Annually, the occurrence of various kinds of occupational accidents in different workplaces imposes various damages to the active manpower and tends to develop life-threatening disabilities and situations [1]. Occupational accident is any physical injury conditions sustained on a worker in connection with the performance of his or her work [2]. In 2016, The International Labor Organization (ILO) reported that there are over 270 million occupational accidents, and those cause two million deaths annually [3]. In many countries, despite the relative improvement in workplace conditions, occupational accidents and its consequences are increasing among employed workers. Studies show that 80–90% of causes of occupational accidents in industrialized countries are due to the unsafe behavior of workers and 10–20% is related to the unsafe working conditions. Although the first priority in the workplace is to reduce hazards through the design and engineering controls, lowering human errors through educating workers and improving their health behaviors are also important [4].
One of the most common human errors is the lack of use of personal protective equipment (PPE). In fact, 34% of occupational accidents were resulting from the lack of use of PPE available at workplace at the time of the accident. In addition, 13% of work-related accidents result from the inappropriate use of PPE [4]. Some studies found that there is a positive relationship between the social and managerial support and the use of PPE at the workplace [5,6,7].
The PPE refers to protective clothing, helmet, or other equipment used by workers to reduce the specific occupational hazards [8]. In other words, PPE includes a wide range of equipment designed and manufactured to protect the various parts of body (from hair to feet) against a variety of possible risks at the work environments. In fact, PPE prevents from injuries or infections through creating a barrier against risk factors [9]. The head of workers could be injured in working settings such as the cement industry when they are involved in activities such as extraction and crushing, baking, production, packaging, and delivery. Even head damage has been reported in other occupational activities such as packaging, building construction, machinery repair services, warehousing, and welding [9].
Improved workers’ health promoting behaviors can prevent occupational injuries in workplaces. Workplace can be regarded as a suitable environment for training, shaping health protecting behaviors, and implementing screening programs on major group of workers [10]. To obtain useful and efficient results, trainings should be designed based on health education theories and models. These theoretical frameworks provide a systematic view of events or achievements and include a systematic process to analyze the successes or failures. In addition, these approaches, as a way map, provide the required guidance to the educational needs assessment, design, implementation, and evaluation of educational interventions [11, 12]. These approaches have potential to promote workers’ efforts to reduce the unwanted accidents [13].
The theory of planned behavior (TPB), as a behavior change theory, is widely applied to alter and improve different health behaviors such as nutritional behavior of women [11], students’ self-monitoring intention and safe practices in workshops and laboratories [14], the appropriate method of manual load carrying among workers [15], effectiveness of training on the workers’ safety performance [16], and obesity preventive behaviors among high school students [17]. The TPB is an extension of the theory of reasoned action which includes an additional construct called the perceived behavioral control [13]. The TPB assumes that behavioral intention determines behavior directly and indicates that three factors influence an individual’s intention, namely attitudes toward a behavior, subjective norms, and perceived behavioral control (PBC) [18].
When an individual wants to perform a behavior, he/she, first, evaluates the outcome and then forms an intention to perform it. Subjective norms are based on the fact that the individual is influenced by others in the society, including partners, parents, religious leaders, relatives, and health officials, and accordingly performs or avoids performing a behavior under their influence or pressure. In fact, the individual builds his intention based on the demands of others. PBC refers to the degree to which an individual feels that the performing of any given behavior is under his volitional control. If the individual believes that there are no opportunities or resources to perform a particular behavior, he/she is likely not to form a strong intention to perform that behavior even though he/she might have positive attitudes toward it or believe that important others would approve it [12, 17].
Considering that the TPB can help to predict and understand environmental and individual factors affecting behavior, the present study aimed to assess the effect of the TPB-based training intervention on helmet use behavior of workers employed in cement factories located at Khoy and Urmia, Northwest of Iran. The results of this study can be helpful in improving health behaviors, and health of the workforce, in turn, may lead to increase the productivity of production centers.
