Occupational Health and Safety Practices Among Primary Healthcare Workers in Bangladesh: A Cross-Sectional Study

Background Healthcare workers (HCWs) in low- and middle-income countries are exposed to substantial occupational risks; however, evidence regarding comprehensive occupational health and safety (OHS) practices in primary healthcare settings remains limited. This study assessed OHS practices and explored factors associated with adequate OHS among primary HCWs in Bangladesh. Methods We conducted a facility-based cross-sectional study among 242 HCWs in eight sub-district hospitals in Bagerhat district, Bangladesh, in 2021. Data were collected using a structured questionnaire covering sociodemographic characteristics, infection prevention practices, personal protective equipment (PPE) use, working conditions, and occupational health services. A composite OHS practice index was constructed using eight binary indicators: handwashing before patient contact, handwashing after patient contact, handwashing for at least 30 seconds, mask use, glove use, goggle use, gown use, and receipt of PPE training. Working conditions, including rest during duty and meal availability, were assessed separately and were not included in the composite index. The total score ranged from 0 to 8, and a score of ≥5 was used as a predefined pragmatic threshold for meeting the composite criterion. Descriptive analysis and bivariable logistic regression were performed to explore associations with age, sex, profession, department, working hours, rest during duty, drinking water availability, training facilities, preventive medical check-up, and accident reporting system. Results Among the 242 participants, 190 were female (78.5%) and 174 were nurses (71.9%), indicating a demographically and professionally homogeneous sample. Hand hygiene before and after patient contact was reported by 214 participants (88.4%) and 238 participants (98.3%), respectively, although only 80 participants (33.1%) reported handwashing for at least 30 seconds. Mask use was reported by all participants (100.0%), while glove use was reported by 194 participants (80.2%). Only four participants (1.7%) reported using goggles and gowns, and 67 participants (27.7%) reported receiving PPE training. Less than half reported adequate rest during duty (47.1%), and none reported access to meals during duty. The mean OHS composite score was 4.31 ± 0.93. Using the predefined threshold of ≥5, 87 participants (36.0%) met the OHS composite criterion. No statistically significant associations were identified in bivariable analysis. Conclusions Only about one-third of HCWs met the predefined OHS composite criterion, highlighting important gaps in selected occupational safety measures, particularly PPE training, handwashing duration, and use of protective equipment beyond masks and gloves. The absence of significant predictors should be interpreted cautiously because the study was underpowered relative to the calculated sample size, used purposive sampling, and included a homogeneous sample dominated by female nurses. The findings should also be interpreted within the 2021 COVID-19 pandemic context, which may have influenced reported safety practices. Future studies should include larger and more occupationally diverse samples to better distinguish individual-level and institutional determinants of OHS practice in primary healthcare settings.