The need for occupational health services In Bloemfontein

Die navorsing is onderneem om die behoefte aan beroepsgesondheidsdienste in Bloemfontein te bepaal vir moontlike aksies om beroepsgesondheidsdienste in klein en medium bedrywe te beplan. In die probleemstelling is gemeld dat klein en medium bedrywe nie algemeen oor die dienste van ‘n beroepsgesondheidsverpleegkundige beskik nie. Die opname metode is gebruik en die navorsing was beskrywend van aard. Vraelyste is gebruik om inligting te versamel en die navorser het met behulp van ‘n kontrolelys die omgewing vir veiligheidsrisiko’s geevalueer. Drie steekproewe is uitgevoer naamlik ‘n ewekansige steekproef om die bedrywe en werknemers te identifiseer en doelgerigte seleksie om die bestuurders te identifiseer. Hoofbevindinge van die navorsing het uitgewys dat bestuurders en werknemers nie oor kennis van beroepsgesondheid beskik nie.


Summary
The research was undertaken to ascertain the need for oc cupational health services in Bloemfontein with the possi bility of planning such services in small and medium indus tries.As mentioned in the problem statement, small and medium industries generally do not employ an occupational health nurse.The survey method was used and the re search was descriptive in nature.Questionnaires were used to collect information and the researcher evaluated the en vironment for safety hazards by means of a checklist.Three samples were conducted: a samples test to identify the in dustries and employees and goal-directed selection to iden tify the managers.The main findings of the research showed that managers and employees do not know about indus trial health.

Introduction
The importance of occupational health services is not in dis pute, yet there are still certain industries that do not provide their workers with these services (Schoeman, 1999:1).There may be a number of reasons for this situation, for instance the poor economic climate, the policy of a particular industry or legislation that cannot be enforced.There is, however, aware ness among the community and the workers in industry that they have a right not to be affected adversely by the work place.This view was stated by the World Health Organization as early as 1950 (Labuschagne, 2001:2).An investigation was therefore undertaken in Bloemfontein to determine the need for occupational health services in industries in order to make appropriate recommendations for the implementation of such services in smaller and medium industries.

Problem statement
Bloemfontein is not a large industrial city.Only five of the 200 businesses in Bloemfontein have occupational health nurses in their service and only three of these are in full-time employ ment.The others have mornings -only posts or are paid by the hour.According to the National Occupational Safety As sociation (NOSA) those businesses that have industrial health nurses in their service have more than 200 employees on their establishment.Smaller and medium industries therefore do not, as a rule, have occupational health nurses on their staff (Schoeman, 1999:1).The question is, how are the health and safety of these workers ensured?According to the literature there is a lack of occupational health services in medium and small industries in other countries too.Jeyaratnam (1992:81) states that only 40% of industries with fewer than 100 workers in Indonesia have occupational health services and in the Phillipines occupational health services in smaller industries are delivered by first-aid workers.The guidance by the Health and Safety Executive on Success ful Health and Safety Management makes it quite clear that the responsibility for health and safety must begin with top man agement.Examples of health and safety philosophies as quoted by the HSE (1997) include the following "Health and safety is a management responsibility of equal importance to production and quality; and V M ?believe nothing is more important than safety ... not pro duction, not sales, not profits." (Health and Safety Executive 1997:58) Health and safety legislation in South Africa is clear as regards requirements of the employer, i.e. to ensure that safe and healthy conditions for workers are maintained (Schoeman 1999:4).Yet many safety surveys still show a wide gap in the perceptions of safety between managers (who would never hesitate to ap prove production being stopped because of a safety problem), front-line workers (who feel that production pressure has a serious effect on safety) and especially first-line supervisors (who know that production takes preference over safety).However, Budworh (1997:20) in his research found on one site that senior members of staff were convinced that safety was being managed well and that staff were well trained, well in formed and not taking short cuts.In contrast junior staff felt poorly trained, that the responsibilities were not well defined and that safety was not being taken seriously.
It is clear from the above that top management and lower level workers have many misconceptions about safety and health.An investigation appeared to be necessary in medium and small businesses to ascertain the real needs regarding occupational health services in Bloemfontein.

