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Contributing Factors of Personal Protection Equipment (PPE) Utilization

among Sand and Gravel (SSG) Mine Workers

Article · April 2020

DOI: 10.37200/IJPR/V24I7/PR270893

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International Journal of Psychosocial Rehabilitation, Vol. 24, Issue 7,
2020 ISSN: 1475-7192

Contributing Factors of Personal

Protection Equipment (PPE) Utilization
among Sand and Gravel (SSG) Mine
Workers
Rr Dian Tristiana1*, Ratih Pravitasari1, Erna Dwi Wahyuni1

Abstract--- The low utilization of personal protection equipment (PPE) can cause a high rate of work
accidents. The contributing factors related to PPE utilization need to be explored. This study aimed to
explore the contributing factors of personal protection equipment utilization among sand and gravel mine
workers. This study was cross-sectional. A total of 118 respondents participated in this study. The
independent variables were belief, knowledge and the attitude of the sand and gravel miners, the availability
of PPE and employee attitude. The dependent variable was the sand workers’ behavior in using the PPE. The
data were collected using a questionnaire, and tested using Spearman Rho test with a significance level of p
<.05. The results showed that the workers’ belief affected their preference related to using PPE (p=.029;
r=.202). The workers’ good understanding was also shown to have a positive effect on using PPE (p=.000;
r= 0,669). On the other hand, the availability of PPE (p=.000; r=.328), the site owners’ awareness, and peer
support were known to have no significant effect on influencing the workers’ behavior in using PPE while at
the mining sites (p=0.917). Knowledge was the strongest influencing factor. Counseling, training, and
motivation regarding the use of PPE should be conducted in order to improve the sand and gravel miners’
knowledge and positive attitude toward using PPE.
Keywords--- Attitude; Knowledge; Personal Protection Equipment; Sand and Gravel Mine Workers

I. INTRODUCTION
Workplace accidents are the main cause of substantial disabilities globally. The International Labor Organization
(ILO) in 2013 recorded that the death rate due to accidents around the world has reached 2 million cases each year due
to workplace accidents and those suffering from work-related illness [1]. In Indonesia, the number of workplace
accidents in 2015 reached 105,182 cases and as many as 2,375 people died. The Manpower and Transmigration Office
of East Java recorded that, by 2015, the number of work accidents in East Java totaled 10,392 cases [2]. Sand mining
companies are the largest type of company among the industrial and construction mining companies in Indonesia,
which was around 112,392 units in 2015[3].
Manual sand dredging involves the mining of sand manually from the riverbed and transporting it to the trucks
for delivery to construction sites. The job involves workers utilizing country boats and hand tools for rowing,

1
Faculty of Nursing, Universitas Airlangga, Surabaya, Indonesia.

Corresponding author
Rr Dian Tristiana
Email [email protected]

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underwater diving, dredging and manual material handling, thereby increasing the risk of work-related disorders [4].
The working environment, being river water and sand, might warrant there being a risk of exposure to hazardous
materials [5]. Furthermore, the unavailability of Personal Protection Equipment (PPE) and social security measures
may increase the exposure to occupational hazards [6]. Thus, an onsite assessment of manual sand dredgers requires
multisystem screening for the identification of the health risks.
A high number of workplace accidents have a serious health impact. Health problems that can arise from
workplace accidents, especially for sand and gravel mining workers, include silicosis, pneumoconiosis and ear
barotrauma. Silicosis is caused by free silica dust in the lungs. Pneumoconiosis is a lung tissue reaction to dust or sand
[7]. Ear barotrauma is the most common injury in divers. Long-term ear bone marrow damage can result in
irreversible hearing loss [8]. Other factors that can lead to increased workplace accidents are the human and
environmental factors. Human factors determine the perceptions of each worker who feels uncomfortable, who is not
alert and who has a lack of knowledge. The environmental factors consist of a lack of available facilities, low social
impulses, such as how they act around their co-workers, and the workplace owners’ perspective [7].
Accidents at the workplace can be reduced by using PPE as a personal protective device during work. The use of
PPE is one of the risk controls for accidents and it can decrease the incidence of accidents in the workplace [9].
However, the facts found in the sand and gravel mining location showed that the frequency of PPE being used by the
workers was still low and the number of work accidents was still high. A preliminary study was held on March 18th,
2017, which obtained as many as 167 workers from six sand and gravel mining sites who did not use standardized
PPE. The workers only used their full clothes, headgear and a face cover to prevent sand from entering their ears
while working in the exploitation group, while, for the transport group, they only wore clothes and hats. Other PPE,
such as eye protection, and feet, nose and hand covers, were not used. The use of less standard PPE resulted in
increased workplace accidents every day, and there was one worker who died in January 2017.
The use of PPE is also regulated in the Act, but it is not well-implemented by all sand and gravel workers. Some
of the reasons that cause PPE to be used improperly are the discomfort of PPE being used at work, the low awareness
of the workers, a lack of supervision from local policy makers (workplace owners), and that the workers perceive that
the use of PPE is slowing down their work speed [10]. Worker behavior in relation to PPE use is very important to
prevent accidents in the workplace. This study aimed to understand the determinant factors of behavior, in addition to
the predisposing factors, supporting factors, and the driving factors involved in the behavior of PPE use among sand
and gravel mining workers.

