Journal of Safety Research 79 (2021) 329–340

Contents lists available at ScienceDirect

Journal of Safety Research

journal homepage: www.elsevier.com/locate/jsr

The acceptance of personal protective equipment among Hong Kong

construction workers: An integration of technology acceptance model
and theory of planned behavior with risk perception and safety climate
Siu Shing Man a,⇑, Saad Alabdulkarim b, Alan Hoi Shou Chan c, Tingru Zhang d
a
Department of Advanced Design and Systems Engineering, City University of Hong Kong, Hong Kong, China
b
Industrial Engineering Department, College of Engineering, King Saud University, Riyadh, Saudi Arabia
c
Department of Systems Engineering and Engineering Management, City University of Hong Kong, Hong Kong, China
d
Institute of Human Factors and Ergonomics, College of Mechatronics and Control Engineering, Shenzhen University, Shenzhen, China

a r t i c l e i n f o a b s t r a c t

Article history: Introduction: The phenomenon that construction workers do not use personal protective equipment (PPE)
Received 2 April 2021 is a major reason for the high occurrence frequency of accidents in the construction industry. However,
Received in revised form 24 May 2021 little efforts have been made to quantitatively examine the factors influencing construction workers’
Accepted 30 September 2021
acceptance of PPE. Method: In the current study, a PPE acceptance model for construction workers
Available online 19 October 2021
(PAMCW) was proposed to address the noted need. The PAMCW incorporates the technology acceptance
model, theory of planned behavior, risk perception, and safety climate for explaining construction worker
Keywords:
acceptance of PPE. 413 construction workers participated in this study to fill out a structured question-
Personal protective equipment
Risk perception
naire. The PAMCW was analyzed using structural equation modeling. Results: Results provide evidence of
Safety climate the applicability of the technology acceptance model and theory of planned behavior to the PPE accep-
Theory of planned behavior tance among construction workers. The positive influence of safety climate and risk perception-
Technology acceptance model severity on attitude toward using PPE was significant. Safety climate positively influences perceived use-
fulness. Risk perception-worry and unsafe was found to positively affect intention to use PPE. Practical
Applications: Practical suggestions for increasing construction workers’ use of PPE are also discussed.
Ó 2021 National Safety Council and Elsevier Ltd. All rights reserved.

1. Introduction According to the (Labour Department, 2020); among different

In 2020, the construction sector in Hong Kong accounted for
4.2% of the gross domestic product (GDP; (Census and Statistics
Department, 2021). Despite this remarkable contribution to the
GDP, the sector has long been infamous for its high accident and
fatality rates. Construction accidents and fatalities in Hong Kong
contributed approximately 32% (2,947) and 73% (16) to the total
industrial accidents and fatalities in 2019, respectively (Labour
Department, 2020). These significant numbers in the construction
industry can be attributable to its temporary, dynamic, and decen-
tralized nature (Li, Lu, Hsu, Gray, & Huang, 2015). The construction
industry had triple the average number of fatalities in other indus-
tries globally (Sousa, Almeida, & Dias, 2014). As a result, many
researchers are dedicated to studying construction safety for
improving the safety performance of the industry.
⇑ Corresponding author.
E-mail address: ssman6-c@my.cityu.edu.hk (S.S. Man).
types of fatal accidents, fall from height is the leading cause of con-
struction fatalities in Hong Kong. A similar phenomenon has also
been observed in other regions, such as the UK where 47% of
work-related deaths were caused by fall from height (Health and
Safety Executive, 2018). According to (Wong, Wang, Law, & Lo,
2016); a major reason for fall from height accidents is that con-
struction workers do not use personal protective equipment
(PPE; e.g., safety harness). Failure to use PPE (e.g., safety shoes,
safety helmet, rubber gloves, and earplugs) is also the main cause
of other accidents at construction sites (Hamid, Majid, & Singh,
2008; Tanko & Anigbogu, 2012). PPE is supposed to be the last bar-
rier and final approach for reducing possible accidents among
workers (Reason, 1990). Diverse methods have been developed
to improve PPE control and monitoring. For instance, (Kelm et al.,
2013) developed a mobile passive radio frequency identification
portal to fulfill PPE improvement. Understanding the underlying
causes for PPE acceptance is of critical importance to reduce con-
struction accidents. The prominent and classic work by DeJoy
(1996) provided a critical review on how theoretical models of