Definitions of terms
For requirements of this research the following definitions were used.

Objectives
The objectives were to: • identify the need for occupational health services by the management of industries • determine the awareness the management of indus -tries of the occurrence of occupational diseases and occupational injuries in their particular industries • identify the needs expressed by employees for occupa -tional health services • determine reasons why occupational health services have not been introduced in some industries.

Research design and method
A non-experimental design was used as no variables were ma nipulated (Uys & Basson, 1991:48;Wilson, 1989:145).The sur vey method by means of a structured questionnaire was fol lowed and the research objective was descriptive and explora tive.The research was contextually bound to the context of the need for occupational health services of employers and employees in Bloemfontein.

Research tecliniques
A variety of research techniques was used to collect data.

Review of tiie iiterature
A computer search of South African as well as international sources were conducted.In view of the fact that occupational health gained momentum only in the early seventies when oc cupational health courses were introduced, sources of the sev enties and later were used.Very little information in South Af rica is available about a private occupational health service as this is a new and unknown field for employers and private nurses.
Smaller industry: An industry with 50 to 99 employ -ees.Medium industry: An industry with 100 to 150 em -ployees.Large industry: An industry with more than 150 em -ployees.
Occupational health: This includes the promotion and maintenance of the physical, psychological and so cial welfare of all employees.It implies industrial hy -giene, biological monitoring of the environment, the management of minor ailments and the presentation of health education (Occupational Health and Safety Act, Act 85 of 1993).

Questioning
The need for occupational health services in Bloemfontein was ascertained by means of questionnaires completed by employ ers and employees.

Observation
The researcher explored the environment and nature of each industry to check the answers of the respondents with regard to occupational hazards as identified.In this way the researcher was able to determine whether the respondents were aware of the occupational hazards in their particular industry.The ob servations were done with the aid of a checklist.

Questionnaires completed by employers and employees
The questionnaires were compiled by the researcher with the aim of ascertaining the needs of the employers and the em ployees for occupational health services.The questionnaires were preceded by a letter in which the aim of the questionnaire and an explanation of how to complete it were set out.Two data collection instruments were compiled, one for employers and one for employees.

Validity and reliability of the questionnaires Validity
Validity may be defined as the degree to which an instrument tests what it is intended to test.Content and face validity were used.Content validity determines whether all the main aspects of the study have been included (Bums & Grove, 1993:346).This information was obtained from the literature, representa tives of occupational health nurses and research.
The researcher therefore attempted to include sufficient ques tions to achieve the objectives.The questionnaires were sub mitted to domain experts, i.e. three experts on occupational health: a research expert, an occupational health nurse and a private occupational health medical practitioner.
The brief of the experts was to determine in terms of the broad research objective whether: • the questions were representative of the domain speci -fied in the objectives (Wilson, 1989:357); • the objectives were satisfactorily built into the ques -tions; and • the appearance of the questionnaires showed face va -lidity.
Corrections were made in terms of the findings of the domain experts and the questionnaires were tested in the pilot study.
The following corrections were made: • the number of inspections carried out by the Depart -ment of Manpower was added as the occupational health nurse found this to be a weakness in occupa -tional health services; • the required responses were divided into subsections; and • the job satisfaction of workers was added.Content validity was obtained as follows: The objectives were covered by specific questions.The researcher collected infor mation about the specific needs of the workers regarding oc cupational health services, specific needs of the employers and reasons why occupational health services had not been implemented.These questions were submitted to a panel of experts in occupational health, research, a private occupational health nurse and doctor to determine the content validity.
Accuracy is part of validity because if the instrument is accu rate the information that should be obtained will be obtained (Bums & Grove, 1993:347;Polit & Hungler 1983:394).The re searcher compiled the data collection instrument in collabora tion with the domain experts.

