Hearing protection use in manufacturing workers: a qualitative study

Occupational noise is a significant contributor to disabling hearing loss worldwide. Noise-induced hearing loss (NIHL) has resulted in huge human and economic consequences costing New Zealand approximately $53M annually and rising. A high proportion of hearing loss claims are made by workers in the manufacturing sector. Hearing protection devices (HPDs) are used together with engineering and administrative controls to minimize noise exposure and to prevent hearing loss. Unfortunately, inconsistent and improper use of HPDs has hindered efforts to prevent NIHL. The purpose of this study was to understand the factors that influence the use of HPDs amongst a group of manufacturing workers in New Zealand. A purposive sample of twenty-five workers was recruited to take part in semi-structured interviews. The open-ended questions were aimed at exploring the participants' knowledge, attitude, beliefs, and behavior towards noise and HPDs. The data were analyzed using conventional content analysis and key themes emerged in relation to HPD use. Themes that emerged from the interviews either supported good hearing protection behavior or acted as barriers against it. Five major themes, (perception of noise, hearing preservation, reluctance to use HPDs, workplace interaction, and value of hearing) and sub-themes described various factors that influence hearing protection use. Both personal and environmental factors influence the use of HPDs. Based on this study, personal and environmental factors need to be targeted for further research using ecological models to develop interventions that promote HPD use amongst workers.     

Development and pilot test of hearing conservation training for construction workers

BACKGROUND: Hearing conservation efforts in construction frequently rely on use of hearing protection devices (HPDs): however, training on HPDs is often not provided, and usage rates remain low. In this study, a hearing conservation training program was developed and pilot tested. METHODS: A theoretical model was selected as the basis for the program, and program contents and delivery methods were selected to optimize the effectiveness and flexibility of the training. Two evaluation measures were selected to assess training-related changes in self-reported HPD use. The first was a validated method using concurrent work-shift noise dosimetry, and the second was a survey concerning workers beliefs and attitudes towards HPDs and HPD use. RESULTS: The training program was pilot tested on a single construction site. Complete assessment data were available for 23 workers. The percent of time when hearing protection was used during noise levels above 85 dBA nearly doubled post-training, and the change was statistically significant. CONCLUSIONS: Pre- and post-training data from participating workers demonstrated that HPD use can be increased significantly with basic model-based training, even in industries with complex noise exposures such as construction.     

Hearing loss among operating engineers in American construction industry

Objective: Occupational noise exposure and noise-induced hearing loss (NIHL) among construction workers has long been recognized as a problem in the United States, yet little is known about the prevalence of NIHL among American construction workers. The purpose of this study was to determine the prevalence and characteristics of hearing loss among operating engineers (OEs) who operate heavy construction machinery. Method: As a part of hearing protection intervention, an audiometric test was conducted for both ears at frequencies 0.5 through 8 kHz in the soundproof booth. Prior to the audiometric test, a paper-pencil pre-hearing test questionnaire was administered and an otoscopic examination was completed. Prevalence of hearing loss was determined based on hearing threshold levels (HTLs) in the worst ear with a low fence of 25 dB. Result: A total of 623 workers were included in the analysis and they were predominantly middle-aged Caucasian males (mean age = 43 years, Caucasian = 90%, male = 92%). Over 60% of OEs showed hearing loss in the noise-sensitive higher frequencies of 4 and 6 kHz. The rate of hearing loss was particularly higher among workers who reported longer years of working in the construction industry. Workers showed significantly poorer hearing in the left ear, and a typical characteristic of NIHL, a V-notch at 4 or 6 kHz, was not shown in this population. Thirty-eight percent reported ringing/buzzing in the ear and 62% indicated having problems in understanding what people say in loud noise. Average reported use of hearing protection devices (HPDs) was 48% of the time they were required to be used. Significant inverse relationship was found between higher frequency (4–6 kHz) hearing loss and use of HPDs (r =–0.134, p < 0.001). Workers using HPDs more had significantly better hearing than those who did not. Conclusion: The study demonstrated a significant NIHL problem and low use of HPDs in OEs. An effective hearing conservation program, including a periodic audiometric testing and hearing protection intervention, for this study population should be in place.     