https://doi.org/10.1016/j.jsr.2021.09.014
0022-4375/Ó 2021 National Safety Council and Elsevier Ltd. All rights reserved.
Siu Shing Man, S. Alabdulkarim, Alan Hoi Shou Chan et al.
health behavior (including environmental/contextual; value-
expectancy; and behavior change models) are applicable to self-
protective behavior of workers. Based on the review (DeJoy,
1996), proposed an integrative framework to conceptualize the
self-protective behavior as composing of four phases; namely, (a)
hazard appraisal, (b) decision making, (c) initiation, and (d) adher-
ence. Recently, (Smith, DeJoy, & Dyal, 2020) conducted a study to
identify factors that influence the use of PPE among firefighters.
The results of their study showed safety motivation was positively
associated with the use of PPE. In the construction safety context; a
qualitative study was conducted by Wong, Man, & Chan (2020) to
explore the causes for construction workers to use or not to use
PPE at construction sites and found that the causes included atti-
tude toward using PPE; risk perception, perceived ease of use,
and perceived usefulness. Although the best control measures
include elimination, substitution, or isolation, PPE is the last line
of defense. This study focused not only on construction workers’
behavioral controls but also on the system-level issues of
organizations.
In the construction safety literature, several limitations were
identified. First, how risk perception influences the PPE acceptance
of construction workers has not been investigated quantitatively.
Second, the effect of safety climate on the PPE acceptance of con-
struction workers has not been studied quantitatively. Third, no
studies integrated the technology acceptance model and theory
of planned behavior to establish a theoretical framework to
account for the PPE acceptance among construction workers. With
the aim of filling the research gaps, the present study proposed a
PPE acceptance model for construction workers (PAMCW) that
integrates the technology acceptance model and theory of planned
behavior with risk perception and safety climate. The technology
acceptance model and theory of planned behavior were selected
because they have been widely used to explain technology accep-
tance and human behavior in different research areas, for example,
transportation (Larue, Rakotonirainy, Haworth, & Darvell, 2015;
Rowe et al., 2016) and construction safety (Choi, Hwang, & Lee,
2017; Fogarty & Shaw, 2010). Moreover, the importance of risk
perception and safety climate in explaining construction workers’
unsafe behavior has been demonstrated in previous studies (Man
et al., 2017, 2021).
2. Literature review and research hypotheses
The following sections justify the inclusion of the specific theo-
ries and constructs as mentioned above. The hypotheses in this
study will also be provided with theoretical knowledge from the
literature.
2.1. Technology acceptance model and theory of planned behavior
The technology acceptance model (Davis, Bagozzi, & Warshaw,
1989); Fig. 1) is one of the most commonly used theories for under-
Fig. 1. Technology acceptance model (Davis et al., 1989).
330
Journal of Safety Research 79 (2021) 329–340
standing how users accept a certain technology. In the technology
acceptance model, perceived ease of use, perceived usefulness, and
attitude toward using a technology are key factors in explaining
people’s technology acceptance. Specifically, an individual’s behav-
ioral intention to use a certain technology is driven by perceived
usefulness and attitude toward using the technology. The attitude
is determined by perceived usefulness and perceived ease of use.
Notably, perceived usefulness is affected by perceived ease of use
and external variables, whereas perceived ease of use is influenced
by external variables. The technology acceptance model was gen-
eric, so this study modified (Davis et al., 1989)’s definitions of per-
ceived usefulness and perceived ease of use to be specific for
construction workers. Moreover; perceived usefulness is regarded
here as construction workers’ belief that using PPE can enhance
their safety performance. Meanwhile, perceived ease of use refers
to construction workers’ belief that that using PPE is free of effort.
A summary of previous research that used the technology accep-
tance model and ideas in safety was shown in Table 1 to justify
bringing this concept and framework across to the context of this
study.
The theory of planned behavior (Fig. 2) was initially developed
by (Ajzen, 1985) for explaining general individual behaviors. In the
theory of planned behavior; three important constructs, namely,
attitude toward a behavior, subjective norm, and perceived behav-
ioral control, drive a behavioral intention, which in turn affects the
behavior. The theory of planned behavior was a generic model, so
this study modified the theory of planned behavior constructs to
better fit in the construction domain. Attitude toward using PPE
is defined as construction workers’ favorable or unfavorable evalu-
ation on the use of PPE. The more favorable the attitude toward
using PPE, the more likely construction workers would use PPE.
Subjective norm is the perception of construction workers that
people who are important to them think they should use PPE.
When construction workers believe that people who are significant
to them agree on using PPE, they are more likely to use them. Per-
ceived behavioral control is the perception of construction workers
that using PPE is easy or difficult. Construction workers with a
higher level of perceived behavioral control on using PPE are more
likely to use PPE.
On the basis of the theoretical knowledge on the technology
acceptance model and theory of planned behavior, the relation-
ships in the construction setting are examined as illustrated in
Figs. 1 and 2. Specifically, the following hypotheses were proposed:
H1: Perceived ease of use positively affects perceived
usefulness.
H2: Perceived ease of use positively affects attitude toward
using PPE.
H3: Perceived usefulness positively affects attitude toward
using PPE.
H4: Perceived usefulness positively affects intention to use PPE.
H5: Attitude toward using PPE positively affects intention to
use PPE.
H6: Subjective norm positively affects intention to use PPE.
H7: Perceived behavioral control positively affects intention to
use PPE.
H8: Intention to use PPE positively affects using PPE.
2.2. Risk perception
According to Slovic (1987), risk perception refers to the subjec-
tive judgment made by people on risks (Man, Chan, &
Alabdulkarim, 2019) developed the Construction Work Risk Per-
ception (CoWoRP) Scale with 13 items for quantifying construction
workers’ risk perception. They identified three dimensions of con-
struction worker risk perception, namely (a) risk perception–prob-
ability, (b) risk perception–severity, and (c) risk perception–worry
Siu Shing Man, S. Alabdulkarim, Alan Hoi Shou Chan et al. Journal of Safety Research 79 (2021) 329–340

Table 1
A summary of previous research that used the technology acceptance model and ideas in safety.

Author (year) Topic Research context

(Karsh, 2004) Beyond usability: designing effective technology implementation systems to Patient safety
promote patient safety
(Donmez, Boyle, & Lee, 2008) Associations between trust and perceived usefulness as drivers adapt to safety Transportation safety
systems
(Böhm, Fuchs, Pfliegl, & Kölbl, 2009) Driver behavior and user acceptance of cooperative systems based on infrastructure- Transportation safety
to-vehicle communication
(Yannis, Antoniou, Vardaki, & Kanellaidis, 2010) Older drivers’ perception and acceptance of in-vehicle devices for traffic safety and Transportation safety
traffic efficiency
(Roberts, Ghazizadeh, & Lee, 2012) Warn me now or inform me later: Drivers’ acceptance of real-time and post-drive Transportation safety
distraction mitigation systems
(Soane, Schubert, Lunn, & Pollard, 2015) The relationship between information processing style and information seeking, and Food safety
its moderation by affect and perceived usefulness: Analysis vs. procrastination
(Hu et al., 2016) Modelling antecedents of safety compliance: Incorporating theory from the Mining safety
technological acceptance model
(Vaezipour, Rakotonirainy, Haworth, & Enhancing eco-safe driving behaviour through the use of in-vehicle human–machine Transportation safety
Delhomme, 2017) interface: A qualitative study
(Choi et al., 2017) What drives construction workers’ acceptance of wearable technologies in the Construction safety
workplace?: Indoor localization and wearable health devices for occupational safety
and health
(Liu, Lu, & Niu, 2018) Extended technology-acceptance model to make smart construction systems Construction safety
successful
(Ahn et al., 2019) Wearable Sensing Technology Applications in Construction Safety and Health Construction safety
(Zhang et al., 2020) Predicting unsafe behaviors at nuclear power plants: An integration of Theory of Nuclear safety
Planned Behavior and Technology Acceptance Model
(Wong et al., 2020) Critical factors for the use or non-use of personal protective equipment amongst Construction safety
construction workers

