This study provides a comprehensive analysis of occupational hazards faced by healthcare workers at Kumasi South Hospital, revealing a multifactorial burden involving physical, chemical, biological, and psychological risks, as well as varying levels of knowledge and adherence to occupational health and safety (OHS) practices. The findings point to systemic and contextual factors shaping workplace safety.

One of the prominent findings is the prevalence of physical hazards, especially those resulting from manual patient handling and physical strain during routine clinical activities. This observation aligns with a study at Ho, indicating that healthcare workers are at an elevated risk for musculoskeletal disorders due to the nature of their work [12]. However, a study from the United States, which is more resourced reports lower physical injury rates, attributed to wider adoption of assistive technologies and structured ergonomic training programs [13]. The persistence of these hazards, despite awareness campaigns, may reflect systemic gaps in ergonomic design, insufficient training on proper lifting techniques, and inadequate staffing levels that increase physical workload. Addressing these risks calls for structural interventions such as ergonomic assessments, procurement of lifting equipment, and routine manual handling training, which can collectively reduce strain injuries and promote workforce sustainability.

Chemical hazards appeared as another significant threat, with healthcare workers commonly exposed to disinfectants, medications, and other hazardous substances. This aligns with findings in similar low- and middle-income countries, where chemical exposure has been linked to chronic disease such as respiratory issues, allergic reactions, and chronic skin conditions [14]. Inconsistent use of PPE, despite high awareness, suggests a difference between knowledge and practice. The reasons could include a lack of constant PPE supply, poor fit or comfort, or time pressures during emergencies. The effect is that PPE provision must go hand-in-hand with behavior-focused training, supportive supervision, and departmental accountability systems.

Exposure to biological hazards, particularly through needlestick injuries, remains a persistent issue. While similar trends are widely reported in the literature [14], the relatively lower incidence of reported infections in this study could be due to post-exposure prophylaxis availability, work overload, inadequate staffing during high-risk procedures, and delayed hazard reporting due to fear of stigma or reprisal. Strengthening infection prevention through regular drills, anonymous reporting systems, and routine access to post-exposure prophylaxis can mitigate these risks and protect both staff and patients.

Although psychological hazards were less frequently acknowledged, indicators of burnout suggest a silent yet impactful threat. Unlike studies from high-income countries that report high levels of workplace-related stress among healthcare workers [15], some underreporting here may reflect cultural stigmas surrounding mental health, limited awareness, or normalization of stress. The implication may be clear without proactive mental health interventions and open dialogue around psychological safety, the workforce remains vulnerable to emotional exhaustion and reduced quality of care. Institutional policies should include routine stress screening, mental health counseling, and wellness initiatives.

Another important insight is the generally high awareness of OHS policies and emergency procedures. This emphasizes the positive effects of targeted training on knowledge and self-efficacy in handling occupational risks [16]. However, having knowledge alone did not lead to safe practices. This was seen in the inconsistent use of PPE and delays in reporting hazards. This gap between what people know and what they actually practice is common in many healthcare systems in low- and middle-income countries [17]. It is often caused by challenges like poor supervision and a lack of follow-up. To improve this, occupational health and safety programs should include regular mentorship, refresher training, and systems that encourage team members to hold each other accountable.

In terms of knowledge, attitudes, and practices (KAP) surrounding OHS, the study found high overall awareness of safety protocols and emergency procedures, confirming prior research that links OHS training to improved safety culture [18]. Workers were generally confident in responding to emergencies and managing chemical exposures. However, the fact that safety discussions typically occurred only post-incident suggests a reactive rather than proactive safety culture. This reactive approach limits the potential for early hazard identification and prevention. To transform workplace safety, healthcare institutions must foster a culture of continuous dialogue, near-miss reporting, and preventive learning.

Importantly, variations in OHS awareness by job role and department were observed, with midwives and obstetric staff demonstrating higher knowledge than their peers. This supports earlier findings suggesting that professionals in high-risk and high-volume departments often receive more intensive and recurrent training [19]. On the other hand, the lower awareness among public health officers suggests a potential neglect of non-clinical units in safety programming. This implies that OHS training must be customized to departmental risks and job roles, ensuring equitable exposure to safety education across all staff categories.

The study also highlights the positive influence of safety training attendance on OHS knowledge and practices. This finding is consistent with international evidence that shows structured safety training improves hazard recognition, risk perception, and protective behavior [20]. Institutions must therefore prioritize regular, mandatory, and participatory training programs tailored to specific hazards and updated with emerging threats. Beyond skill development, such initiatives help embed a culture of collective responsibility and continuous improvement. This study highlights several areas requiring urgent attention, from strengthening PPE access and ergonomic design to enhancing mental health support and cultivating proactive safety cultures. The findings reinforce that improving OHS among healthcare workers is not a one-time event but a continuous process requiring policy commitment, tailored training, structural investment, and staff engagement. Future OHS programs must prioritize comprehensive, department-specific interventions that empower healthcare workers with both the knowledge and the means to protect themselves, ultimately leading to safer healthcare environments and better patient outcomes.