Magnitude of self-reported non-fatal work-related injuries and associated factors among construction workers in Aleta Wondo, Sidama, Ethiopia – Nature.com 04:54

Scientific Reports volume 15, Article number: 4339 (2025) Cite this article

Abstract

Ethiopia has experienced rapid urbanization over the past three decades, leading to the explosion of building construction. The job created in the construction industry of the country was hazardous due to the nature of the activities involved in the industry. However there is paucity of evidence regarding the prevalence and risk factors of injuries in the industry to make evidence-based policy framework within the country. Therefore, this study seeks to examine the magnitude of non-fatal occupational injuries and the associated factors among building construction sites workers in Aleta Wodo, Sidama, Ethiopia. An institutional based cross-sectional study was conducted in South Ethiopia from September to October 2023. The study utilized a multi-stage sampling technique to select the 613 study participants. The data was collected using a structured interviewer administered questionnaire. Epi Inf version 7.2 was used to enter data and the data was analysed using IBM-SPSS version 22. Bivariate and Multivariate logistic regression was conducted to assess association between the outcome and predictor variables. During the multivariable regression p-value less than 0.05 were taken to determine significant association. The annual prevalence of wok-place injury in the current study was 64.1% (95 CI: 60.7, 67.9). Male construction workers [AOR = 3.6, 95% CI (2.12, 6.15)], monthly income of ≤ 1000 [AOR = 4.56, 95% CI (1.56, 13.36)], 1001–3000 [AOR = 9.7, 95% CI (3.45, 27.3)], and 3001–5000 [AOR = 6.56, 95% CI (1.96, 21.9)], working more than eight hours [AOR = 7.9, 95% CI (4.36, 14.64)], drinking alcohol [AOR = 3.28, 95% CI (1.63, 6.6)] and participants unsatisfied with their job [AOR = 3.12, 95% CI (1.36, 7.16)] were significantly associated with non-fatal occupational injury. The magnitude of non-fatal occupational injury among construction workers was high in the study area. The study concluded that sex, monthly income, length of working hours, drinking alcohol and dissatisfaction with job were risk factors for occupational injuries among construction employee.

Introduction

Ethiopia has experienced rapid urbanization over the past three decades. Several cities expanded rapidly and many satellite towns sprung up around the major cities. This led in a significant need for infrastructure, specifically construction of commercial, industrial, and residential buildings1. Even though the construction industry provides numerous solutions to complications caused by accumulated demand for infrastructure, the industry is blamed for failing to integrate sustainable practices and propose enforcing a shift from traditional methods to sustainable construction2,3.

The issue of creating decent work had been compromised in most of the industries including the construction sector, production industry sector, agricultural sector, and healthcare and hospitality sector. The construction industry poses serious threats to workers’ safety and well-being, due to poor working conditions and prevalent occupational hazards compared to the others4. The industry has a higher accident and hazard rate than other industries and workers are exposed to an increased risk of injury at work5,6. The incidence of injury among construction workers is higher when compared to other sectors and the industry is accountable for more than half of all workplace injuries and deaths, globally7.

The construction industry is characterized by varied and complex project environment containing variety of high-risk activities that make the industry hazardous for the employees8,9. The industry predominantly involves working at heights, working underground, working in confined spaces and proximity to falling materials, manually handling loads, dealing with hazardous materials, noises, dusts, using plant and equipment, fire, exposure to electrical cables, poor housekeeping, and ergonomics are some of the most well-known health and safety hazards on construction sites10.

The prevalence of occupational injury among construction industry workers in Africa was 57%11. The pooled prevalence of occupational injury among construction workers in Ethiopia was 46.78%. Studies reported that abrasions and cuts were the most prevalent type of injuries. The most frequently reported factors for the injuries were sex, abuse to alcohol, work period, training on health and safety, supervision and use of personal protective equipment12,13.