and unsafe. Risk perception-probability and risk perception-
severity are construction worker judgments about the ‘‘probabil-
ity” of experiencing an injury or accident and its ‘‘severity” because
of exposure to hazards, respectively. Risk perception-worry and
unsafe is associated with whether construction workers ‘‘worry”
about and whether they feel ‘‘unsafe” with hazardous scenarios.
Risk perception-probability and risk perception-severity are con-
sidered cognitive risk perception, whereas risk perception–worry
and unsafe is regarded as affective risk perception. In the construc-
tion safety literature, risk perception negatively affects construc-
tion worker risk-taking behavior (Man, Chan, Alabdulkarim, &
Zhang, 2021). In technology acceptance studies, risk perception
has been considered an important factor that positively influences
attitude toward use and intention to use a technology (Huijts,
Molin, & Steg, 2012; Man, Xiong, Chang, & Chan, 2020; Ooi &
Tan, 2016; Schierz, Schilke, & Wirtz, 2010; Yang, Liu, Li, & Yu,
2015). Therefore, risk perception- probability, risk perception-
severity, and risk perception-worry and unsafe may have a positive
effect on attitude toward using PPE and intention to use PPE among
construction workers.
Slovic and Peters (2006) suggested that ‘‘affect;” which is a
‘‘faint whisper of emotion,” guides people to evaluate a risk. Specif-
ically, people who have a negative affect tend to perceive a high
risk. In the construction safety context, the association between
the perceived dread of an accident due to risk-taking behavior
and the cognitive risk perception was confirmed among construc-
tion dumper drivers (Bohm & Harris, 2010). Thus, the following
hypotheses were proposed:
H9: Risk perception – probability positively affects attitude
toward using PPE.
H10: Risk perception – probability positively affects intention
to use PPE.
H11: Risk perception – severity positively affects attitude
toward using PPE.
H12: Risk perception – severity positively affects intention to
use PPE.
H13: Risk perception – worry and unsafe positively affects atti-
tude toward using PPE.
H14: Risk perception – worry and unsafe positively affects
intention to use PPE.
H15: Risk perception – worry and unsafe positively affects risk
perception-probability.
H16: Risk perception – worry and unsafe positively affects risk
perception-severity.