Reliability
Reliability is the most important prerequisite for any data col lection instrument (Uys & Basson, 1991:82).The reliability of an instrument can be ascertained by the degree to which it provides the same information every time it is used (Bums & Grove, 1993:291).In this study reliability was measured by the test-retest method.The instruments were applied in a representative sample of the target population in a pilot study.The respondents were re quested to complete the questionnaire again after a fortnight.According to Wilson (1989:306) there is no set standard for the interval of time between two tests, but it must be long enough to ensure that respondents are not able to recall their responses to the first test.After this the two sets of questionnaires were compared to determine reliability.The respondents gave the same responses.Mouton and Marais (1989:79) state that the reliability of obser vations or data can be determined by the following variables: • the researcher; • the measuring instmment; and • the research context, that is, the circumstances under which the research takes place.Political activities such as trade union activity in a specific industry may have an influence and especially the extent to which the trade unions dictate to and make demands on the em -ployers and workers.
The researcher distributed the questionnaires personally and explained to the workers where necessary.The questionnaires of illiterate workers would have been filled in for them after the questions were read out to them.This would have ensured reliability as the technique remained the same.The same pro cedure would have been followed in the pilot study.However, as it happened, no illiterate workers were drawn for the study so no questions were asked orally.The questionnaires were translated into Sotho.
No reliability coefficient was statistically determined as con sistency was assumed as a result of the judgment of the do main experts.

45
A pilot study was conducted in non-selected industries to: • test the validity and reliability of the questionnaires; • test the feasibility of the study; • trace problems in the research design; • determine the accuracy of the data collection instru -ment; • familiarise the researcher with the data collection in stmment; and

Curatlonis May 2003
provide the researcher with experience of the subject, methodology and set-up of the businesses and re -spondents (Bums & Grove, 1993:48) A pilot study was conducted in ten per cent of the industries.Three industries were used and ten per cent of the workers of each industry completed the questionnaires.The businesses used for the pilot study were not included in the sample.The respond ents gave the same responses in the test-retest to all the questions and all the respondents completed the questionnaires.
During the pilot study the researcher realised that the original method of handing out questionnaires which the respondents were required to fill in immediately could not be realised.The reason was that due to pressure of work the employers would not excuse the workers for long enough to fill in the question naires.To ensure good relationships with the employers the researcher distributed the questionnaires, explained what was required to the workers and collected them the following day.

Validity and reliability of the instrument to identify occupational hazards Validity
The five-star system of NOSA was adapted and used to com pile the instrument for observation of the environment.This system was used as it is approved and used by NOSA to in spect industries.
Content validity was ensured by virtue of the fact that the instrument was checked by an official of NOSA for complete ness.The researcher did not use all aspects of the 5 star sys tem as it is an extensive programme for large mines and facto ries.Only aspects that applied to the industries in the research were used which is why the official was asked to check it.The instrument was accurate as regards the industries in the study as the information obtained was intended to be obtained.

Observation of the working environment
According to Mouton and Marais (1989:160) observation in science can take many forms, such as recording the activities in the environment in terms of specific criteria.The researcher observed the working environment of the various industries to ascertain whether the employers and employees were aware of the particular occupational hazards in their working environ ment.
In view of the fact that the researcher had to remain objective at all times, the observations were conducted in terms of a

Reliability
Reliability of the instrument resided in the fact that it was an approved instrument of NOSA and that it provided the same information every time even though it was used by different evaluators (Bums & Grove, 1993:291).
Mouton & Marais (1989:79) state that the reliability of obser vations or data is also determined by variables such as the researcher, the measuring instrument and the research context.The researcher inspected the working environments person ally with the same measuring instrument and the circumstances remained the same.The researcher did not manipulate the en vironments and recorded only that which was observed.structured, objective, standardised observation technique (Mouton & Marais, 1989:165).A checklist was used as a guide.
The five star NOSA system was adapted by the researcher.It includes aspects with regard to the environment for example the floors, illumination, ventilation, facilities, and pollution.Aspects with regard to safety measurements were also in cluded.The researcher asked the manager or personnel officer to show her the working environment to enable her to check her answers regarding occupation health hazards with those of the employers and employees.The visits to the industries took an average of one hour per industry and the managers were all very helpful.

