Do work stress and sleep problems mediate the link between occupational injury and psychological distress? Evidence from a cross-sectional study of Ghanaian small-scale miners

Despite the high prevalence of occupational injuries (OCI) in artisanal and small-scale mining, limited evidence exists on how they are linked to mental health disorders, particularly in low-resource settings. This study examined the association between OCI and psychological distress (PD) among small-scale workers in Ghana and investigated the mediating role of work stress and sleep problems in this link. Data were drawn from a community-based cross-sectional survey involving 664 small-scale workers aged 18 and above. OCI was measured using a 7-item binary checklist. PD was assessed using the 10-item Kessler Psychological Distress Scale, and work stress was measured via a 5-item Job Stress Questionnaire. SP were assessed with two self-reported items adapted from the World Health Organization Disability Assessment Schedule 2.0. Multivariable ordinary least squares models and bootstrapped mediation analyses were used to estimate direct and indirect effects. The sample had a mean age of 28.8 years (SD=8.2), with 84.3% being male. Approximately, 35% of the participants reported at least one occupational injury. After adjusting for relevant covariates, OCI was significantly and positively associated with higher levels of PD (B = 0.888, 95% CI = 0.62 to 1.15). Work stress (18.35%) and sleep problems (20.82%) partially explained the OCI-PD link. Occupational injuries in artisanal small-scale mining settings are associated with higher levels of PD, and this is partially explained by higher levels of work stress and sleep difficulties. Policies to improve occupational safety and psychosocial well-being are crucial in informal mining communities. • Occupational injuries are linked to psychological distress among miners. • 35% of miners reported at least one occupational injury. • Work stress and sleep issues mediate injury-distress link. • Urgent need for safety and mental health support in mining areas