Introduction

Activities in the meat processing industry predispose worker to various form of injuries, such as deep lacerations, falls, fractures and bites from animals [1,2,3,4,5]. Non-fatal injuries such as sprains and strains are common often requiring time off work or job modifications based on severity [6, 7]. Most studies on injuries in the meat processing industry come from high-income countries. But the few studies that have addressed injuries in the meat processing industry in Africa have shown a high prevalence of injuries among workers, often associated with factors such as dirty slippery floors, kicks and stamps from irate animals and sharp machinery [8,9,10].

Globally and in Ghana, abattoirs are obligated to have occupational safety policies that will mitigate the occurrence of injury. Regrettably these policies are inadequate, poorly coordinated or non-existent in most abattoirs [11,12,13,14].

In Ghana, there has been attention to other occupational safety issues, such as those in construction and mining, food safety and infectious disease risk from abattoirs [15,16,17,18,19]. However, there has been almost no attention paid to injury and safety risks for abattoir workers in Ghana. To support the development of occupational injury control strategies, it is imperative to obtain detailed information on injury characteristics. This study addressed the gap by assessing injury prevalence, types, and outcomes in abattoirs workers in Ghana.

Methods

Study design and setting

The study employed a quantitative research approach using descriptive cross-sectional design to solicit for information from abattoir workers in the Greater Kumasi Metropolis of Ghana. The city has a heterogeneous population and enhanced economic activities. It is the second largest city in Ghana with a population of 3,490,000 and a land size of 299km2 [20]. Meat processing industries in Kumasi receive their supply of animals from different regions in the country, and neighboring countries like Mali and Niger [21].

Study population

The city has 3 major meat processing facilities and 17 smaller facilities with less than 20 workers each. This study was carried out in the three main meat processing facilities. This includes Kumasi Abattoir, the Subtui Musah Slaughterhouse and the Akwatia Line slaughter slab with worker population of 200, 560 and 290 respectively. These three facilities cut across the different grades of meat processing facilities in the country. Workers include those who move animals and work in lairage as well as butchers and slaughterers engaged in killing, singeing and processing of the meat. There are also retailers, administrators and general workers who dispense, inspect the site and keep the facility operating.

Data collection

A structured questionnaire adapted from previous injury literature was employed for the data collection [15, 17]. It was divided into demographic characteristics, types and frequencies of injuries, and outcomes of the injuries occurring in the abattoir. A three-day training was done for the research assistants. The training focused on building understanding on the questionnaire and the objective of the study, conducting interviews and maintaining confidentiality. The questionnaire was in English but most of the respondents had low levels of education. Hence research assistants were trained on how to translate the questions into a language directly understood by the participants, mostly Twi and Hausa. The questionnaire asked about injuries over the prior six months. If a respondent had more than one injury event during that time, they were asked to report on whichever injury they chose.

The tool was pretested at a separate facility (Sofoline Slaughterhouse) not involved in the remainder of the study to assess the questions and the interview skills of the research assistants. Four questions were modified to assess the specific department in which the worker is engaged. Content validity assessment was done by seven experts, who have published extensively on injury related studies and necessary modifications were made before the actual data collection.

An estimated sample size of 300 was calculated using the Yamane formula [22]. Purposive sampling was used. After obtaining ethical clearance and administrative approval from authorities, the principal investigator and research assistants visited the three worksites for a total of eight days. During this time, they approached for interviews workers who were at the worksite that day. The principal investigator sought written informed consent from workers, explaining the objectives of the study. Workers who consented were interviewed. The principal investigator and research assistants interviewed as many workers as possible during the time allotted each day, up until the goal of 300 was achieved. All 300 workers approached agreed to be part of the study. Interviews were anonymous and no names or other identifying information about the respondents were collected. Data collection ran from April to June 2023.

Data analysis

Quantitative tools were employed in data analysis. Data were first cleaned and checked for completeness then exported to IBM SPSS Version 25.0, USA for analysis using descriptive statistics. Continuous variables were expressed as mean ± standard deviation (M ± SD) and the results were presented in tables, frequencies and percentages. Test of association was established by Chi square analysis.

Results

Respondents’ demographic characteristics

A total sample of 300 respondents participated in the study. Table 1 summarizes their demographic characteristics. The largest single group of participants were between 40–49 years, representing 28.3% of the respondents. The industry is predominantly male (96.7%), and are married (78.0%). Similar proportions of the respondents have primary (24.0%), junior high (21.0%) and secondary education (25.0%) with only 9.0% having tertiary education. Nearly fifty percent of respondents have over 10 years of working experience in the abattoir. Majority (60.0%) are casual workers (46.3%) hired and paid daily wages.

Table 1 Demographic characteristics of respondents
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Prevalence, types and outcome of injuries

In the 6 months prior to the study, 249 workers reported at least one injury for a prevalence of injury of 83.0% (Table 2). Laceration was the most frequent injury sustained by respondents, representing 46.0%, followed by musculoskeletal pain (16.7%) and bone fractures (14.0%). Other leading injuries included swelling of various body parts (13.0%), burns and scalds (7.3%), and dislocation, sprains, or strains (6.7%). Close to half (42.0%) of these injuries sustained required immediate medical attention (42.0%) at health facilities. Another large group (36.7%) were treated first aid by co-workers at the worksite. In terms of long-term outcome, more than half (58.9%) of injuries were moderately severe, leading to 2–7 days of lost work.