Evaluating the effect of training along with fit testing on earmuff users in a Chinese textile factory

A hearing protection fit testing was conducted on workers (n = 189) in a textile factory in southern China. The 3M E-A-Rfit Dual-Ear Validation System was used to measure the personal attenuation rating (PAR) on an over-the-head style earmuff at the work site. In addition, PARs were obtained several times throughout the same work shift to capture different fits on 39 workers. Follow-up visits were conducted in approximate 6-month or 12-month intervals to repeat the fit testing. Both the immediate and residual effects of training on the field attenuation of hearing protection devices obtained by workers, and the effects of training toward improving the attenuation and protection of earmuffs after a period of daily use, were observed. A questionnaire survey was used to assess the awareness of hearing health and motivation toward the use of earmuffs in a high temperature environment. The results showed that there were wide variations in PARs among the workers tested. The one-on-one training together with fit testing improved PAR and helped to reduce the negative impact caused by use of protective hair covers. Since earmuffs are often used for long periods of time (>1 year), repeating fit tests could be helpful in order to verify the attenuation received throughout their useful life.     

The effectiveness of hearing protection among construction workers

Effective hearing conservation programs in the construction industry are rare. Where programs are present, they often rely on workers' use of hearing protection devices (HPDs) rather than on exposure controls to reduce noise exposure levels. Dependence on HPDs for protection from high noise is problematic, as the protection provided by the HPD depends on both the HPD's attenuation level and the time the HPD is used. This article presents an analysis of data on noise exposure and hearing protection among construction workers drawn from several large datasets covering nine construction trades. A unique combination of 1-min dosimetry noise exposure levels and simultaneous self-reported use of HPDs was evaluated, as were occupational and nonoccupational HPD use data collected by questionnaire as part of a longitudinal study of noise exposure and hearing loss among apprentices. Direct measurements of HPD attenuation were also made on workers at their work site. The workers assessed in this study were found to use hearing protection less than one-quarter of the time that they were exposed above 85 dBA. Workers who reported always using HPDs in high noise on questionnaires were found to wear them only one-third of the time their exposures exceeded 85 dBA. Workers' self-reported use of HPDs during most noisy nonoccupational activities was also found to be low. Direct attenuation measurements found that workers were able to achieve more than 50% of the rated attenuation of their HPD on average, but that the variability in achieved attenuation was large. When the measured HPD attenuation levels and use time data were combined, the effective protection afforded by HPDs was less than 3 dB, a negligible amount given the high exposure levels associated with construction work. However, there was substantial variation in effective protection among the different trades assessed. These results demonstrate the need for better hearing conservation programs and expanded noise control efforts in the construction industry.     

Assessment of Personal Protective Equipment Use Among Farmers in Eastern North Carolina: A Cross-sectional Study

ABSTRACT

Agriculture consistently ranks among the top hazardous occupations, accounting for a significant number of injuries and fatalities in the workplace. Eastern North Carolina has a significant number of small, independent, family-run, owned, and operated farms. However, little is known about perception, behavior, training, accessibility, or purchasing personal protective equipment (PPE) for safety among farmers in the region. In this study, telephone interviews were conducted among participating farmers between March and June 2012 (N = 129). Univariate and bivariate analyses were conducted to examine associations between PPE behavior and workplace hazards, health-related concerns, and wearing and purchasing PPE. Findings indicated that personal behavior of wearing hearing protection devices (HPDs) and protection from the sun among farmers was low. However, a relatively high percentage of farmers reported wearing PPE when working with agricultural chemicals. Most farmers received training from agricultural extension offices. The findings indicate that, in general, farmers are well aware of the risks associated with occupational hazards and recognize concern for health and safety protection in the workplace. Transitioning these concerns into preventative action remains a challenge and priority for the agricultural health professional.     

Applying the health promotion model to development of a worksite intervention.

INTRODUCTION: Consistent use of hearing protection devices (HPDs) decreases noise-induced hearing loss, however, many workers do not use them consistently. Past research has supported the need to use a conceptual framework to understand behaviors and guide intervention programs; however, few reports have specified a process to translate a conceptual model into an intervention. PURPOSE: The strongest predictors from the Health Promotion Model were used to design a training program to increase HPD use among construction workers. SUBJECTS/SETTING: Carpenters (n = 118), operating engineers (n = 109), and plumber/pipefitters (n = 129) in the Midwest were recruited to participate in the study. DESIGN: Written questionnaires including scales measuring the components of the Health Promotion Model were completed in classroom settings at worker trade group meetings. MEASURES: All items from scales predicting HPD use were reviewed to determine the basis for the content of a program to promote the use of HPDs. Three selection criteria were developed: (1) correlation with use of hearing protection (at least .20), (2) amenability to change, and (3) room for improvement (mean score not at ceiling). RESULTS: Linear regression and Pearson's correlation were used to assess the components of the model as predictors of HPD use. Five predictors had statistically significant regression coefficients: perceived noise exposure, self-efficacy, value of use, barriers to use, and modeling of use of hearing protection. Using items meeting the selection criteria, a 20-minute videotape with written handouts was developed as the core of an intervention. A clearly defined practice session was also incorporated in the training intervention. CONCLUSION: Determining salient factors for worker populations and specific protective equipment prior to designing an intervention is essential. These predictors provided the basis for a training program that addressed the specific needs of construction workers. Results of tests of the effectiveness of the program will be available in the near future.     