II. METHOD
The design used in this study was a descriptive correlation with a cross-sectional approach. The total population
in this study consisted of 167 people, totaling 94 people in the sand and gravel dredging group and 73 people in the
sand and gravel transporting group. The respondents were collected from six sand and gravel mining sites. The
inclusion criteria for respondents were age >18 years, have been working minimum two years, and were still actively
working. The sample size in this study was 118 respondents consisting of 66 respondents in the sand and gravel
dredging group and 52 respondents in the sand and gravel transporting group.
This study was conducted by approaching the respondents one by one because it was not possible to do a group
approach. This was because the situation and conditions in the field were not very conducive to that method. The data
collection was carried out over 60 minutes in the lunch break. Before filling out the questionnaire, the respondents

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were given an explanation of the study and then signed the inform consent. After agreeing to participate in the study,
the respondents were asked to fill out the questionnaire honestly.
The study used a questionnaire that was developed from the previous questionnaire. It was tested for validity and
reliability on 15 respondents. The questionnaire was used to measure knowledge [11], consisting of two answers,
namely: Yes= 1 and No= 0. To measure attitude [12], we used a Likert scale consisting of 10 questions with four
answers, namely: strongly agree = 4, agree = 3, disagree = 2, strongly disagree = 1 for the positive questions and for
the negative questions, there was strongly agree = 1, agree = 2, disagree = 3, strongly disagree = 4, its validity test
is .690. We measured worker confidence [13] in relation to the use of personal protective equipment through six
statements in the form of a Likert scale consisting of four answers, namely: very trusting = 4, believe = 3, do not
believe = 2, strongly do not believe = 1 for the positive statements and for the negative statements, it was very trusting
= 1, believe = 2, do not believe = 3, strongly do not believe = 4, its validity test in range of .635 till .885. Measuring
the availability of facilities and infrastructure for personal protective equipment [14] consisted of nine questions. Each
"Yes" answer was given a score of 1 and every "No" answer was given a score of 0, its validity test is .775. Measuring
the driving factors of the workers' perceptions of the owners’ attitude and actions [15] consisted of seven questions
with the form of the answers being Yes = 1 and No = 0. To measure behavior [12], we used an observation sheet
consisting of six points, using the answer format of "Yes" with a value of 1 and "No" with a value of 0, its validity test
in range of .613 till .861. The data analysis used in this research was the Spearman Rho test, which is variable relation
analysis with an ordinal data scale with significance level was <.05. This study was approved by the Health Research
Ethics Commission of the Faculty of Nursing of Universitas Airlangga number 371-KEPK.

III. RESULTS
The results of this study include demographic and specific data used to analyze the relationship between the
variables. Table 1 shows that the age that dominates in the sand and gravel dredging group was 26-35 years, and that,
in the sand and gravel transporting group where most were over the age range of> 45 years, most of the respondents
had worked for 10-15 years. The level of education of both groups was junior high school, and both groups had never
received any previous PPE training.
Table 1. Respondents’ characteristics in the sand and gravel dredging and transporting group.
Exploitation Group Transportation Group
Characteristic
n (%) n (%)
Age (year)
19-25 3 (4.5) 6 (11.5)
26-35 26 (39.4) 15 (28.8)
36-45 18 (27.3) 11 (21.2)
>45 19 (28.8) 20 (38.5)
Work Duration (years)
5-9 33 (50) 24 (46.2)
10-15 33 (50) 28 (53.8)
Educational background
No Education 6 (9.1) 5 (9.6)
Elementary school 12 (18.2) 15 (28.8)
Junior High School 30 (45.5) 21 (40.4)
Senior High School 18 (27.3) 11 (21.2)

Table 2. Determinant factor related to the sand and gravel mining workers’ behavior in terms of PPE usage

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2020 ISSN: 1475-7192

Variable n (%) p-value r

Beliefs 0.029 0.202
Positive 72 (61.0)
Negative 46 (39.0)
Knowledge 0.000 0.669
Good 41 (34.7)
Fair 59 (50.0)
Less 18 (15.3)
Attitude 0.607 0.048
Positive 62 (52.5)
Negative 56 (47.5)
PPE availability 0.000 0.328
Good 40 (33.9)
Fair 20 (16.9)
Poor 58 (49.2)
Owners’ attitude toward PPE usage 0.917 - 0.010
Good 0
Fair 18 (15.3)
Poor 100 (84.7)
Behavior
Good 34 (28.8)
Poor 84 (71,2)
Most of the respondents have a positive belief about the importance of using PPE, enough knowledge about PPE
benefit usage, they perceive there to be good enough PPE availability in the workplace and they consider that the
workplace owner has a low attitude towards PPE usage for their workers (Table 2).
The statistical analysis show that the worker’s beliefs (p=0.029; r=0.202), the worker’s knowledge (p=0.000;
r=0.669) and PPE availability (p=0.000; r=0.328) were significantly correlated with the worker behavior in terms of
PPE usage. Worker attitude (p=0.607) and the workplace owner’s attitude toward PPE usage (p=0.917) were not
significantly correlated with worker behavior in PPE usage.