The United Nations under the Sustainable development Goal 8 promotes the issue of creating decent work which prevent injuries and requires data related to injuries to take appropriate measures14. Hence, measuring the magnitude of occupational injury helps to manage risks, create safe and descent work condition in the construction industry besides achieving the project objectives in terms of time, cost and quality15. Therefore, identifying the magnitude of injury in different work types and examining the risk factors helps to develop a workable accident prevention intervention program.

In Ethiopia, there is paucity of information regarding on accident records for building construction injuries, and the types of the injuries are not well investigated. Therefore, this study seeks to examine the magnitude of non-fatal occupational injuries and the associated factors among building construction sites workers in Ethiopia.

Methods and materials

Study area, design and period

An institutional based cross-sectional study was conducted in Aleta Wodo Town, Sidama, Ethiopia from September to October 2023. During the study period there were 9 construction sites in the Town with more than 1400 employees in more than 10 different job categories.

Source and study population

Source population

The source population for this study was all construction workers found in Aleta Wodo Town, Sidama Ethiopa.

Study population

The study population was randomly selected construction workers who were on work within the study period.

Inclusion and exclusion criteria

Inclusion criteria

All construction site workers who are above 18 years of age working in any job category that has direct involvement in the construction process were included.

Exclusion criteria

Construction workers below the age of 18 years and workers who are not directly involved in the construction process were excluded from the study.

Sample size determination and sampling technique

Sample size determination for first objective

The sample size was calculated using the formula for a single population proportion using Epi Info Version 7.2 software. As indicated in the below formula

αn=(Zα/2)2×P(1−p)d2

The following assumptions were considered to calculate the sample size for the first objective:

Accordingly, the sample size calculated (n) is equal to 382, then multiplying the sample size with 1.5 design effect and adding 10% non-response rate the final sample size required for the study is 631.

Sampling technique and procedure

The study utilized a multi-stage sampling technique to select the study participants. During the study period, there were nine large-scale construction sites and 5 (50%) were randomly selected using a simple random sampling technique. Then, the construction industry workers were stratified into 6 different major job categories: daily laborers, masons (including all working any cement work), carpenters, metal workers (involved any kind), electricians, and site engineers (including foremen) since the nature of the job predominantly determine the magnitude of injuries. The sample size of workers from each job categories was determined by using proportional allocation with the total number of workers in each job categories obtained from the construction sites. Then, the sample size in the 6 job categories was proportionally allocated to the selected 5 construction sites. Finally simple random sampling technique was employed to select the study participants in each construction site from each stratum. The payroll was used as a sampling frame to pick the study participants.

Operational definition

Self-reported occupational injury

include injuries that occurred due to incidents at the workplace during the past 12 months; and those injured workers should have been away from work at least one day because of the injury, in addition to the day of the incident16.

Data collection instrument and procedure

Data collection instrument

The study used interviewer administered structured questionnaire prepared after reviewing different relevant literature. The questionnaire was prepared in English and translation to Amharic. The tool includes comprised four different parts collecting data on socio-demographic characteristics, work related characteristics, prevalence of non-fatal occupational injury and awareness related characteristics of respondents.

Data collection procedures

The data was collected through individual face to face interview after obtaining written informed consent from participants. A study team was organized with professionals having a good command of English, Amharic and local languages (Sidamigna/Sidamoaffo), as well as with previous experience on interviewer administered surveys. The team was composed of one supervisor (MPH in Environmental Health) and three data collectors (BSc in Environmental Health ). A one day training was provided (theoretical and field training) at the study area prior to data collection.

Data quality control

Primarily, to ensure the clarity and consistency of the data collection tool pre-test was conducted in a neighbouring town among construction workers by taking 5% (37 persons) of the total sample size, and then necessary modifications were made before executing the study. Before the data collection period, one-day training was given to the supervisor and interviewers on the contents of the instrument, and ethical and technical issues on quantitative data collection. During the data collection period completed questionnaires were checked by the principal investigator for completeness and correctness daily.

Data analysis

The collected data was coded and entered using data entry template designed in Epi Info version 7.2. Then, the data will be cleaned by checking for outliers, inconsistencies and missing values and analyzed using SPSS version 20 software.