Noise exposures aboard catcher/processor fishing vessels

BACKGROUND: Commercial fishing workers have extended work shifts and potential for 24 hr exposures to high noise. However, exposures in this industry have not been adequately characterized. METHODS: Noise exposures aboard two catcher/processors (C/P) were assessed using dosimetry, sound-level mapping, and self-reported activities and hearing protection device (HPD) use. These data were combined to estimate work shift, non-work, and 24 hr overall exposure levels using several metrics. The length of time during which HPDs were worn was also used to calculate the effective protection received by crew members. RESULTS: Nearly all workers had work shift and 24 hr noise levels that exceeded the relevant limits. After HPD use was accounted for, half of the 24 hr exposures remained above relevant limits. Non-work-shift noise contributed nothing to 24 hr exposure levels. HPDs reduced the average exposure by about 10 dBA, but not all workers wore them consistently. CONCLUSIONS: The primary risk of hearing loss aboard the monitored vessels comes from work shift noise. Smaller vessels or vessels with different layouts may present more risk of hearing damage from non-work periods. Additional efforts are needed to increase use of HPDs or implement noise controls.     

Fit-testing hearing protectors: an idea whose time has come

The performance of hearing protection devices (HPD) worn by individual workers in specific noise-exposure environments has been difficult to assess using the hearing protector ratings printed on HPD packages. Because the role of the HPD in prevention of hearing loss remains as a vital last line of defense against the effects of noise exposure, proper assessment of their performance is increasingly critical. HPD fit-testing procedures now allow the individual fit-testing of HPD to assist in appropriate selection of HPD for individual workers, to aid in training workers on proper use of HPDs, and a range of other applications. Understanding these technologies, their strengths and weaknesses, and appropriate application of the results of fit-testing may enable employers to make improvements in their hearing loss prevention program performance.     

Variability of real-world hearing protector attenuation measurements

The attenuation provided by a hearing protection device (HPD) in the field is usually estimated by applying a derating factor to the laboratory-determined noise reduction rating (NRR) of the HPD. However, attenuation is highly dependent on individual-specific HPD fit. Prediction of an individual's attenuation depends on the accuracy of the measurement system and the variability of attenuation over time (e.g. after HPD refitting). Variability in attenuation and attenuation test systems has not been adequately characterized to allow for such an assessment. This study compared attenuation measurements made with two systems, Real-Ear-at-Threshold (REAT) and Microphone-in-Real-Ear (MIRE), on 20 workers using two earplugs (foam and custom-molded). Workers' perceptions of the earplugs were also evaluated. Individuals' attenuation results were summarized as personal attenuation ratings (PARs, similar to NRRs). Variability in PARs from between-subject, within-subject and within-day (i.e. repeated tests on a subject without earplug refitting) differences was assessed and used to present the lower confidence limit, or uncertainty factor (UF), of an average individual's attenuation. The custom-molded earplug PARs achieved a higher mean percentage of labeled attenuation than did the foam earplug with both test systems. The custom-molded earplugs also had higher overall acceptance among workers. MIRE PAR levels were lower than REAT levels for both earplugs, but the relationship between the two test systems was highly variable. The MIRE system had lower within-day variability than the REAT system. One individual's MIRE results were highly influential; removal of these results greatly reduced the UF for the custom-molded earplug/MIRE combination. UFs ranged from 8.8 to 13.5 dB. These findings highlight the importance of evaluating variability in individual-specific protection results for personal protective equipment like HPDs, rather than relying on single measurements.     

