The construction industry is known for the high number of accidents and fatalities. In 2018, the construction industry had the highest accident rate (31.7) per 1,000 workers and the highest number of fatalities that accounted for 87.5% of industrial fatalities amongst all industries in Hong Kong (Labour Department, 2019). Notably, most construction fatalities are attributable to falls from height (78.6%). This phenomenon also occurs in other regions, such as the USA, Singapore, Norway and Korea. Therefore, falls from height have attracted considerable research attention and become an important research topic in construction safety.

Previous studies have attempted to identify the causes of falls from height of construction workers. The root cause of falls from height of construction workers is the non-use of personal protective equipment (PPE). However, no previous studies have made a concentrated effort in understanding the PPE acceptance by construction workers. Therefore, this work aimed to identify critical contributing factors of the use and non-use of PPE by construction workers. In addition, the influence of these factors on the PPE acceptance by construction workers and the interaction amongst these factors were examined. This work used a mixed-method design that adopted qualitative and quantitative approaches (i.e. individual interview and questionnaire survey) to understand the PPE acceptance by construction workers.

In Phase I study, 60 individual interviews were conducted to explore the attitudes and experiences of construction workers towards the use of PPE and identify the underlying reasons for their use or non-use of PPE at work. Findings showed that the influencing factors of construction worker’s use or non-use of PPE could be classified into three contexts, namely, personal, technological and environmental. In the personal context, the factors included accident experience, attitude towards using PPE, habituation, risk perception, safety consciousness and safety knowledge. In the technological context, outcome expectations, perceived ease of use and perceived usefulness were identified. Social influence, safety management system (e.g. safety incentives, safety–offence point system, safety rules, safety supervision and safety training) and time pressure and workplace conditions (i.e. PPE availability and workplace limitation) were involved in the environmental context. However, the extent to which each factor influences the PPE acceptance by construction workers has not been assessed quantitatively.

For addressing the limitations of Phase I study, Phase II study proposed a research model for understanding the PPE acceptance by construction workers. Specifically, the extent to which the factors identified in Phase I study influence the use of PPE and the interaction of the factors was examined. A questionnaire survey was conducted with 300 frontline construction workers employed in five Hong Kong construction sites. Participants were determined using a convenience sampling technique. Potential participants were construction workers who worked at the construction sites during our visit. A total of 46 invalid data that had missing values were identified and removed from this study, and this procedure resulted in 254 valid questionnaires (84.67% of response rate). The collected data were analysed to test the proposed model using structural equation modelling. Safety management practices (i.e. safety–offence point system, safety supervision and safety training), safety consciousness, perceived ease of use, perceived usefulness and attitude towards using PPE significantly influenced the PPE acceptance by construction workers. Safety consciousness, perceived ease of use and perceived usefulness were significant mediators in the relationships between the safety management practices and attitude towards using PPE of constriction workers.

The results from the two studies made significant theoretical contributions to the literature on construction safety. Also, several practical recommendations based on the results were proposed to encourage the use of PPE of construction workers. These recommendations were related to PPE design, work design and safety management practices.