Sample 46
Three samples were used: one for the industries; one for the employers; and one for the workers.-ers) and small (50-99 workers) was carried out.The sample comprised 30% of the population.

Sampling of the industries
and Industry in Bloemfontein who conducted a computer search.
Random selection of 30% of the industries in each group of small and medium industries was carried out.
The names of the small industries were listed alpha -betically and every fourth industry was selected.The same method was followed with the medium indus -tries and in this case every third name was selected as fewer medium industries were listed (See Table 1).
A random stratified selection of the 52 industries reg -istered with the Chamber of Commerce and Industry in Bloemfontein was done.These industries have 50 workers and not more than 150 workers.Thirty per -cent of the businesses and 10% of the total number of workers in each business were selected.There were 38 small and 14 medium industries in Bloemfontein that met the inclusion criteria.
The following information was obtained before the sample was drawn: industries registered with the Chamber of Commerce and Industry; and number of workers.

Obtaining consent
The research was planned in collaboration with the Bloemfontein National Occupational Safety Associa -tion (NOSA) and the Bloemfontein Chamber of Com -merce and Industry as the industries are registered with them.
After the sample was drawn the industries concerned were contacted by telephone and appointments were made with the managers.Their consent for the re -search was obtained and no problems were encoun -tered in this regard.The appointments were con firmed in writing.

Sampling of worlcers
A random sample of 10% of the workers in each in -dustry was obtained.The percentage was determined by a statistician of the University of the Free State as it appeared that this was adequate to generalise in terms of Bloemfontein.The sampling is illustrated in Table 2 The information was obtained from the Chamber of Commerce This table shows that the eleven small industries com -prised retail, printing, security, industrial, hotel, fur The four medium industries with 1 (X) to 150 workers comprised a motor, retail and two food industries.

Sampling employers
A non-random sample of the employers was drawn.Goal-directed selection was carried out in terms of in -elusion criteria.These were that the person should be in a management post.According to Uys and Basson (1991:101) goal-directed selection is also about the convenience of the researcher.Anyone in a management position who was willing and available was considered to be adequate to provide the required information.

Ethical issues
Ethical issues refer to those abstract codes and regulations that guide a researcher in conducting a study (Bums & Grove, 1993:120).Respondents were informed in such a manner that they understood the procedure of the research and the re search method.Written consent to participation was requested.Anonymity and confidentiality were assured as the names of the industries and respondents were not made known to the public.Privacy was assured by virtue of the fact that the re spondents could complete the questionnaires at home without interference from outside.

Data analysis
The data was analysed in the computer centre of the Univer sity of the Free State on a Convex computer and SPPS pro gramme (Statistical Package for the Social Sciences).Frequency tables and the Chi-quadrate analysis was performed by cross tables.

Discussion of the findings Gender and age of managers
Fourteen managers completed the questionnaire, 12 of whom were men and two women.Seven were between 25 and 35 years old, five between 36 and 45 years and only two fell in the age group 46 years and older.

Occupational hazards in the specific industries
The managers were requested to identify the occupational haz ards in their industries.Table 3 indicates the managers' knowl edge of occupational hazards in their industries.The researcher identified occupational hazards in the selected industries by means of the literature, the five star system of NOS A and ob servation of the working environment.As indicated in the ta ble the researcher identified more occupational hazards.Only a few of these were mentioned in each industry by the managers.As occupational hazards were not clearly mentioned in the responses it may be interpreted as ignorance.It is cause for concern that occupational hazards such as loss of hearing and incorrect actions were not mentioned by some and that five managers could not identify any hazards.