The descriptive data was presented using frequencies, tables and graphs. The bivariate analysis was conducted to examine the various associations using Binary logistic analysis. All variables with a P-value < 0.2 during the bivariate analysis was selected as candidate for further fit to multivariable logistic regressions for better prediction of association. Crude and adjusted odds ratio with 95% confidence intervals was computed to determine the strength of association between the outcome and predictor variables. A p-value less than 0.05 were taken to determine significant association.

Ethical considerations

The study is undertaken in compliance with the Declaration of Helsinki. Ethical clearance was obtained from Dilla University Institutional Ethical review board. Written informed consent was obtained before each interview after clear explanation was given about the aim of the study to each respondent. The respondents were assured that the information provided by them is confidential and will only be used for the purpose of research.

Result

Socio-demographic characteristics of respondents

Out of the sampled participants 613(97.1%) participated in the study. The majority of the 494 (80.6%) the study participants were male. age of the participants ranged from 19 to 42 years with a mean 30.2 SD ± 7.04. All the study participants can read and write with 40.8% completed secondary school and 3.4% having college diploma/above. Concerning monthly income, almost half (48.5%) of the study participants have an income of in the rage between 1001 and 3000 Ethiopian birr (Table 1).Table 1 Socio-demographic characteristics of construction workers in Aleta Wondo Town, Sidama Ethiopia, 2023.

Full size table

Occupation related characteristics of respondent

The study participants were majorly labours (50.7%) and masons (17.2%). Concerning their employment status, more than three fourth (77.7%) were temporary employees in the construction sites. Only 117(19.1%) have more than 10 years of experience. Of the study participants, 314(51.2%) works more than 8 h a day and two third reported the presence of safety supervisor (Table 2).Table 2 Work related characteristics of construction workers in Aleta Wondo Town, Sidama Ethiopia, 2023.

Full size table

Personal habit related characteristics of respondents

Regarding personal habits, among the study participants 234(38.2%), 151(24.6%) and 63(10.3%) uses alcohol, Khat and cigarette, respectively. Only 158(25%) were satisfied by their job and two hundred twenty one (36.1%) were satisfied by their salary (Table 3).Table 3 Personal habit related characteristics of construction workers in Aleta Wondo Town, Sidama Ethiopia, 2023.

Full size table

Training, knowledge and practice on work place safety and health

Regarding training on occupational safety and health, only 137 (22.3%) had training on work place safety and health. Of the study participants, three hundred thirty four (54.5%) know the hazards in their work place and only 18.9% uses personal protective equipment (Table 4).Table 4 Training, knowledge and practice on workplace safety and health among construction workers in Aleta Wondo Town, Sidama Ethiopia, 2023.

Full size table

Magnitude of work-related non-fatal injuries

The annual prevalence of wok-place injury in the current study was 64.1% (95 CI: 60.7, 67.9). Of the participants who suffered from injuries, 297 (75.6%) had only one injury and 3 (0.7%) had five and more types of injury. The top three reported injuries were cut, abrasion and dislocation (Table 5).Table 5 Magnitude of injuries suffered among construction workers in Aleta Wondo Town, Sidama, Ethiopia, 2023.

Full size table

Factors associated with non-fatal work-related injuries

Bivariate analysis was conducted on all possible predictor variables, and only six of them were found to be significant at a p-value of < 0.2. The multivariate analysis was conducted on these variables, and five i.e. sex of respondents, monthly income, working hours a day, drinking alcohol, and job satisfaction, became significant with a p-value of < 0.01 (Table 6).Table 6 Factors associated with non-fatal work-related injuries among construction workers in Aleta Wondo Town, Sidama Ethiopia, 2023.

Full size table

Male construction workers had higher odds of suffering from occupational injury as compared to their counterparts [AOR = 3.6, 95% CI (2.12, 6.15)].

