practices.

from 2023(pre-upgrade) and 2024(post-upgrade). The data collected was to evaluate changes in behaviour,

effectiveness of training, the level of management support, and the availability of PPE. Both correlation and

regression analyses were conducted to determine the relationships between these variables and compliance

with PPE uses.

compliance rose from 70.14% to 73.96%. Correlation and regression analyses showed that increased

availability and training alone did not lead to behaviour change, as weakened management enforcement and

reduced risk perception played larger roles. Regression results (R² = 0.88) confirmed that perceived risk and

Compliance

The use of Personal Protective Equipment (PPE) plays a crucial role in safeguarding worker health and

ensuring product safety across industries such as healthcare, pharmaceuticals, construction, agriculture, and

food and beverage manufacturing. PPE serves as the final barrier between workers and hazards, particularly

where engineering or administrative controls are insufficient. Despite its importance, challenges with PPE

compliance persist, often resulting in preventable injuries, illness, or product contamination.

Studies have shown that poor adherence to PPE protocols significantly increased the risk of work-related

accidents, some of which can be catastrophic [1]. While PPE reduces exposure to hazards when other controls

are not feasible, it does not eliminate the risks themselves, making consistent and proper usage critical [1, 2].

sustained behavioural change [6, 7].

This study addressed that gap by evaluating PPE compliance levels before and after a factory modernization

carried out between 2023 and 2024. A mixed-methods approach was used to analyze quantitative and

qualitative data on changes in compliance behaviour, training effectiveness, perceived risk, and management

support.

Given the post-pandemic emphasis on health and safety, this research was timely and relevant. It examined

whether structural upgrades alone can shift safety behaviours or whether a more integrated approach was

needed. The study aimed to provide practical insights for aligning infrastructural improvements with

behavioural strategies to promote sustainable PPE compliance and a stronger safety culture.

behaviours. These upgrades often involve enhanced facility layout, controlled environments, improved

workflows, and stricter hygiene and safety standards. However, there was limited empirical evidence on

whether such environmental improvements alone were effective in driving behavioural change, particularly

regarding PPE usage [6, 7].

To address this gap, the study evaluated PPE compliance before and after a cGMP-compliant factory upgrade

to determine whether physical modernization improved compliance or if behavioural factors such as perceived

risk and supervisory enforcement played a greater role. The findings aimed to inform how structural

enhancements can be integrated with targeted behavioural strategies to support sustained PPE adherence and a

stronger safety culture

the extent to which the factory upgrade influenced workers’ PPE compliance behaviour; identify and compare

the key factors contributing to PPE non-compliance, before and after the factory upgrade; and explore

overall safety culture.

H₀₂: Factory upgrade has no significant impact on workers’ PPE compliance behaviour.

H₀₃: There is no significant difference in the factors contributing to PPE non-compliance before and after the

factory upgrade.

H₀₄: There is no significant change in perceptions of the upgrade’s effectiveness on PPE use and safety culture

Personal protective equipment (PPE) is crucial in the workplace to minimize exposure to hazards that can lead

monitoring for effectiveness. Regulatory agencies such as the Occupational Safety and Health Administration

(OSHA) provide standards addressing PPE use across industries, including general industry, construction, and

maritime [3]. Outside of industrial contexts, PPE is also part of daily life, including motorcycle helmets,

sunglasses, and safety boots, which provide protection in both occupational and non-occupational

environments.

Several studies have explored why workers fail to comply with PPE guidelines, identifying a combination of

individual, organizational, and environmental factors.

explaining 45% of the variance in PPE use. Poor awareness, especially regarding specific items like earplugs

and safety nets, contributed to non-use, highlighting the need for targeted training programs and awareness

Baye et al., in 2022, upon studying factory workers in Debre Berhan, Ethiopia, found that only 34.5% of

workers consistently used PPE. Key barriers included non-availability, discomfort, the desire to save time, and

negligence. On-the-job training, history of workplace injury, supervisory enforcement, and the presence of

clear safety guidelines were found to positively influence compliance [12].

Safety culture refers to the shared beliefs, practices, and attitudes within an organization regarding safety. A

strong safety culture marked by visible management commitment, effective communication, and active

workers’ involvement is a critical determinant of PPE compliance. According to Empactivo, organizations

with robust safety cultures typically experience lower accident rates and higher adherence to safety protocols

[13]. Faqir, highlighted that management commitment is fundamental to building a strong health, safety, and

environmental (HSE) culture and requires the active participation of all employees [14]. However, a growing

lack of practical, genuine efforts has contributed to a decline in meaningful commitment. To foster a positive

safety culture, management must set clear expectations, model safe behaviours, and provide consistent

Effective safety training is crucial for enhancing PPE compliance, as it not only imparts knowledge, but also

found that factors such as PPE comfort, availability, and workplace safety culture significantly influence PPE

usage among manufacturing workers. The study advocated for a holistic approach that combined ergonomic

workplace design with behavioural interventions to foster a safer working environment [16]. These findings

underscore the necessity for comprehensive training programs that enhance safety knowledge and address

workers' risk perceptions, thereby promoting consistent PPE usage and improving occupational safety.

Workplace design and environmental conditions significantly influence PPE compliance. Poor ventilation,

overcrowding, and physically demanding layouts can deter PPE use, especially when equipment is

uncomfortable or restricts movement. Conversely, infrastructure enhancements such as improved lighting,

ventilation, workflow optimization, and spatial organization can indirectly boost PPE adherence by reducing

The Health Belief Model (HBM) is frequently seen as a significant theoretical framework for explaining

personal health conduct, which encompasses the decision to use or forgo personal protective equipment (PPE)

in construction and industrial workplaces. It was originally developed in the 1950s by social psychologists

Hochbaum, Rosenstock, and Kegels in collaboration with the U.S. Public Health Service to explain preventive

health behaviours [18]. The study revealed that one's health decisions are affected by their perceptions of

potential risks, benefits, impediments, and motivational cues [19]. This makes it highly relevant for explaining

why workers often fail to use PPE consistently, even when the risks are well known, safety protocols are in

place, and PPE is both available and essential.

not previously been affected. The HBM posits that unless individuals feel personally vulnerable

The effectiveness of personal protective equipment in lowering workplace threats may not be clear to workers,

particularly if they have not encountered any accidents or injuries. The HBM indicates that individuals are

more motivated to take health-related actions if they are convinced that these actions will alleviate their risks

or reduce the severity of potential outcomes [18]. However, a lack of safety training or previous exposure to

incidents may limit this belief. Studies have shown that when workers understand the practical benefits of PPE,

behaviour. The HBM identifies such external cues as essential for triggering protective actions, especially in

dynamic or high-pressure environments.

Elshaer and Agage, (2022), reported an 81.9% compliance rate among Egyptian nurses during the COVID-19

pandemic, linking adherence to strong risk perception and knowledge [9]. Kim et al., (2024), reported a

comparable trend in South Korea, revealing that the compliance of nurses with PPE (rated 4.28/5) was driven

by their awareness, clinical experience, and previous COVID-19 exposure [28]. Maglio et al., (2016) found

Wotherspoon and Conroy, (2021), highlighted low PPE compliance among Australian medical officers,