2.3. Safety climate

Safety climate, as initially proposed by Zohar (1980); is the

reflection of workers’ perceptions about the relative importance
of safe conduct in their occupational behaviors. The concept of
safety climate has been used in different research areas, for exam-
ple, healthcare (McLinton, Dollard, & Tuckey, 2018), transportation
safety (Curcuruto, Griffin, Kandola, & Morgan, 2018), and construc-
tion safety (Dale, Colvin, Barrera, Strickland, & Evanoff, 2020;
Newaz, Davis, Jefferies, & Pillay, 2019; Schwatka et al., 2019).
Numerous studies have confirmed the positive correlations
between safety climate and safety behavior and between safety cli-
Fig. 2. Theory of planned behavior proposed by Ajzen (1985). mate and safety performance in the construction industry context
331
Siu Shing Man, S. Alabdulkarim, Alan Hoi Shou Chan et al.
(Seo, Lee, Kim, & Jee, 2015; Shin, Gwak, & Lee, 2015). According to
Hu, Griffin, and Bertuleit (2016), organizational safety support pos-
itively affects the perceived usefulness of risk-awareness proce-
dures among miners. However, no studies have examined the
effect of safety climate on perceived usefulness of PPE among con-
struction workers. Fugas, Silva, and Meliá (2012) also found that
safety climate positively influences workers’ safety attitude in a
transportation company. Pandit, Albert, Patil, and Al-Bayati
(2019) discovered that a positive safety climate can increase con-
struction workers’ risk perception. Therefore; the following
hypotheses were proposed:
H17: Safety climate positively affects perceived usefulness.
H18: Safety climate positively affects attitude toward using PPE.
H19: Safety climate positively affects risk perception-
probability.
H20: Safety climate positively affects risk perception-severity.
H21: Safety climate positively affects risk perception-worry and
unsafe.
2.4. Research model
On the basis of the developed hypotheses, the PAMCW was pro-
posed for explaining construction workers’ use of PPE (Fig. 3). A list
of abbreviations is also provided in the Appendix.
3. Methods
A questionnaire-based approach was adopted in this study for
data collection to quantitatively test the hypotheses developed in
the previous section. The following sections provide the details
related to measurements, participants, and data analysis.
3.1. Measurements
The items in the structured questionnaires were based on pre-
vious studies. Nine subscales were used for measuring each of
Fig. 3. PAMCW to be tested in the current study. PEOU = perceived ease of use; PU = perceived usefulness; ATUP = attitude toward using PPE; SN = subjective norm;
PBC = perceived behavioral control; ITUP = intention to use PPE; RPP = risk perception – probability; RPS = risk perception – severity; RPWU = risk perception – worry and
unsafe; SC = safety climate; and UP = using PPE.
332
Journal of Safety Research 79 (2021) 329–340
the constructs. Perceived ease of use, perceived usefulness, attitude
toward using PPE, intention to use PPE, perceived behavioral con-
trol, subjective norm, and using PPE were measured by four, five,
four, three, three, three, and three items, respectively. These items
were adapted from the study of (Davis et al., 1989) and the recom-
mendations made by Ajzen (2006) to make the items relevant to
this research context. Three dimensions of risk perception (i.e.; risk
perception-probability; risk perception-severity, and risk
perception-worry and unsafe) and safety climate were measured
using the CoWoRP Scale with 13 items (Man et al., 2019) and Lib-
erty Mutual Safety Climate Short Scales with eight items (Huang
et al., 2017), respectively. In the safety climate scale, four items
were used to measure organization-level safety climate and four
items were used to measure group-level safety climate. Table 2
indicates the item details for all the constructs. All constructs other
than risk perception were rated with a five-point Likert scale that
ranged from 1 = ‘‘totally disagree” to 5 = ‘‘totally agree.” This scale
format has been widely used in studies related to the technology
acceptance model, theory of planned behavior, and safety climate.
The CoWoRP Scale format adopted an 11-point phrase completion
scale recommended by Man et al. (2019).
3.2. Participants
A total of 413 Hong Kong construction workers were randomly
selected to participate in this study. The workers were from gov-
ernment construction projects. It is important to weaken possible
response bias. Therefore, before the survey started, the workers
were informed of having the right to quit the survey and that the
collected data would be processed in an anonymous and confiden-
tial way. After the participants completed the questionnaires, the
questionnaires were checked by researchers who were trained
and experienced in conducting questionnaire surveys to ensure
no missing values in the questionnaires. If there were missing val-
ues in questionnaire items, the participants were asked to respond
to the items. They also provided informed consent. Table 3 summa-
rizes the distribution of participants’ age, gender, education level,
 Table 2
Item contents of each construct.
Construct
Perceived ease of use (PEOU)
Perceived usefulness (PU)
Attitude toward using PPE (ATUP)
Intention to use PPE (ITUP)
Subjective norm (SN)
333
Perceived behavioral control (PBC)
Risk perception –probability (RPP)
Risk perception – severity (RPS)
Risk perception –worry and unsafe
(RPWU)
Siu Shing Man, S. Alabdulkarim, Alan Hoi Shou Chan et al.
Item Content Scale format
In daily work, A five-point Likert scale, ranging from 1 = ‘‘totally
PEOU1 the way of using PPE is clear and understandable. disagree” to 5 = ‘‘totally agree”.
PEOU2 using PPE does not require many steps.
PEOU3 it is easy to get PPE to protect yourself.
PEOU4 using PPE is easy.
In daily work, A five-point Likert scale, ranging from 1 = ‘‘totally
PU1 using PPE can protect you from safety hazards. disagree” to 5 = ‘‘totally agree”.
PU2 using PPE can protect you from health hazards.
PU3 using PPE can reduce your probability of getting hurt.
PU4 using PPE can reduce your severity of getting hurt.
PU5 you find PPE to be useful to your safety and health.
In daily work, A five-point Likert scale, ranging from 1 = ‘‘totally
ATUP1 using PPE would be a good idea. disagree” to 5 = ‘‘totally agree”.
ATUP2 using PPE would be a wise idea.
ATUP3* you like the idea of using PPE.
ATUP4* using PPE would be a pleasant experience.
ITUP1 Assuming you have access to PPE, you intend to use it. A five-point Likert scale, ranging from 1 = ‘‘totally
ITUP2 Given that you have access to PPE, you predict that you would use it. disagree” to 5 = ‘‘totally agree”.
ITUP3 If you have access to PPE, you want to use it as much as possible.
SN1 People who are important to you (such as your parents, children, and spouse) would think that you should use PPE A five-point Likert scale, ranging from 1 = ‘‘totally
in daily work. disagree” to 5 = ‘‘totally agree”.
SN2 People who influence you (such as your coworkers or supervisor) would think that you should use PPE in daily
work.
SN3 People who are important to you (such as your parents, children, and spouse) would prefer that you should use PPE
in daily work.
In daily work, A five-point Likert scale, ranging from 1 = ‘‘totally
PBC1 you would be able to use PPE. disagree” to 5 = ‘‘totally agree”.
PBC2 using PPE was entirely within your control.
PBC3 you had the resources, knowledge, and ability to use PPE.
If you experience the following work events or situations, how likely will you be to experience negative An 11-point phrase completion scale ranging from 0
consequences in your perspective? (indicating ‘‘not at all likely” to 10 (indicating
RPP1 Working on a moving route of lifting. ‘‘extremely likely”)
RPP2 Engaging in electrical works (e.g., electric arc welding) in a workplace that is affected by rainy weather.
RPP3 Using electrical equipment with damaged wires.
If you experience the following work events or situations, how severe will the potential negative consequences be An 11-point phrase completion scale ranging from 0
in your perspective? (indicating ‘‘not at all severe” to 10 (indicating
RPS1 Working on an unstable trestle ladder. ‘‘extremely severe”)
RPS2 Working at heights with high winds.
Journal of Safety Research 79 (2021) 329–340
RPS3 Working under suspended materials.
RPS4 Using electrical equipment without insulation and proper earthing of electrical circuitry in a wet workplace.
If you experience the following work events or situations, how worried will you be about the potential negative An 11-point phrase completion scale ranging from 0
consequences? (indicating ‘‘not at all worried” to 10 (indicating
RPWU1 Improperly placing wires on the ground. ‘‘extremely worried”)
RPWU2 Using a phone when working on a construction site.
RPWU3 Not wearing masks when working in a dusty workplace.
If you experience the following work events or situations, how unsafe will you feel regarding the potential negative An 11-point phrase completion scale ranging from 0
consequences? (indicating ‘‘extremely safe” to 10 (indicating
RPWU4 Walking through an improperly paved carpet or mat. ‘‘extremely unsafe”)
RPWU5 Wearing protective gloves of inappropriate size to move heavy objects.
RPWU6 Not wearing a reflective vest when working in a dim workplace.
(continued on next page)
Siu Shing Man, S. Alabdulkarim, Alan Hoi Shou Chan et al. Journal of Safety Research 79 (2021) 329–340

A 5-point Likert scale, ranging from 1 = ‘‘totally disagree” marital status, and work experience in the construction industry.

A 5-point Likert scale, ranging from 1 = ‘‘totally disagree”

81.11% of the participants were over 25 years old. The percentages
of participants who were male and married were 91.77% and
64.41%, respectively. In addition, 92.98% of participants obtained
primary school education or higher. Most of the participants
worked in the construction industry for at least one year (92.01%).

3.3. Data analysis

The PAMCW (Fig. 3) was assessed using structural equation

modeling (SEM). A two-step procedure was followed for SEM
to 5 = ‘‘totally agree”.

to 5 = ‘‘totally agree”.
(Anderson & Gerbing, 1988). In the first step, confirmatory factor
analysis was used to evaluate the measurement model for examin-
ing reliability and construct validity (including discriminant valid-
Scale format

ity and convergent validity). In the second step, SEM was

conducted to evaluate the structural model (i.e., the PAMCW)
and estimate the structural relationships among constructs for
testing developed hypotheses. SPSS 21 and AMOS 21 were used
to analyze the data.

4. Results

4.1. Measurement model assessment

frequently makes sure workers follow all the safety rules (not just the most important ones).

Testing nested measurement models was conducted to demon-

strate construct validity. Model fit indices, namely, the ratio of chi-
frequently requires each manager to help improve safety in his or her department.

square to its degree of freedom (v2/df), root mean square error of

frequently uses explanations (not just compliance) to get workers to act safely.

approximation (RMSEA), standardized root mean squared residual

frequently uses any available information to improve existing safety rules.

(SRMR), Tucker-Lewis index (TLI), and comparative fit index (CFI),

were used to assess the measurement models (Kline, 2015). The
frequently provides workers with a lot of information on safety issues.

criteria of the model fit indices included v2/df < 5, TLI  0.9,
frequently reminds workers who need reminders to work safely.