Study participants who had an income of ≤ 1000, 1001–3000, and 3001–5000 were more likely to be injured than participants having an income of more than 5000 ETH with [AOR = 4.56, 95% CI (1.56, 13.36)], [AOR = 9.7, 95% CI (3.45, 27.3)] and [AOR = 6.56, 95% CI (1.96, 21.9)], respectively.

Construction site employees who work more than eight hours a day were 8 times more likely to experience workplace injury compared to those who work eight or fewer hours a day [AOR = 7.9, 95% CI (4.36, 14.64)].

The chance of suffering from occupational injury was 3.2 times higher among alcohol-drinker workers compared to those who didn’t drink alcohol [AOR = 3.28, 95% CI (1.63, 6.6)].

Job satisfaction was also a predictor variable, those participants who were unsatisfied with their jobs had a 3-fold higher odds of experiencing non-fatal injury compared to the satisfied ones [AOR = 3.12, 95% CI (1.36, 7.16)].

Discussion

The annual prevalence of non-fatal occupational injuries among construction workers was found to be 64.1% in the present study. The result was much higher compared to studies conducted in different countries of Africa including Uganda, Ethiopia, Egypt and Gambia with a prevalence of 32.4%17, 39.2%18, 46.2%19 and 56%20, respectively. However, the finding was lower compared to studies conducted in Addis Ababa Ethiopia, which reported 67.7%21and 84.7%22 prevalence of injury among construction workers. The difference in these studies including the current one is likely attributed to the difference in the scale of the construction sites, machinery and tools used, the presence of workplace safety measures, and the level of awareness and understanding among employees about workplace safety measures23. Furthermore, the difference might be due to the provision of training to the workers, the presence of internal and/or external monitoring and evaluation of the safety culture, and the difference in policy and regulatory framework among the nations.

The three major types of injuries reported by the respondents were cuts, followed by abrasion and dislocation. Similar to this finding, studies conducted in different places showed a high prevalence of cuts, abrasion, and dislocation among construction workers18,24. This might be associated with the nature of the dominant activities involved and the types of hazards presented at the construction site. The high prevalence of cuts is associated with activities like carpentry, and metal and glass work. Construction workers are exposed to various abrasive materials, such as concrete, asphalt, or rough metal surfaces, which results in a high prevalence of abrasion injuries. The highly physically demanding nature of the job and the presence of repetitive activities also led to a high burden of dislocation injuries among construction workers.

The findings from this study showed that males were more likely to experience non-fatal workplace injuries compared to their female counterparts. Similarly, studies conducted in the North East, Ethiopia25, and Ghana26 reported that males were more likely to suffer from injury than females in the construction sector. The main reason behind the high prevalence of injury among men is that most labour-intensive and risky activities which can increase vulnerability to workplace accidents are predominantly covered by male workers27,28. In addition men have increased risk taking tendency in most cases compared to women, which will likely leads them to engage in unsafe condition and neglect safety measures leading to increased risk of injury.

The monthly income of construction site employees was also one of the predictors of the prevalence of injuries in the study area. Participants with middle and lower monthly incomes were more likely to encounter workplace injuries compared to employees with relatively high monthly incomes. The findings of the study are in line with studies conducted in Uganda17and Ghana26, which reported high odds of experiencing occupational injuries among lower-income employees compared to higher ones. Studies suggested that low-wage workers, who are often assigned to highly physically demanding activities, dangerous hand tools, and long working hours as well, are less likely to have access to necessary Personal Protective Equipment (PPEs) and training compared to higher-wage workers, and this increases the risk of occupational injuries among low-income workers29,30.

Study participants working more than eight hours a day were more likely to be injured than those who worked eight or fewer hours a day. A study conducted in Gondar, Ethiopia revealed a similar finding. In addition, studies conducted in Ethiopia31and Egypt19 showed that long working hour was associated with a higher incidence of workplace injury. A study showed that employees working for long hours become fatigued, resulting in reduced cognitive ability, reaction time, and decision-making, which can contribute to an increased risk of accidents and injuries in the workplace32.