Hearing loss prevention for carpenters: part 2 - demonstration projects using individualized and group training

Two demonstration projects were conducted to evaluate the effectiveness of a comprehensive training program for carpenters. This training was paired with audiometry and counseling and a survey of attitudes and beliefs in hearing loss prevention. All participants received hearing tests, multimedia instruction on occupational noise exposure/hearing loss, and instruction and practice in using a diverse selection of hearing protection devices (HPDs). A total of 103 apprentice carpenters participated in the Year 1 training, were given a large supply of these HPDs, and instructions on how to get additional free supplies if they ran out during the 1-year interval between initial and follow-up training. Forty-two participants responded to the survey a second time a year later and completed the Year 2 training. Significant test-retest differences were found between the pre-training and the post-training survey scores. Both forms of instruction (individual versus group) produced equivalent outcomes. The results indicated that training was able to bring all apprentice participants up to the same desired level with regard to attitudes, beliefs, and behavioral intentions to use hearing protection properly. It was concluded that the health communication models used to develop the educational and training materials for this effort were extremely effective.     

A comparison of "Train-the-Trainer" and expert training modalities for hearing protection use in construction

BACKGROUND: Few assessments have been conducted on the impact of a "Train-the-Trainer" (T3) approach for training delivery. The present study compared the effectiveness of a noise induced hearing loss (NIHL) prevention training delivered using "Train-the-Trainer" and expert trainer modalities. METHODS: Participating construction companies were assigned to the Train-the-Trainer or expert trainer modalities. Workers were recruited from each company and then trained. The effectiveness of the modalities was assessed through the use of surveys. The accuracy of self-reported hearing protection device (HPD) use was also evaluated through on-site observation. RESULTS: Post-training scores for hearing conservation knowledge, perceived barriers, and current and intended future use of HPDs improved significantly for both training modalities. Subjects trained by T3 trainers significantly increased their beliefs regarding general susceptibility to NIHL, desire to prevent NIHL, and ability to recognize, and control hazardous noise exposures. The expert-trained groups significantly increased their beliefs regarding the benefits of HPD use and ability to ask for help with HPDs. The only changes that were significantly different between modalities were in general susceptibility to NIHL and effective use of HPDs. However, these beliefs differed significantly between subjects in the two-modality groups prior to training. Self-reported HPD use was poorly correlated with observed use, calling into question the validity of survey-based HPD use measures in this context. CONCLUSIONS: The training improved beliefs regarding HPD use, increased workers' hearing conservation knowledge, and increased self-reported HPD use. The effectiveness of the training was not found to be dependent on training modality.     

Expression of concern: false claim to be free of conflicts in asbestos biopersistence debate

Abstract

Background: Participatory training on occupational health is widely used in the world. Evaluations of local experiences are necessary to its successful performance.

Objectives: The project evaluated the effectiveness of participatory training on occupational health improvement in small and medium enterprises of China, and explored local practice experiences.

Methods: Participatory training was provided to 525 welding workers from 25 small and medium enterprises in ship building and machinery manufacturing industries. This training consisted of interactive learning, worksite assessment and group discussion on laws/regulations, safety of machine operation, prevention of slips and trips, fire/explosion prevention, ergonomics, and recognition and prevention of other workplace hazards. Workers completed knowledge, attitude, and practice and worksite assessement questionnaires before and 3 months after intervention.

Results: Knowledge, attitude, and practice scores were significantly increased through the training. An inventory of workplace safety modifications was proposed by participants and many were fixed by workers and employers. Health management and personal protective equipment provision/use were most often improved, but improvements in engineering control and health-related accommodations remained unsatisfactory.

Conclusions: Workers could recognize and fix workplace hazards after the participatory training. More efficient measures in China are to be explored to improve implementing solutions, especially on preventive engineering and human ergonomics.     

Effects of changes in early retirement policies on labor force participation: the differential effects for vulnerable groups

Objectives:This study investigated the effects of a national early retirement reform, which was implemented in 2006 and penalized early retirement, on paid employment and different exit pathways and examined whether these effects differ by gender, income level and health status.Methods:This study included all Dutch individuals in paid employment born six months before (control group) and six months after (intervention group) the cut-off date of the reform (1 January 1950) that fiscally penalized early retirement. A regression discontinuity design combined with restricted mean survival time analysis was applied to evaluate the effect of penalizing early retirement on labor force participation from age 60 until workers reached the retirement age of 65 years, while accounting for secular trends around the threshold.Results:The intervention group postponed early retirement by 7.41 months [95% confidence interval (CI) 6.11–8.72], and partly replaced this by remaining 4.87 months (95% CI 3.60–6.24) longer in paid employment. Workers born after the threshold, annually earning €25 000–40 000, spent 1.24 months (95% CI 0.31–2.18) more in economic inactivity than those born before. The working months lost to unemployment increased by 1.50 months (95% CI 0.30–2.71) for female workers and 1.99 months (95% CI 0.06–3.92) for workers reporting multiple chronic diseases.Conclusions:The national reform successfully prolonged working lives of older workers. However, workers with a middle income, female workers, and workers with chronic diseases were more vulnerable to premature exit from the labor market through unemployment or being without any income or benefit.     