CFI  0.9, SRMR < 0. 08 and RMSEA < 0.08 (Byrne, 2013). For Model
tries to continually improve safety levels in each department.

1, all items were included. The results of Model 1 showed that the
frequently discusses how to improve safety with workers.

When working above ground, you always wear seat belts.

factor loading of the items ATUP3 and ATUP4 was 0.507 and 0.674,
respectively. Because of the factor loading smaller than 0.7, the
In daily work, you always wear a pair of safety shoes.

items were removed to form Model 2. The results of the Model 2

In daily work, you always wear a safety helmet.

showed that the correlation between group-level safety climate

and organization-level safety climate was 0.850. Because group-
level safety climate and organization-level safety climate were
related to safety climate, it was reasonable to combine them as
Top management at this company:

one-factor safety climate to form Model 3. Table 4 shows that all

Organization-level safety climate

Note: An asterisk means the item was excluded due to factor loading less than 0.7.

the model fit index values of all the three models achieved the rec-
ommended requirements and reflected acceptable construct valid-
Group-level safety climate

ity. However, only Model 3 was considered the final measurement

Your direct supervisor:

model to represent the data and for conducting SEM.

Cronbach’s alpha (Cronbach, 1951), the measurement of the
internal consistency reliability of a scale, was used with a criterion
level of 0.7 (Hair, Black, Babin, & Anderson, 2010). The results
Content

showed that all the constructs had values of Cronbach’s alpha

between 0.849 and 0.963 (Table 5), which were larger than the cri-
terion level. This finding means that the measurement had accept-
able internal consistency reliability. Convergent validity is defined
Item

UP1
UP2
UP3
SC1
SC2
SC3
SC4

SC5
SC6
SC7
SC8

as the assessment of whether the same construct’s multiple indica-

tors are in agreement, whereas discriminant validity means the
extent to which the constructs differ from one another empirically
(Ab Hamid, Sami, & Sidek, 2017). Fornell and Larcker (1981) rec-
ommended that the composite reliability (CR) value for each con-
struct and factor loading values of items should exceed 0.7 for
verifying convergent validity. Moreover, each construct should
Safety climate (SC)

have a value of average variance extracted (AVE) larger than 0.5.

Table 2 (continued)

Using PPE (UP)

Table 5 showed that all the criteria were satisfied, suggesting

acceptable convergent validity of the measurement. The technique
Construct

suggested by Fornell and Larcker (1981) was used for verifying the
measurement’s discriminant validity. This technique is the com-
parison of the square roots of the AVE of constructs and the corre-
334
Siu Shing Man, S. Alabdulkarim, Alan Hoi Shou Chan et al. Journal of Safety Research 79 (2021) 329–340

Table 3 tion to use PPE positively influences using PPE. Risk perception-
Participants’ demographic information (n = 413). severity positively influences attitude toward using PPE. Risk
Description Frequency Percentage perception-worry and unsafe has significant positive influences
(%) on intention to use PPE, risk perception-probability, and risk
Age (years) 18–25 23 5.57 perception-severity. Safety climate has significant positive influ-
26–35 86 20.82 ences on perceived usefulness, attitude toward using PPE, and risk
36–45 82 19.85 perception-worry and unsafe. These results are presented in Fig. 4.
46–55 99 23.97
56–65 61 14.78
In addition, the PAMCW can explain 78.0% and 31.9% of the vari-
>65 7 1.69 ance in intention to use PPE and using PPE, respectively.
Unspecified 55 13.32
Gender Male 379 91.77 5. Discussion
Female 30 7.26
Unspecified 4 0.97
Construction workers’ non use of PPE at work may place them-
Education level No formal 18 4.36 selves and others at risk. Thus, understanding the factors that influ-
education
ence their acceptance of PPE is necessary. Accordingly, this study
Primary school 102 24.70
Lower 137 33.17 proposed the PAMCW, which integrates the technology acceptance
secondary model, theory of planned behavior, risk perception, and safety cli-
Higher 101 24.46 mate to explain the construction worker acceptance of PPE. In
secondary accordance with the collected data from 413 construction workers,
Post-secondary 44 10.65
Unspecified 11 2.66
the utility of the PAMCW for explaining construction worker
acceptance of PPE was assessed. The study results have significant
Marital status Unmarried 111 26.88
Married 266 64.41
theoretical and practical contributions.
Divorced/ 9 2.18
separated/ 5.1. Theoretical contributions
widowed
Unspecified 27 6.53
This study provides several theoretical contributions to the rel-
Work experience (years) in <1 9 2.18 evant literature. First, the applicability of the technology accep-
the construction industry 1–5 105 25.42
6–10 103 24.94
tance model and theory of planned behavior to the explanation
11–20 108 26.15 of construction worker PPE acceptance is supported. Concerning
21–30 51 12.35 the part of the technology acceptance model, the positive effects
>30 13 3.15 of perceived usefulness and perceived ease of use on attitude
Unspecified 24 5.81
toward using PPE are significant. Intention to use PPE is positively
Note: Unspecified means participants did not provide clear or explicit responses. affected by attitude toward using PPE and then positively influ-
ences using PPE. These results are consistent with the postulations
of the technology acceptance model (Davis et al., 1989). In other
lations among the constructs. The measurement can be confirmed words, construction workers who have high levels of perceived
to have acceptable discriminant validity if the square roots of the usefulness and perceived ease of use on PPE tend to have a favor-
AVE values are larger than the correlations among constructs. able attitude toward using PPE. Thus, they are more likely to use
Results showed that the correlations among constructs were smal- PPE. These results also provide supportive evidence for the qualita-
ler than all square roots of the AVE of constructs (Table 6), suggest- tive findings of (Wong et al., 2020); who reported that perceived
ing the measurement had acceptable discriminant validity. usefulness and perceived ease of use are important factors in con-
struction worker’s use of PPE. For the part of the theory of planned
4.2. Structural model assessment behavior, intention to use PPE is positively affected by attitude
toward using PPE, subjective norm, and perceived behavioral con-
The PAMCW was investigated using SEM. v2/df, RMSEA, SRMR, trol. This result is in line with the theory of planned behavior
TLI, and CFI were used to evaluate the PAMCW. The model fit index (Ajzen, 1991), where attitude toward a certain behavior, subjective
values satisfied the suggested requirements (Table 7). This finding norm, and perceived behavioral control are the important drivers
implies that the PAMCW can sufficiently represent the hypothe- of people’s intention to the behavior. Among the three drivers, per-
sized relationships. The results showed that 14 hypotheses were ceived behavioral control has the strongest influence on the accep-
statistically supported (Table 8). Perceived ease of use positively tance of PPE of construction workers, followed by attitude toward
influences perceived usefulness and attitude toward using PPE. using PPE and subjective norm. Similar findings are found in other
Perceived usefulness positively influences attitude toward using technology acceptance studies, such as online games (Lee & Tsai,
PPE. Attitude toward using PPE, subjective norm, and perceived 2010), Facebook (Al-Debei, Al-Lozi, & Papazafeiropoulou, 2013),
behavioral control positively influence intention to use PPE. Inten- and mobile healthcare (Wu, Li, & Fu, 2011). Choi, Ahn, and Lee

Table 4
Measurement model assessment results.

