The finding of this research indicated that, only 172 [41.7 %] of the workers were considered to have good PPE utilization. This finding was much lower than the study done in Thailand and Addis Ababa, which indicated that [70.1%] and [64.80%] of the workers had good PPE utilization respectively [22, 30]. On the contrary the finding of this research was higher than the study done in Gujarat, India that showed only 25 % of the workers were considered to have good PPE utilization. This difference might be due to methodological differences, like study population and methods of data collection, and workplace conditions, employees’ level of awareness on hazard control and disease prevention.
The use of PPE varied considerably depending on the item examined with the respirator and coverall being the most commonly used protective items. The finding was inconsistent with the study done in Hawasa town among Wood and Metal Worker that showed eye protector and safety shoe were the most utilized protective items. On the other hand, in this research ear protector was found to be the least utilized type of PPE. The finding was different with the study done in Missouri, USA that indicates helmet was found to be the least utilized PPE type. This difference might be due to the difference in the nature of factories considered in the study.
In this research none of the socio-demographic factors were significant at a p value of < 0.05. This finding was inconsistence with the study done in different countries. For example a research done in Uganda showed that among the socio-demographic factors sex was found to be a significant predictors of PPE utilization in which Female respondents were used PPE more than male respondent [AOR] = 6.64; 95% CI: 1.55–28.46]. Similarly in Nepal Female respondents were used PPE 3.65 times than male [AOR] = 6.64; p = 0.031]. This difference might be due to the difference in educational level and culture of the participants.
Another socio-demographic factor which was found to be insignificant predictors of PPE utilization was age of the workers. The finding was consistent with the study done in Uganda and Mombasa County, Kenya[24, 27]. But finding of this research regarding age was against with different research. For instance a research conducted in Indonesia among a sample of 200 workers indicated that, workers who have the age of greater than 30 years have the possibility to use PPE 7.54 units higher than those below 30 years.
Similarly employment form, income, working experience and marital status was among the socio-demographic factors that were not predictors of PPE utilization. Similar finding was obtained from a study conducted in Kenya and Addis Ababa, in which employment form, income, working experience and marital status were not determinate factors of PPE utilization[27, 41].
Regarding the HBM constructs, Perceived susceptibility, perceived severity, Perceived self-efficacy and perceived barriers were significantly associated with PPE utilization. On the other hand perceived benefit and cues to action towards PPE utilization were not found to be independent predictors.
Perceived susceptibility of occupational illness and injury has shown statistically significant association with PPE utilization. The study showed that as a unit increase in total score of perceived susceptibility the odds of utilizing PPE was also increased by 20%. This finding is in line with different studies conducted in USA and Thailand [28, 30]. This might be explained as the study participants those having high susceptibility may belief that using PPE has the potential to protect work related disease and injuries. Similarly as a unit increases in total score of perceived severity the odds of using PPE was increased by 10%. This finding is consistent with the studies conducted in Indonesia and USA. This might be due to the workers beliefs about the seriousness of the occupational illness, injury and possible outcome of the disease. The other explanation may be high perceived susceptibility and severity towards occupational illness and injury may also increase the perceived threat of respondents; thus the participants could use PPE. In general, workers who perceived as they are highly susceptible to work related illness & injury and that they perceived work related disease is a serious disease, they would be more likely to utilized PPE.
The other predictor variable towards PPE utilization was perceived barrier, it was significantly associated with PPE utilization and it indicated that as a unit increases in sum score of perceived barriers the odds of using PPE was decreased by 13%. Similar finding was reported from cross-sectional study conducted in Hawassa and Nigeria that showed barriers like inconvenience, unavailability, and increased cost were found to be predictors of PPE utilization[55, 56].
Self-confidence in using PPE [perceived self-efficacy] was found to be a significant predictor of PPE utilization, in which, per a unit increases in the total score of perceived self-efficacy towards PPE utilization the odds of using PPE was increased by 20%, [AOR = 1.2, 95 %, CI [1.082–1.349]]. The possible justification might be People with high self-efficacy show elevated confidence in their skills and have no doubt about themselves. In these cases, factory workers consider the problems as a challenge, not a threat, and they actively search for new situations. In addition, high self-efficacy reduces fear of failure, increases the level of motivation, and improves problem-solving and analytical thinking abilities. In the same way, high self-efficacy in working a hazardous environment may promote the use of PPE.
On the other hand, Perceived benefit [AOR = 1.05, 95 %, CI [0.95–1.17, P = .302]] were not found to be predictors of PPE utilization. This finding was in line with the study done in USA, in which Perceived benefit towards using PPE was not found to be independent predictors. Similarly cues to action were not predictors of PPE utilization. The finding is inconsistent with the study done in Indonesia to identify factors influencing the use of PPE [[OR = 7.17; 95%CI = 2.17 to 23.62; p = 0.001]. This inconsistency may be due to the difference of educational level, media exposure and culture of the participants.