Measures to protect workers from occupational hazards
Table 4 indicates the measures that managers instituted to pro tect workers against occupational hazards.The managers could have indicated more than one measure: Four of the managers left the question unanswered or indi cated that occupational hazards did not apply in their indus tries.However, the researcher found that there were occupa tional hazards in all the industries (See Table 3).

Need for occupational health services
Eleven (73%) of the managers felt a need for the identification of occupational hazards and advice about the prevention of injuries due to the indicated hazards.Ten (66%) indicated that they also felt a need regarding the management of injuries on duty, first aid training and health education.
Nine (60%) of the managers mentioned a need for the following services: pre-employment examinations periodic examinations retirement examinations information regarding legislation information regarding safety programmes information regarding occupational safety and hy -giene

S up ervision 5
A ction a g a in st w o rke rs w h o ca rry o u t d a n g e ro u s actio ns 2 T rain ing th e worl<ers 8 P rovidin g p ro te ctive clo th in g 1 N ot an sw e red 4 Although five of the managers knew nothing about occupa tional hazards (see Table 3), it may be assumed from Table 4 that the training of workers is an important aspect of the pre vention of occupational hazards, as eight of the managers indi cated that they tried to prevent these hazards by training their workers.

Statistics of injuries and illnesses
The employers were asked whether they had statistics of inju ries on duty and absence due to illness to determine the inci dence.Twelve (80%) of the industries did keep statistics of injuries on duty and absence due to illness.According to the statistics of the industries over a period of a year, seven man agers indicated that there were fewer than 10%, four that there were between 11 and 15% and only one that there were be tween 15 and 20% absences due to illness.This indicates that the industries surveyed in the research did not suffer serious illness absences and injuries on duty.
The management of minor injuries was mentioned by 10 (66%).
It is clear that managers feel a need for occupational health services in their work places.

Occupational health services delivered in the industries
Only one of the industries made use of a private occupational health nurse on an hourly basis.Two of the other industries receive visits from safety representatives of NOS A. The man agers were asked why they do not employ an occupational health nurse.Six (40%) replied that the industry could not af ford one and four (26%) did not answer the question.Two (13%) felt that such a service was not necessary in a small industry.In response to the question whether they were aware of the health needs of the workers only four (26%) answered yes.Eight (53%) answered no and two (13%) were unsure.

Curatlonis May 2003
The employees Eighty-five employees returned the questionnaire which com prised an 80% response.

Age distribution of employees Table 5: Age distribution of employees (N=85)
considered when planning occupational health serv -ices and specific health education.The hazards of their posts and types of industry should be empha sized in education about occupational hazards.

AGE Frequency Percentage
19 ye a rs and you ng er According to Table 5 the greatest age distribution (73%) was between 20 and 40 years.Only 1 % of the workers were younger than 19 years, while 26% were older than 41 years.In total 93% of the workers were between 20 and 50 years old.These statis tics show a normal distribution, because, according to Hurlock (1981:207) and Papalia (1995:365) early adulthood is from 18 years to 40 years and these are working people's most produc tive years when they are active in the labour market.

Language preference
Most respondents (53%) preferred Afrikaans and Sotho (27%).Other languages spoken were English (9%), Tswana (9%) and Xhosa (2%) as indicated in Figure 6.3.The main language groups in the industries are, therefore, Afrikaans and South Sotho.This corresponds with the language of the Free State region where most people speak these two languages.

Qualifications of workers
The qualifications of the employees varied between Grade 7 and post-schooling training.The highest qualification of most of the workers (43%) was Grade 12 (matriculation).Almost the same percentage of workers had Grade 10-11 (20%) and post-schooling training (19%) as their highest qualification.Only 18% of the employees had a lower qualification, that is.Grade 7 to 9 as their highest qualification.