Nested models v2 v2/df TLI CFI RMSEA SRMR

(p-value) (p-value)
Model 1: All items 2291.614 2.483 0.906 0.916 0.06 0.045
(<0.001) (<0.001)
Model 2: Items ATUP3 and ATUP4 removed 1,865,557 2.232 0.926 0.934 0.055 0.038
(<0.001) (0.011)
Model 3: One-factor Safety climate 2068.411 2.442 0.913 0.922 0.059 0.042
(<0.001) (<0.001)

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Table 5
Reliability and convergent validity assessment results.

Construct Item Mean SD Factor loading AVE CR Cronbach’s alpha

Perceived ease of use (PEOU) PEOU1 4.082 0.802 0.787 0.588 0.851 0.849
PEOU2 3.910 0.886 0.722
PEOU3 4.138 0.784 0.735
PEOU4 4.114 0.812 0.820
Perceived usefulness (PU) PU1 4.206 0.769 0.834 0.646 0.901 0.901
PU2 4.094 0.806 0.745
PU3 4.249 0.778 0.799
PU4 4.245 0.779 0.812
PU5 4.160 0.800 0.827
Attitude toward using PPE (ATUP) ATUP1 4.061 0.800 0.886 0.778 0.875 0.875
ATUP2 4.053 0.787 0.878
Subjective norm (SN) SN1 4.179 0.799 0.854 0.673 0.860 0.859
SN 2 4.092 0.819 0.761
SN 3 4.245 0.767 0.843
Perceived behavioral control (PBC) PBC1 4.201 0.751 0.842 0.678 0.863 0.862
PBC2 4.111 0.742 0.831
PBC3 4.157 0.777 0.797
Intention to use PPE (ITUP) ITUP1 4.077 0.791 0.835 0.711 0.881 0.880
ITUP2 3.998 0.814 0.866
ITUP3 4.024 0.830 0.829
Risk perception –probability (RPP) RPP1 7.303 2.666 0.824 0.847 0.943 0.941
RPP2 7.080 2.982 0.984
RPP3 7.123 3.025 0.946
Risk perception – severity (RPS) RPS1 7.525 2.517 0.924 0.866 0.963 0.963
RPS2 7.695 2.460 0.946
RPS3 7.775 2.480 0.935
RPS4 7.804 2.490 0.918
Risk perception –worry and unsafe (RPWU) RPWU1 7.378 2.073 0.870 0.689 0.930 0.930
RPWU2 6.956 2.219 0.809
RPWU3 7.521 2.073 0.854
RPWU4 7.107 2.100 0.780
RPWU5 7.109 2.042 0.840
RPWU6 7.685 2.059 0.826
Safety climate (SC) SC1 4.065 0.823 0.826 0.643 0.935 0.934
SC2 4.010 0.824 0.837
SC3 3.995 0.845 0.777
SC4 4.048 0.781 0.783
SC5 4.041 0.831 0.818
SC6 3.998 0.899 0.755
SC7 4.167 0.803 0.788
SC8 4.080 0.810 0.829
Using PPE (UP) UP1 4.058 0.933 0.896 0.670 0.858 0.851
UP2 4.133 0.864 0.829
UP3 4.230 0.899 0.722

Table 6
Correlations among constructs.

PEOU PU ATUP SN PBC ITUP RPP RPS RPWU SC UP

PEOU 0.767
PU 0.761*** 0.804
ATUP 0.682*** 0.776*** 0.882
SN 0.575*** 0.651*** 0.720*** 0.820
PBC 0.765*** 0.747*** 0.751*** 0.764*** 0.824
ITUP 0.682*** 0.637*** 0.752*** 0.744*** 0.823*** 0.843
RPP 0.091 0.115* 0.084 0.044 0.044 0.143** 0.921
RPS 0.202*** 0.245*** 0.272*** 0.279*** 0.235*** 0.303*** 0.538* 0.931
RPWU 0.445*** 0.357*** 0.386*** 0.432*** 0.464*** 0.493*** 0.303* 0.630*** 0.830
SC 0.679*** 0.688*** 0.711*** 0.701*** 0.760*** 0.700*** 0.143** 0.242*** 0.394*** 0.843
UP 0.618*** 0.508*** 0.477*** 0.468*** 0.605*** 0.522*** 0.049 0.115* 0.328*** 0.565*** 0.819

Note: The diagonal values are square roots of AVE; the off-diagonal values are correlations; PEOU = perceived ease of use; PU = perceived usefulness; ATUP = attitude toward
using PPE; SN = subjective norm; PBC = perceived behavioral control; ITUP = intention to use PPE; RPP = risk perception – probability; RPS = risk perception – severity;
RPWU = risk perception – worry and unsafe; SC = safety climate; UP = using PPE.
*
p < 0.05.
**
p < 0.01.
***
p < 0.001.

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Table 7
Structural model assessment results.

Model fit index Value Recommended value Result Reference

v (p-value)
2
2326.513 (<0.001) Not available (Byrne, 2013)
v2/df 2.659 <5 Acceptable
CFI 0.908 0.9 Acceptable
TLI 0.900 0.9 Acceptable
SMRM 0.068 <0.08 Acceptable
RMSEA (p-value) 0.063 (<0.001) <0.08 Acceptable

Table 8
Hypothesis testing results.

