state to be more informed about their research.

 To society, May serve as a guide for developing programmes aimed at

discouraging risk-taking behaviours in societies and also validate previous

findings or/and provide evidence for new research.

 It will also enrich the library.

Scope of the study

This study focuses on the aim to assess the occupational hazards faced among nurses

in Chukwuemeka Odumegwu Ojukwu university teaching hospital Amaku Awka ,

Anambra state,Nigeria.
This research project is delimited in scope to nurses in Chukwuemeka odumegwu

ojukwu University Teaching Hospital, Anambra during the period of this study.

Chukwuemeka Odumegwu Ojukwu university teaching hospital Amaku

Awka,Anambra state,(COOUTH) is a tertiary health institution which provides a wide

range of medical, surgical, diagnostic, out-patient, rehabilitative and support services

to a catchment population of 120. Coouth has a functional accident and emergency

unit and provides 24 hours emergency services all year round. The key activities

includes: pediatrics, general medicine, general surgery, obstetrics and gynecology,

laboratory services, radiology, HIV/STI services, pharmaceutical services,

anaesthesiology, intensive care unit, ophthalmology, dietetics ,physiotherapy. The

language of the area is Igbo.

It is also delimited to risk-taking behaviours of nurses and factors that influence such

behaviours.

Operational definition of terms

Perceived Risk-taking behaviours: In this study, it includes all

activities and behaviors that nurses engage in, that bring them into contact with

pathogens in blood and or body fluids, mucus membrane and other contaminants

that could risk their safety and predispose them to hospital associated infections

(HAIs). Such nursing behaviours include: improper hand washing, misuse of

instruments, improper use of barriers (e.g., gloves, gown, cap, mask), improper care

of devices, equipment and clothing used during care, improper handling, recapping of

needles and inadequate discarding of sharp instruments.

Nurses working in COOUTH: In this study, nurses refer to nurses and midwives

registered with the Nursing and Midwifery Council of Nigeria, with current license to

practice in Nigeria, working full-time in Chukwuemeka Odumegwu

Ojukwu University Teaching Hospital, Amaku Awka, Anambra state. Nigeria

irrespective of the units of work such as wards, clinics.

Occupational exposure:In this study, occupational exposure among nurses has been

defined as any contact with skin, eyes, mucous membranes or any other parenteral

contact with blood or other potentially infected fluids or materials that take place

during their daily clinical practice.

Factors influencing risk-taking behaviours: In this study, it refers to those variables

which form the basis on which risk-taking behaviours of nurses thrive. They

include engineering factors such as design of sharps, barrier devices; behavioral

factors such as recapping , disposal-related issues organizing factors such as

availability of supplies, reporting policies.

Post-exposure behaviours: In this study, post-exposure behaviours refer to actions

taken by nurses in event of perceived exposure to pathogens.