Providing healthcare under ISIS: A qualitative analysis of healthcare worker experiences in Mosul,Iraq between June 2014 and June 2017

ABSTRACT

During ISIS occupation of the Northern Iraqi city of Mosul between June 2014 to June 2017, healthcare workers remaining in Mosul continued to provide medical services. Little is currently known about Iraqi healthcare workers’ personal and professional lives in the ISIS healthcare system, and how these individuals adapted. This study sought to explore their experiences during occupation through thematic analysis of qualitative data from twenty interviews conducted immediately after ISIS withdraw from Mosul in August 2017. Participants were sampled from healthcare facilities still in operation after liberation and included healthcare workers of varying disciplines, age and gender. Participants described major changes to their personal and professional lives under ISIS and an extremely limited perceived ability to negotiate the challenges of providing healthcare in the ISIS system. They described terrifying working environments, the strict separation between the sexes, restricted movement, and continuous monitoring by the Al-Hesba morality police. Infractions of ISIS law and subsequent punishment, deaths and kidnappings, changes in personal relationships, poverty and the disrupted schooling of children were also discussed. The importance of protection by supervisors, access to additional money and transportation were highlighted. Understanding these hardships may help support the recovery of health workers experiencing similar situations.

Abbreviations: HCW: Healthcare Worker; PHCCs: Primary Health Care Clinics; ISIS: Islamic State of Iraq and Syria     

Letting Go of the Land

Abstract

Background: Farmers have high rates of hearing loss, yet little is known about the hearing status of migrant agricultural workers. We performed a cross-sectional survey to assess the prevalence and impact of hearing loss in this population.

Methods: One hundred fifty migrant and seasonal agricultural workers were surveyed at a series of health fairs held at migrant camps. A bilingual questionnaire included items related to hearing loss risk factors and subjective hearing difficulties. Pure tone audiometry and tympanometry were performed in a mobile testing van.

Results: More than half the subjects had some degree of hearing loss at audiometric frequencies between 500 and 6000 Hz, especially in the higher frequencies. Hispanic males in the sample had significantly greater prevalence of high-frequency hearing loss compared to adults in the national Hispanic Health and Nutrition Examination Survey (HHANES). More than 35% of respondents complained of subjective difficulty hearing or understanding speech, yet no workers reported use of hearing aids. Even after adjusting for measured hearing loss, Hispanic farm workers were more likely than their English-speaking counterparts to complain of difficulty hearing or understanding speech, suggesting that language barriers could worsen the impact of hearing loss. Risk factors for hearing loss included age and abnormal tympanometry. Occupational exposures to noise from tractors and other machinery as well as pesticides were frequently reported, while use of hearing protection was rare.

Conclusion: Hearing loss is a significant and under-recognized problem in the migrant worker population. Further preventive and treatment efforts are warranted.     

Using mobile technology to increase safety awareness among dairy workers in the United States

Background: Modern U.S. dairy farm operations present multiple safety hazards which may result in worker injuries, illnesses and fatalities. The U.S. industry trend towards large-herd milking operations, especially in the Western U.S., necessitates an increased number of workers on each farm. The U.S. dairy workforce is comprised of an increasing percentage of immigrant workers with limited English proficiency which presents a safety training challenge. Our objective was to develop, deliver and evaluate safety awareness training to U.S. dairy farm workers using mobile tablets as a personal learning environment. Methods: A non-random sample of 1,436 dairy workers received safety awareness training on a mobile device platform. Kirkpatrick Levels 1, 2 and 3 training effectiveness evaluations were performed. Results: Approximately 58.7% of training participants received a middle school education, and 22.7% were from Guatemala who reported K’iche’ as their native language. A statistically significant large effect size suggests safety knowledge was gained among training participants when comparing post-test scores to pre-test scores (Level-2). Training participants rated their training experience favorably (Level-1), and applied knowledge gained in their daily work activities three months after training (Level-3). Conclusion: Our findings suggest the utilization of mobile learning techniques is an effective means to deliver safety awareness training content to dairy workers. Dairy worker safety training should be culturally, linguistically, and literacy appropriate and comprehensive in nature to include all applicable dairy safety hazards. Our observations support the use of mobile devices as just one component of a more comprehensive health and safety management program on farms.     