The study revealed that workers who drink alcohol were more likely to suffer injury than those who didn’t drink alcohol. In line with this study, studies conducted in different parts of Ethiopia showed that the likelihood of injury is much higher among alcohol consumers as compared to those who didn’t consume alcohol24,33,34. Evidences suggested that alcohol consumption impairs psychomotor skills and cognitive performance, which in turn increases the risk of accidents and injuries in the workplace35. In addition, studies suggested that alcohol and other drug consumers are associated with having higher deviance proneness, potentially leading them to shortcuts or malpractices bypassing the use of appropriate safety measures, which significantly increases the chance of injury36.

Job satisfaction was also one of the predictors for the prevalence of injury with the odds of being injured higher among unsatisfied workers. Similarly, multiple studies conducted in Ethiopia revealed that construction employees who are unsatisfied with their jobs are more likely to experience injuries compared to satisfied employees18,33. Low job satisfaction can result from high job demands, lack of control, or poor working conditions, which can contribute to stress and increase the likelihood of injuries, particularly in physically demanding occupations37. The other reason might be that job dissatisfaction likely leads to high turnover of senior staffs. Thus, this in turn will lead to the recruitment of new workers with less experience leading them to higher risk of injury.

Limitations of the study

The cross-sectional nature of the study limits the finding to determine causal inference. In addition, there might be a slight over or under estimation of the magnitude due to recall bias among participants. Despite the challenges in obtaining the data, it was better to include medical record reviews to better estimate the magnitude. The study didn’t incorporate qualitative study design to collect information that would help to understand the severity and causes of injuries from the relevant individuals.

Conclusion

The magnitude of non-fatal occupational injury among construction workers was high in the study area. The most prevalent types of injuries are cuts, abrasion, and dislocation. The study concluded that sex and monthly income of employee are the socio-demographic factors contributing to injuries. The study highlights that working more than eight hours a day is a risk factor for occupational injuries among construction employee. It was evident that drinking alcohol and dissatisfaction with job were the factors associated with the likelihood of non-fatal injury. Therefore, the concerned government organ including Ministry of Labour and Social affairs and Ministry of Health better collaborate to develop policy and legislative framework that can enhance the betterment of the employee health through establishing institutional arrangement that can specifically work on occupational health and safety issues. The ministry of urban and infrastructure development should also establish institutional arrangement starting from the ministry to the local respective offices to enforce the implementation of occupational health and safety guidelines and legislations.

Data availability

The relevant data are included in the study. However, the datasets are available for any interested parties including researchers upon reasonable request from the corresponding author (agziabel@gmail.com).

Abbreviations

AOR:

Adjusted odds ratioCI:

Confidence intervalCOR:

Crude odds ratioOHS:

Occupational health and safetyPPE:

Personal protective equipment

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Acknowledgements

The authors would like to express their deepest appreciation to the study participants for their valuable contributions.

Author information

Authors and Affiliations

  1. Center for Sustainable Development, Addis Ababa University, Addis Ababa, EthiopiaAbel Afework & Mahlet Gashaw
  2. Centre for Sustainability, University of Otago, Dunedin, New ZealandAiggan Tamene
  3. Department of Preventive and Social Medicine, University of Otago, Dunedin, New ZealandAiggan Tamene
  4. Department of Construction Technology and Management, Debremarkos University, Debremarkos, EthiopiaMahlet Gashaw

Contributions

AA was the study’s principal investigator, overseeing everything from the study’s inception, design, and data collection through the final analysis and manuscript production. AT and MG was involved in the study’s design, methods and materials and manuscript production. The final manuscript was approved by all authors.

Corresponding author

Correspondence to Abel Afework.

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The authors declare no competing interests.

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Afework, A., Tamene, A. & Gashaw, M. Magnitude of self-reported non-fatal work-related injuries and associated factors among construction workers in Aleta Wondo, Sidama, Ethiopia. Sci Rep 15, 4339 (2025). https://doi.org/10.1038/s41598-025-88945-x

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