The construction industry remains highly hazardous, particularly in developing countries where labour-intensive practices, weak regulatory enforcement and informal training systems prevail. In these settings, small and medium-sized enterprises (SMEs) rely heavily on artisans who face significant health and safety (H&S) risks associated with routine material handling. However, limited empirical evidence exists to explain how material exposure, H&S awareness and handling practices interact to influence occupational outcomes. This study aims to examine these interrelationships among artisans in Ghanaian construction SMEs, with implications for similar developing-country contexts.
A quantitative cross-sectional survey was administered to 360 artisans across 32 towns in all 16 regions of Ghana. A structured questionnaire captured materials use, H&S awareness, handling practices and self-reported health outcomes. Descriptive statistics, one-way ANOVA and Pearson Correlation were used to examine associations and group differences among key variables.
Cement, sand and sandcrete blocks or bricks were the most frequently handled materials, indicating routine exposure to dust, alkaline contact and heavy loads. Safety awareness showed positive associations with safer handling practices and negative associations with adverse health outcomes, although safety awareness alone did not guarantee consistently safe behaviour. Material-handling practices demonstrated strong associations with reported health risks, indicating that handling practices form a key pathway linking exposure to occupational outcomes. No statistically significant differences emerged across trades, suggesting that safety challenges are systemic rather than trade-specific within SMEs.
This study advances Ghanaian H&S research by extending previous work on personal protective equipment access, safety culture and artisan safety to examine the awareness-practice-risk interaction framework within construction SMEs. It shows how hazardous material exposure, safety awareness and handling practices jointly shape artisans’ H&S outcomes. By identifying material handling as a distinct mechanism of occupational risk, the study offers transferable insights for improving H&S in labour-intensive construction systems in Ghana and similar developing-country contexts.
