The study findings is discussed using the constraint-response accident model with focus on the interplay between the promixal and distal factors. Accordingly, the discussion is organized as follows: 1) prevalence and type of injuries sustained by construction workers; 2) distal factors influencing occupational injuries; and 3) proximal factors predicting of occupational injuries.
The prevalence and type of injuries sustained
The study showed that more than half, (57.9%) of construction workers had experienced occupational injuries. The prevalence appears to be higher, when compared to previous estimates elsewhere [29]. Even though there is no national representative data on the extent of injuries sustained by construction workers, the current prevalence is about 9.3 times higher than previous reports by the labour commission, which estimated that 6.2% of occupational accidents leads to deaths in construction [18]. Of relevance, the present finding demonstrates an increase burden of injuries among workers. This confirms previous literature which reported the industry to be injury prone [16, 22, 23]. Specifically, injuries sustained by the workers were open wounds, superficial (on surface) and concussion and internal injury. These injuries are similar to the categories of injuries reported to be sustained by construction workers globally [30–35]. The study recommends that policy makers and occupational health experts should develop preventive and management strategies that incorporate specific injury part sustained.
Distal factors influencing occupational injuries
The distal factors influencing occupational injuries highlights the individual socio-demographic profile and health status of frontline construction workers. These factors had relationship with occupational injuries. In this study, the socio-demographic profile such as age, sex and income significantly predicted occupational injuries among construction workers. In particular, males were at high risk of being injured compared with females. In Ghana, the socio-cultural characteristics restricts the construction activities to males. This is due to the rigorous and hazardous nature of the construction industry [36]. In addition, the income level of construction workers is a significant risk factor to occupation injury. Tasks with high risk of injury usually requires an expert to execute. However in performing such duties, the worker’s exposure to such risk becomes higher which may eventually translates to injuries compared to other workers assigned to simple tasks. In Ghana, construction workers with these technical expertise are usually short in supply and also demand relatively higher wage than those doing menial and causal works. This possibly explains why workers in this category were at higher risk of occupational injury.
In addition, the risk of occupational injury increased with older workers compared to the youthful age group (economic active population). Older workers are susceptible to severe injury than younger ones [29, 37–39]. Aging process involves series of physiological changes to the body that can make construction task very difficult for old people. The strength and ability required of a person to carry out physically demanding task effectively reduce as one ages. Decrease cardiac output may affect a worker’s performance on physical demanding activity and increase his susceptibility to injury [40]. The study recommends stakeholder to consider the age profile, gender identity and socio-economic status of construction workers when designing preventive and management strategies for injuries. Further, researchers interested in occupational health related issues should explore the reasons for the increased occupational injuries among different age, gender and socio-economic wealth quintiles.
Proximal factors predicting of occupational injuries
The proximal factors predicting occupational injuries describe the organizational and work-related characteristics associated with these injuries. Specifically, the study showed daily production targets, job location, work structure, trade specialization and off working days influence the risk of occupational injuries among frontline building construction workers. Working continously without breaks, off-days and vactions predict the risk of injury among construction workers. Our study showed that, a worker who enjoy off-days in a month is 96% protected from injury occurrence compared to those working everyday throughout the month. Once a worker engages in continuous work without vacations, holidays and off-days, there is the possibility of fatigue setting in, and when this happens it affects performance and productivity [17].
Working on permanent basis or as temporal worker makes a worker more susceptibility to injuries more compared to working daily paid workers. Daily paid workers in the Ghanaian construction industry are normally engaged for relative short period, they visit job site as and when they think they need to work. Such workers are mostly hired to carry out simple task which does not require any special expertise. Permanent workers are likely to experience the cummulative effects of the exposures on their health, unlike the daily paid workers. Finding from our study revealed that, workers operating from all location and lower grounds were 71% and 39% protected from the possible risk of experiencing injury compared to working from rooftop and elevated ground. This suggest that the chance of slipping from high and its impact on the individual is greater. This corroborate with previous findings which indicated that working from a height and elevation above the ground is the most cited cause of fall related injuries [39, 41–43]. The study recommends that policy makers and occupational health expert should incorporate the proximal factors in the design of injury prevention as well as management strategies.