Hypothesis Standardized path coefficient p-value Result

H1: Perceived ease of use positively affects perceived usefulness. 0.565 <0.001 Supported
H2: Perceived ease of use positively affects attitude toward using PPE. 0.144 0.047 Supported
H3: Perceived usefulness positively affects attitude toward using PPE. 0.431 <0.001 Supported
H4: Perceived usefulness positively affects intention to use PPE. 0.127 0.056 Not supported
H5: Attitude toward using PPE positively affects intention to use PPE. 0.318 <0.001 Supported
H6: Subjective norm positively affects intention to use PPE. 0.170 0.007 Supported
H7: Perceived behavioral control positively affects intention to use PPE. 0.542 <0.001 Supported
H8: Intention to use PPE positively affects using PPE. 0.565 <0.001 Supported
H9: Risk perception – probability positively affects attitude toward using PPE. 0.070 0.060 Not supported
H10: Risk perception – probability positively affects intention to use PPE. 0.066 0.056 Not supported
H11: Risk perception – severity positively affects attitude toward using PPE. 0.100 0.036 Supported
H12: Risk perception – severity positively affects intention to use PPE. 0.040 0.366 Not supported
H13: Risk perception – worry and unsafe positively affects attitude toward using PPE. <0.001 0.980 Not supported
H14: Risk perception – worry and unsafe positively affects intention to use PPE. 0.127 0.009 Supported
H15: Risk perception – worry and unsafe positively affects risk perception – probability. 0.331 <0.001 Supported
H16: Risk perception – worry and unsafe positively affects risk perception – severity. 0.649 <0.001 Supported
H17: Safety climate positively affects perceived usefulness. 0.310 <0.001 Supported
H18: Safety climate positively affects attitude toward using PPE. 0.312 <0.001 Supported
H19: Safety climate positively affects risk perception – probability. 0.002 0.973 Not supported
H20: Safety climate positively affects risk perception – severity. 0.017 0.717 Not supported
H21: Safety climate positively affects risk perception – worry and unsafe. 0.416 <0.001 Supported

(2016) previously examined the role of social norms; including
perceived management norm and perceived workgroup norm, in
construction worker safety behavior. They found that workers’
safety behavior is affected by perceived management norm and
perceived workgroup norm. Although the present study realized
the importance of subjective norm in construction worker accep-
tance of PPE, investigating the influence of perceived management
norm and perceived workgroup norm on construction worker
acceptance of PPE is still of interest in future studies.
Fig. 4. PAMCW assessment results where the values are standardized path
coefficients (dotted lines indicate non-significance, whereas solid lines indicate
significance). PEOU = perceived ease of use; PU = perceived usefulness; ATUP = at-
titude toward using PPE; SN = subjective norm; PBC = perceived behavioral control;
ITUP = intention to use PPE; RPP = risk perception – probability; RPS = risk percep-
tion – severity; RPWU = risk perception – worry and unsafe; SC = safety climate;
and UP = using PPE.
Second, aside from the combination of the technology accep-
tance model and theory of planned behavior, three dimensions of
risk perception (i.e., risk perception-probability, risk perception-
severity, and risk perception-worry and unsafe) were considered
in the PAMCW to explain construction worker acceptance of PPE.
Previous studies on the role of risk perception in people’s technol-
ogy acceptance failed to consider the dimensions of risk percep-
tion. For example, (Wang, Wang, Wang, Wei, & Wang, 2018)
found that risk perception is an important factor in shaping con-
sumers’ intention to use ride-sharing services. However; they did
not take the dimensions of risk perception into account. One pos-
sible reason is the absence of psychometrically sound measure-
ments for assessing different dimensions of risk perception. In
the present study, the three dimensions of risk perception were
considered because of the valuable contribution made by Man
et al. (2019) in developing a reliable and valid scale for quantifying
construction worker risk perception. This study shows that risk
perception-severity and risk perception-worry and unsafe are sig-
nificant factors; whereas risk perception-probability is an insignif-
icant factor in explaining construction worker acceptance of PPE.
Risk perception-severity and risk perception-worry and unsafe
have a positive effect on attitude toward using PPE and intention
to use PPE, respectively. The insignificance of risk perception-
probability may be attributable to construction workers’ percep-
tion that construction accidents are less likely to happen to them
than to average workers (Caponecchia & Sheils, 2011). Among
the three dimensions of risk perception, construction workers’
intention to use PPE is merely affected by risk perception– worry
and unsafe. Construction workers who hold a high level of risk
perception-worry and unsafe tend to use PPE, demonstrating the
crucial role of affective risk perception in construction workers’
behavioral decision making. This finding is in line with the study