Posts filled by employees
The employees included in the research filled a wide spectrum of posts.These varied from 10 (11%) ad ministrative posts, 14(16.4%)labourers, 10(11%) salesmen, 10(11%) supervisors, 32 (37%) artisans and 3 (3.5%)marketers.Two (2.4%) each were mechan -ics, instructors, hairdressers, industry, switchboard operators and storemen.A book binder, chef, labora -tory assistant and teller were also included in the research.The posts occupied by the workers must be Eighty percent of the respondents had at least two years' experience in the specific industry which could mean that they were aware of the occupational haz -ards of their posts.However, the 20% who had nought to one year's experience possibly could not yet iden -tify all the occupational hazards.Jeyaratnam (1992:128) emphasizes the responsibility of occupa -tional health nurses in pre-employment, periodic and retirement examinations and the follow-up of new workers in the industry, especially with regard to the identification of occupational hazards and the train -ing of workers to identify these hazards themselves.

Job satisfaction of the employees
Workers were requested to indicate whether they were satisfied with their working circumstances.Seventytwo percent indicated that they were satisfied.Only 26% were sometimes unhappy in their work and two (2%) were never happy in their work.

Aspects that made workers happy in their work
Workers could indicate more than one aspect.Table 6 indicates that most of the employees (50,6%) placed a high premium on good interpersonal relationships to ensure job satisfaction.An important factor for 24.7% was that their work should be challenging and recog -nition was important to 22.4%, while 17.6% wanted to achieve good results.Good communication be -tween workers and managers was important to 11.8% of the respondents.Less important aspects for job satisfaction were good working conditions (9.4%) and fairness (7.1 %), while only 1.2% of the respond ents mentioned a stable industry as an aspect that made them happy.Two (2.4%) respondents indicated that nothing in the industry made them happy.

Curationis May 2003
Herzberg's motivation/maintenance theory emphasizes the characteristics of the work and the working environment as important factors in influencing behaviour in the work situa tion.Actual satisfaction in the work comes from intrinsic moti vation.No employer can provide intrinsic motivation, but the work situation can be structured to encourage intrinsic moti vation.This is done by providing motivation factors, that is, opportunities for personal development and promotion, rec ognition of achievements, challenges and responsibility.Herzberg also writes that hygiene factors do not need to be excellent to make workers happy in their work.Many workers are happy and satisfied in their work without earning large salaries or working in ideal circumstances (Herzberg, 1968:61).The research shows clearly that motivation factors are very important to workers.Schilling (1981:183) stated that periodic investigations and inspections should be carried out by the occupational health nurses in the working environment to en sure that the workers remain happy in their work and that they are suited to the posts they occupy.

Occupational safety Occupational hazards in industry
The employees were requested to make a list of occu -pational hazards which in their view, could be associ -ated with their specific industry.Table 7 shows the hazards identified by the workers.M a n a g e m e n t o f m in o r a ilm en ts

Aspects that make the workers unhappy in their work
The two most important aspects that made the work -ers unhappy in their work were poor interpersonal relationships (19%) and poor communication (15.2%).
Poor working conditions and poor salaries were sited by seven workers (8.9%) as the causes of job dissatis -faction.Factors that the respondents regarded as less important causes of job dissatisfaction were poor results and staff shortages (6.3%).Double standards, poor management and poor fringe benefits (5.1%) were also mentioned as contributory factors.Only three (3.8%)workers identified autocratic management and intimidation as causative factors, while 2 (2.5%) men -tioned poor facilities and unrealistic pressure as un desirable aspects that could lead to unhappiness.