IV. DISCUSSION
This study found there to be a low use of PPE (71.2%) among the sand and gravel mining workers in Indonesia.
This result contrasts with several factors related to the use of PPE by the sand and stone workers. This study showed
that most of the sand and gravel mining workers had positive beliefs in relation to the importance of PPE usage, but
they still did not use it. The workers have the belief that PPE usage slows down their work and disrupts the work
process. This belief has led to the avoidance of PPE usage. A previous study also highlighted the workers’ ignorance
as contributing to poor safety practices and low PPE usage [16].
Most of the sand and gravel mining workers have a low educational background and they have not received
information about PPE usage. The workers’ ignorance of PPE usage could be affected by their beliefs and prior
experience of PPE usage [17,18]. Other studies showed that a lack of general knowledge or knowledge about safety
training also reduced PPE usage [19,20]. Environmental factors and supporting factors, such as the availability of
facilities for PPE and the attitude of the workplace towards PPE usage, also influenced the workers in terms of PPE
usage [21].
This study results showed that the sand and gravel mining workers had an average age of 45 years with a work
duration that varied from 5 to 15 years. The results of this study indicated that there is no relationship between attitude
with the employee’s behavior in terms of PPE usage. In general, the sand and gravel mining workers have a positive
attitude, but show negative behaviors. The same result was found by another study in that attitudinal ambivalence was

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present as a partial mediating factor of safety attitude and safety behavior [22]. The condition of ambivalence could
come from the conflicts in cognitive and affective attitudes of sand and gravel mining workers.
Workers conflicts might happen in several ways, namely; the priority of safety could be conflicting with an
emphasis on schedule or cost; sand and gravel mining workers may change their safety acts when they choose to
enjoy the convenience or are under stress, anger, and difficult operating conditions; safety trainings can be conflicting
with habitual unsafe behavior in sand and gravel mining workers groups, which may lead to unsafe behavioral intent
when the habitual unsafe behavior prevails; safety attitudes and safety behavior can be inconsistent among different
team members, and the influence from their coworkers can be greater than that from the project organization’s higher
safety management, which makes it harder for safety leadership to be effective in construction crews [22,23]. This
condition is supported by the unavailability of PPE facilities, the lack of supervision and attention from the owners,
and less support from the owner when it comes to using PPE. The workers’ attitude is influenced by several factors,
such as the availability of PPE facilities, the owner’s supervision, and the workers’ beliefs in the importance of PPE
usage. The sand and mining owners in this study explained that they provided PPE for the sand and mining workers,
but that they never supervised the PPE usage.
Small-scale sand and mining locations have provided employment to many people around the site in Indonesia.
The sector plays a role in the government and society in terms of development. However, the benefits are not
accompanied by the safety issue in terms of site location. The role of the local government regarding the policy of
PPE usage and the owners’ role in increasing the workers’ knowledge of PPE usage at the sand and mining sites is
very important and needs to be improved. Other study found need to encourage supervision to ensure that PPE is
comfortable, and to always check, maintain, and replace PPE to improve the practice of wearing PPE and also
emphasized the importance of enforcing employees to comply with the use of PPE through disciplinary action,
incentives, and education [24].
However, this study has limitations that should be considered in the interpretation. We used a cross-sectional
design where PPE usage was assessed once. An observational study on site for a longer period would have been a
strength, but this requires more resources. Besides this, there is the possibility of reporting bias during the interviews.
In addition, our findings are limited to sand and mining in one site in Indonesia and the application of these results to
other sites in Indonesia or other industries may not be valid. This study gave a description of sand and gravel mining
workers in PPE usage which is not greatly studied, so the finding of this study should be meaningful information.

V. CONCLUSION
PPE usage by the sand and mining workers can be influenced by the workers’ beliefs about PPE usage importance.
Other factors that contribute to PPE usage include motivation, social support and PPE facility availability. The role of
the local government regarding the policy related to PPE usage and the owners’ role in increasing the workers’
knowledge of PPE usage is also important.
CONFLICT OF INTEREST
No conflicts of interest have been declared.

ACKNOWLEDGMENT
All authors of this study would like to thank to Universitas Airlangga.

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