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Siu Shing Man, S. Alabdulkarim, Alan Hoi Shou Chan et al.
of (Man et al., 2021). They affirmed risk perception-worry and
unsafe negatively influences construction worker risk-taking
behavior. However; this finding is unlikely in the cases of risk
perception-probability and risk perception- severity.
Third, safety climate was included in the PAMCW. Safety cli-
mate positively affects perceived usefulness. This result is in line
with the finding of (Hu et al., 2016). They reported that organiza-
tional safety support positively influences perceived usefulness of
the risk-awareness procedure among miners. Moreover; safety cli-
mate positively affects attitude toward using PPE and risk
perception- worry and unsafe. These findings suggest that, with
good safety climate, construction workers tend to have a high level
of perceived usefulness, attitude toward using PPE, and risk
perception-worry and unsafe. Although (Pandit et al., 2019) found
that safety climate can increase risk perception-probability and
risk perception-severity of the U.S. construction workers; this
study found that safety climate positively influences risk
perception-worry and unsafe but not risk perception-probability
and risk perception-severity. The possible reason for this different
conclusion may be cultural differences and the different measure-
ments for quantifying risk perception and safety climate. It is inter-
esting to replicate this study in the U.S. construction industry to
verify the findings of this study. The importance of safety climate
in construction workers’ use of PPE was confirmed in this study.
In addition, this study was the first and successfully contributed
the theoretical knowledge to the safety climate literature in the
context of construction workers’ PPE acceptance.
5.2. Practical contributions
In accordance with the present study’s findings, several practi-
cal recommendations are suggested to encourage construction
workers to use PPE and potentially decrease construction acci-
dents. First, for the technological aspect, the results show that per-
ceived ease of use and perceived usefulness are antecedents in
driving using PPE through the mediator of attitude toward using
PPE. Thus, both antecedents are important in overcoming the
impediment of construction workers using PPE. The PPE designers
should be aware of the importance of the usefulness and ease of
use in developing new PPE for construction workers. PPE setup,
daily usage, and maintenance should be intuitive with clear
instructions. Before designing PPE, the needs of construction work-
ers should be thoroughly examined, which is beneficial to increase
the PPE usefulness and ease of use. Second, from an organizational
perspective, because of the positive influence of safety climate on
perceived usefulness, attitude toward using PPE, and risk
perception-worry and unsafe, construction companies should
improve their safety climate by organizing safety weeks in which
different activities can be conducted (e.g., safety conferences, site
visits, and safety video competitions). Concerned authorities can
hold construction safety promotional campaigns to enhance safety
climate. With good safety climate, construction workers can have a
high level of perceived usefulness, attitude toward using PPE, and
risk perception-worry and unsafe, which positively affect intention
to use PPE. Lastly, from an individual perspective, this study shows
that risk perception-worry and unsafe and perceived behavioral
control positively influence intention to use PPE. Construction
practitioners can provide safety training to strengthen construc-
tion workers’ risk perception (Namian, Albert, Zuluaga, & Behm,
2016). Virtual reality (VR) technology is suggested in safety train-
ing because it can present perceptual cues that activate the emo-
tions of construction workers (Diemer, Alpers, Peperkorn, Shiban,
& Mühlberger, 2015) and enhance safety self-efficacy (Nykänen
et al., 2020). The use of VR technology in safety training can
demonstrate the alarming consequences of not using PPE, which
338
Journal of Safety Research 79 (2021) 329–340
are useful in the enhancement of risk perception-worry and unsafe
of construction workers. Moreover, construction workers can be
equipped with more PPE knowledge in safety training. Accordingly,
their perceived behavioral control on using PPE can be increased.
The use of PPE among construction workers is expected to increase
with a high level of risk perception-worry and unsafe and per-
ceived behavioral control.
5.3. Limitations and future research opportunities
Despite the valuable contributions of this study in terms of the-
ory and practice, some limitations were realized. First, the data col-
lection of this study was conducted using a cross-sectional survey.
Thus, longitudinal studies on construction workers’ acceptance of
PPE should be conducted to generate a comprehensive insight into
the use of PPE among construction workers in the future. A longi-
tudinal approach can be used to obtain evidence about how factors
affect the construction worker acceptance of PPE over time. Sec-
ond, this study did not collect multisource or temporally separated
data on actual PPE usage of construction workers. The data may
provide further insights into the use of PPE among construction
workers. This limitation should be addressed in the future. Third,
this study considered only the general safety climate in explaining
the construction worker acceptance of PPE. The influence of differ-
ent dimensions of safety climate, such as coworkers’ interaction,
workers’ involvement in safety, and safety environment (Li, Ji,
Yuan, & Han, 2017) was not addressed in this study; this research
gap can be investigated in future studies. Fourth, data collection
was conducted in Hong Kong. Thus, cultural differences may lead
to non-generalizable results in other regions. The replication of this
study should be made in various regions to examine the general-
ization of the findings. Lastly, the PAMCW can account for 78.0%
and 31.9% of the variance in intention to use PPE and using PPE,
respectively. This finding implies that other critical factors, such
as safety motivation and personalities, should be considered in
the PAMCW. This study also did not include external variables that
influence perceived usefulness and perceived ease of use in the
PAMCW due to the limited length of the questionnaire. If the
length of a questionnaire is excessively long, then construction
workers may be reluctant to participate in a study; this gap pro-
vides future research opportunities to further investigate construc-
tion workers’ acceptance of PPE by including external variables,
such as self-satisfaction and facilitating conditions.
6. Conclusion
The phenomenon that construction workers do not use PPE is a
main cause of construction accidents. However, little knowledge
about the acceptance of PPE among construction workers was
available in the construction safety literature. Therefore, this study
represented the first formal attempt to empirically examine the
construction worker acceptance of PPE by incorporating the tech-
nology acceptance model and theory of planned behavior with
safety climate and risk perception. The results support the applica-
bility of the technology acceptance model and theory of planned
behavior in understanding the construction worker acceptance of
PPE. This study also emphasized the importance of safety climate
and risk perception in determining attitude toward using PPE
and intention to use PPE. Given the findings of this study, construc-
tion practitioners, concerned authorities, and PPE designers can be
in a good position to design useful safety interventions, safety poli-
cies, and user-friendly PPE for promoting the use of PPE among
construction workers and potentially prevent construction
accidents.
Siu Shing Man, S. Alabdulkarim, Alan Hoi Shou Chan et al. Journal of Safety Research 79 (2021) 329–340

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Siu Shing Man obtained his B.Sc. in Industrial Engineering and Engineering Man-
agement from the City University of Hong Kong. He was then obtained his Ph.D.
from the same university. His research focus is construction safety, in particular,
risk perception and risk-taking behavior of construction workers.
Saad Alabdulkarim obtained his B.Sc. in Industrial Engineering from the King Saud
University in 2011. He was then awarded his M.Sc. and Ph.D. in Industrial and
Systems Engineering (human factors focus) from Virginia Tech in 2015 and 2017,
respectively.
Alan Hoi Shou Chan obtained his B.Sc. in Industrial Engineering from the Univer-
sity of Hong Kong in 1982. He was then awarded his MPhil and Ph.D. in human
factors studies from the same university in 1986 and 1995, respectively. He has a
wide range of research interests in work safety, work design, cognitive ergonomics,
and compatibility.
Tingru Zhang is an associate professor at the Institute of Human Factors and
Ergonomics, College of Mechatronics and Control Engineering, Shenzhen University,
Shenzhen, China. She received her bachelor’s degree in engineering from the
Shandong University in 2010, a master’s degree from the Tsinghua University in
2012, and Ph.D. from the City University of Hong Kong in 2015. From 2015 to 2017,
she worked as a postdoctoral researcher in the Human Factors Laboratory of
Massachusetts State University, USA. In September 2017, she joined the Institute of
Human Factors and Ergonomics, College of Mechatronics and Control Engineering,
Shenzhen University, Shenzhen, China. She mainly engaged in the research of
driving safety behavior, driver’s attention distribution, and human-computer
interaction in autonomous driving. She published more than 30 academic papers
including SCI in high-level journals at home and abroad and served as a reviewer for
Accident Analysis and Prevention, Safety Science, Transportation Research Part F
and other international journals and conferences.