Exposure to Organic Solvent, Health Symptoms and Safety Practices Among Automobile Spray Painters in Johannesburg, South Africa

Abstract

Automobile spray painters in small informal workshops in developing countries face high occupational exposure to organic solvents. Although health effects are well known, the influence of workers’ knowledge, attitudes, and practices (KAP) on these effects is less well understood. This study examined spray painters’ KAP regarding organic solvents and health symptoms and assessed workplace safety compliance. A cross-sectional study in Region F, Johannesburg, collected data among 152 spray painters across 47 workshops using a questionnaire and checklist. KAP scores were analysed with multivariable logistic regression to identify associations with eye, skin, respiratory, and CNS symptoms, while controlling for confounders. Workplace controls were inadequate: 64% of workshops conducted spray painting outdoors, while only 17% had a functioning spray booth. Although knowledge scores were high (45.29/50 ± 6.025), practice scores remained low (9.01/20 ± 5.275). After adjustment, higher knowledge was significantly associated with reduced odds of eye (AOR = 0.846), skin (AOR = 0.915), and respiratory symptoms (AOR = 0.890). Better practice scores also correlated with fewer skin symptoms (AOR = 0.891). No KAP construct was linked to CNS symptoms. In the absence of engineering controls, workers’ knowledge is strongly linked to lower reporting of solvent-related symptoms affecting the eyes, skin, and respiratory system. However, knowledge does not appear to influence CNS symptoms, which are probably driven by ambient solvent concentrations that individual behavioural measures cannot effectively manage. Therefore, knowledge acts as a supplementary, rather than a substitute, safeguard where engineering controls are lacking. Interventions should include education and enforceable regulations to empower workers and ensure the use of engineering controls, especially in spray booths.