Curationis May 2003
Although the employees identified more occupational hazards than the managers, it was significant that the term occupa tional safety was unknown to 49.4% of them.Three workers (3.5%) were under the impression that there were no occupa tional hazards in their industry.The researcher investigated the working environment of all the industries in the sample and none were completely free of occupational hazards (see Table 3).Table 7 indicates that five employees (5.9%) identified a lack of protective clothing as an occupational hazard and four (4.7%) identified exhaust gases.Three workers (3.9%) sited slippery work surfaces and the use of electricity, two (2.4%) communi cable diseases, back injuries and dust, and one ( 1.2%) worker mentioned noise, smoke and the use of stepladders as hazards.
education (53%).None of the respondents mentioned a safe working environment.According to Table 7 they did not know the term occupational safety and were therefore not fully ori entated to occupational hazards.
Lastly the workers were asked how such a service, if it were instituted, would affect them with regard to their work.Their responses are shown in Table 9.
Table 9 shows that the respondents gave relevant responses, i.e. that production would be increased (37%) and 65% men tioned the promotion of health.Again there was no mention of a safe environment or occupational hazards.
According to this study 49% of male and 50% of female re spondents were unaware of the occupational hazards in the industries in which they worked.Fifty-two percent of the South Sotho, Tswana and Xhosa-speaking respondents were not fa miliar with the hazards in their immediate working environment.
In the age group 31-50 years 59% of the respondents indicated that they were unaware of the occupational hazards in their industries.This age group represented most of the workers (52%) and they require health education regarding occupa tional hygiene.Kotze (1992:64) emphasized that the levels of exposure to specific stress factors must be within safe limits.Continuing supervision of the working environment and the workers by the occupational health nurse is necessary to en sure a safe workplace.
Fifty-five per cent of the respondents with low qualifications did not know about occupational hazards compared with 45% of those with matric and post-schooling training it may indi cate that respondents with low qualifications are not aware of occupational hazards.

Conclusions
From the data obtained from employers it was clear that they were ignorant of occupational health and occupational haz ards in their industries.It also appeared that they were not focused on these matters as only one manager mentioned pro tective clothing as a measure against hazards.However, they did indicate that they felt a need for services in their industries and that the most important reason for the lack of occupational health services was that they were unaffordable.
Although most of the workers were happy and satisfied in their work, they were ignorant of occupational hazards and safety aspects in their industries.The workers could identify more occupational hazards than the managers which indicates that management are not really focused on occupational safety.Workers indicated that they needed occupational health serv ices with regard to health education and the management of minor ailments.They did not experience a need for a safe work ing environment.Sixty-five per cent of the workers mentioned that the institution of an occupational health service would promote their health, which was a relevant response and could indicate that they experienced a need for occupational health services.

Protective clothing and problems in the working environment
Only 18 (21 %) of the workers were aware of measures insti tuted against occupational hazards by management but it was good to note that 72% of the employees were aware that pro tective clothing was to be worn.Fifteen (18%) of the respond ents believed that they became ill as a result of problems in the working environment.

Recommendations
Occupational health nurses have an important task in providing information to employers and employees as this research showed that there is ignorance re garding occupational health.
Occupational health nurses should become visible and play their role in a manner that makes them really essential and indispensable.

Need for occupational health services
The respondents were asked what their needs would be if an occupational health service were to be offered.Their needs are indicated in Table 8.They were allowed to mention more than one need.
It appears from Table 8 that their greatest need was for health

55
Current occupational health legislation in the coun try should be enforceable Gaps in the market, for instance the introduction of occupational health services to industries with more than 50 employees on an hourly and affordable basis by occupational health nurses should be taken up by nurses with initiative and drive.

A
stratified random sample (Uys & Basson, 1991:99) of all the industries registered with the Chamber of Commerce and Industry in Bloemfontein was drawn.The aspect used for stratification was the size of the industry.A stratification of medium (100-150 work Curatlonis May 2003 g e m e n t o f d ru g d e p e n d e n ce 1 7 20 M a n a g e m e n t o f d e p re ssio n n and tre a tm e n t o f se xu a lly tra n sm itte d in fe ction s