Evaluation of half-mask respirator protection in styrene-exposed workers

Objective: The protection afforded by respirators to styrene (St)-exposed workers varies considerably. Our objective was to study the effective `in the field' reduction in St exposure obtained by negative-pressure half-mask respirators worn by a group of fiberglass-reinforced plastics (FRP) workers. Protection was evaluated by measuring the reduction in urinary St (StU) excretion. Methods: Seven FRP workers not using respiratory protection devices were studied for a week. External exposure to St was evaluated by personal passive sampling, and the internal dose by StU measurement. Then workers were asked to use a half-mask respirator for a week for the entire morning half-shift, and St exposure and internal dose were re-assessed. Results:. Mean environmental levels of St during the morning half-shift were 230–280 mg/m³, i.e., about three times the current limit proposed by ACGIH; the difference among days was not significant. Using respirators was accompanied by a large inter-individual and also intra-individual variability: the estimated reduction of StU values ranged from 30% to 90% (mean 60%). Mean StU values increased by 50% from Monday to Friday, while environmental St concentrations remained steady. Furthermore, the proportion of workers exceeding the biological equivalent exposure limit (BEEL) was 14% on Monday, double (33%) on Thursday, and triple (43%) on Friday. These data suggest a decrease of protection during the week. Conclusions: The protection afforded by negative-pressure half-mask respirators varies widely, which stresses the need to assess the effective reduction of exposure whenever these devices are introduced for St-exposed workers. If respirators are to be re-used for several days, their performance must be evaluated during the last shift of use. Measurement of urinary excretion of unmodified St proved a useful tool for the evaluation of respirator effectiveness in exposed workers. Received: 5 February 1999 / Accepted: 14 June 1999     

A trail of individual education for hearing protection with an instrument that measures the noise attenuation effect of wearing earplugs

The aim of this study was to investigate the effect of individual training of workers, using an instrument to quantitatively evaluate the noise attenuation gained with the use of earplugs, on the efforts to promote the use of hearing protection devices. The subjects were 68 male workers exposed to noise of above 80 dBA at an electronic parts manufacturer in Japan. They received group instruction on the prevention of noise-induced hearing loss, and individual education on the effect of the proper use of earplugs. The individual education was done with the use of an instrument that measures the noise attenuation effect of wearing earplugs. After the training, the prevalence of the regular use of hearing protectors increased. Among workers in loud working environments, it increased from 46% to 66% over two months after the training. The percentage of workers who obtained a sufficient noise attenuation effect of>or=25 dB in both ears with the proper use of earplugs also increased, from 46% before the training to 72% immediately afterward. These effects were still observed about two months after the intervention. The results suggest that the present individual training may be an effective means to increase both the usage rate and the proper use of hearing protection devices, perhaps because it deepens individuals' understanding of the effect of the proper use of such devices.     

Personal protective equipment (PPE) use and its relation to accidents among construction workers

Background:The construction industry is characterized by a high prevalence of accidents and injuries. Inadequate risk management measures, including failure to use or incorrect use of personal protective equipment (PPE) may significantly increase the risk of accidents.Objectives:The main objectives of the current study were to measure the prevalence of PPE use and accidents and their associated factors among construction workers.Methods:A cross-sectional field study with an analytic component was carried out on 384 workers from different sites in Port-Said, Egypt, using an interview administered questionnaire. The questionnaire included sociodemographic and occupational data, practice of PPE use and accident analysis.Results:About 60% of workers use PPE during work. Main reasons for non-use are discomfort, lack of knowledge on how to use it and poor fit. Occupational accidents in the last 12 months were reported by 64.3% of workers. The main accident types were: being hit by falling objects, falls from height, and tool related accidents. Safety training was the significant independent predictor of PPE use (AOR=2.0). However, age, marital status, smoking, safety training, and PPE use were also significant independent predictors of accidents (AOR=2.4, 3.1, 0.5, 0.5, and 0.2; respectively).Discussion:Among construction workers, PPE utilization is low with significant relation to safety training while occupational accidents are common and significantly related to safety training and PPE use. Therefore, safety training should be provided, and PPE use should be enforced at construction sites.Key words: Accidents, construction, PPE, safety