Table 2 Prevalence, types and outcome of injuries in the meat processing industry
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Association between socio-demographic characteristics, safety measures and injuries among workers in the abattoir

Table 3 shows a significant association between gender, employment status, wages and injuries among abattoir workers (p < 0.05). There was low availability of fire extinguisher (33.7%), first aid kits (16.8%), smoke detector (1.4%), emergency exit (12.1%), safety boots (63.2%) and injury incidence record book (4.1%). Only 30.1% of the respondents used PPEs at work. Use of PPEs, availability of fire extinguisher, first aid kits, and smoke detector respectively were significantly associated with injuries (p < 0.05).

Table 3 Association between socio-demographic characteristics, safety measure and occupational injuries among workers in the abattoir in Kumasi, Ghana
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Discussion

This study reports the injury burden in the meat processing industry in Kumasi, an industry that has seen little attention in terms of research. The study assessed the prevalence, types and outcome of injuries sustained by workers. This study suggests that the prevalence of injury is high with the types being predominantly lacerations, followed by musculoskeletal pain. A significant number of workers sustained moderately severe injuries, losing 2–7 days of work time, as well as requiring medical attention, both of which represent financial losses for the workers. Gender, employment status, wages and availability and use of safety equipment were significantly associated with injuries.

Our findings need to be put into the context of other studies. In high-income countries, injury rates are generally much lower. For instance, injury incidence rates of 15.2 to 22.8 per 100 full-time employees and an annual total injury rates per 100 workers of 6.4% (poultry) and 13.2% (pork) have been reported in abattoir facilities in the United States [7, 23, 24]. All of these reports show far fewer injuries than the current study's finding of 83.0% of workers sustaining at least one injury during the past 6 months (approximately equivalent to 166 injuries per 100 workers per year).

The high burden of injury in Ghana is similar to what has been reported from other African countries. In a study of slaughterhouses in Kenya, Cook et al. found that 25% of workers reported an injury at least once per month, with 8% of workers still having a wound at the time of the interview [25]. In a different study, Makori et al. found that 85% of slaughterhouse workers in the Nairobi area had been injured in the past year [26]. Among 203 workers in five slaughter houses in Ilorin, Nigeria, 88% of workers reported having had at least one injury ever [27].

We examined the types of injuries sustained by workers and our data highlighted lacerations as the most dominate type of injury. It is unsurprising as workers in this sector are usually exposed to numerous hazards such as sharp cutting tools and bones. This finding agrees with studies, both in Africa and in countries elsewhere [9, 23, 25, 28,29,30]. Musculoskeletal pain was the next common type of injury reported by this study possibly due to the repetitive movement and heavy lifting associated with abattoir operations [9, 28]. However, in another study conducted in the United States, bovine related injuries dominated [31].

This study highlights an association between employment status, wages and injuries. Most of the workers in the current study were casual employees who are paid based on their daily wages irrespective of their decade working experience in the industry. Taking a day off is considered as absenteeism and no commission is earned by the worker [32]. It is possible that employees usually work shifts and overtime to make ends meet. Worker tiredness affects attention and reaction times and raises the risk of accidents. Studies have linked shift work and weariness to the probability of accidents [27, 28]. This may possibly be a factor to the high prevalence of injury reported by this study.

Majority of injuries were moderately severe requiring between 2 and 7 days for treatment and recovery, with most respondents needing immediate medical attention. It can be anticipated that the lost wages and cost of treatment will have considerable negative economic consequences to these workers and their families. Most workers received daily pay and would not be paid while out of work. Also, the cost for treatment of even work-related injuries is usually borne by the worker and their families.

Gender of the worker was significantly associated with injuries in this study. It is evident from this and other studies that the industry is male dominated [1, 7, 25] and possibly puts this gender at risk for injuries. This mirrors findings from other studies where gender of the worker has been anticipated to be a major influencer on work place injury [33]. Although other studies suggest that the risk of injury is equivalent for both male and female [8].

The study highlights low PPE usage and the absence of safety equipment in the facilities, similar to findings of other studies in the industry [9, 10, 14, 24, 25]. Meanwhile there is a significant association between these factors and injuries. This finding agrees with other studies that using PPE properly, dramatically lowers the risk of injuries in the industry [27, 34].

Conclusion

The types of injuries noted in the meat processing industry are mostly lacerations, musculoskeletal pain and bone fractures and the frequency of these injuries is high. Most of these injuries are moderately severe necessitating immediate medical treatment. This study highlights a high burden of injuries in the meat processing industries. This reinforces calls for enforcement of existing occupational health policies in this industry.

Strengths and limitations of the study

The study depended on self-report of injuries and there was no way of verifying answers about the types, frequencies and outcome of injuries sustained. A six-month recall period was used which could have led to recall bias for earlier injuries. Despite these limitations, the present study has several strengths. The sample size was large and also the study was conducted in three geographical locations in separate slaughterhouse facilities in the metropolis thereby increasing generalizability.