Risk perception and safety behaviors in high-risk workers

Our Summary

According to the International Labour Organization (ILO, 2022), more than 2.9 million workers worldwide die each year due to occupational accidents and diseases. Beyond these fatalities, poor working conditions also represent a considerable economic burden, amounting to nearly 5.4% of the global gross domestic product (GDP) annually.
It is therefore logical that the United Nations' 2030 Agenda for Sustainable Development includes significant emphasis on occupational safety and health (Goal 8) and well-being in working conditions (Goal 3).
A crucial factor influencing workers' safety behaviors is their perception of occupational risks. This is the core focus of the literature review.
 

Definition of the Considered Scope

Risk perception, as defined by the Society for Risk Analysis (Aven, 2018), refers to the “subjective judgment or evaluation of risk by an individual”.

Traditional risk assessment involves evaluating the probability of experiencing negative consequences associated with a hazard (deliberative dimension). However, the social sciences also highlight the importance of intuitive, affective, and emotional reactions that people associate with a stimulus (affective dimension).

Under these conditions, risk perception can be conceptualized as a three-dimensional construct comprising:

This risk perception influences not only individual behaviors but also the acceptance and adherence to policies and standards (Wilson et al., 2019). This holds true at the individual level (e.g., health recommendations) as well as at the organizational level for promoting safety across various sectors.

Literature Review

The proposed literature review examines the links between risk perception and workers' safety behaviors. It encompasses publications from the past 20 years on quantitative studies concerning a wide range of physically high-risk professions, as defined by the European Agency for Safety and Health at Work (2023). These professions involve exposure to:

• Physical risks: loud noises, vibrations, chemical or biological agents, extreme temperatures, moving parts of machinery or vehicles, hazardous materials.
• Physiological risks: repetitive movements, awkward postures, manual handling of loads, etc.
   

A total of 89 articles are included in the review, more than half of which were published in the past five years. They cover a wide range of countries in Europe (with Italy leading with 8 articles), the Western Pacific region (with China leading with 9 articles), and the Americas (with the United States leading with 14 articles). Nearly one-third of the sample consists of articles on the healthcare sector (34%), followed by construction (20%), agriculture (18%), and manufacturing (12%).

Different Ways of Assessing Risk Perception

The first focus of the analysis is on how risk perception is assessed. 71% of the articles do not provide a definition of risk perception. Among those that do (29%), the majority define risk perception as the subjective judgment of a particular risk. Only a few explicitly refer to the full conceptual reality—that is, its dual deliberative and affective components.
The articles that address the affective dimension mainly use elements related to emotional reactions such as worry (n = 13), concern (n = 5), and fear (n = 7).

In total, the authors distinguish five categories of articles based on the definition of risk perception they adopt:

1. General (n = 22) – includes articles that assess risk perception in a general and unspecified way.
2. Probability and Consequences (n = 10) – focuses exclusively on the deliberative dimension of perceived risk, evaluating the perceived probability of potential negative consequences of a hazard and the perceived severity of those consequences, without taking the affective dimension into account.
3. Affect (n = 2) – includes articles that take the opposite approach, evaluating risk perception solely in terms of emotional reactions (worry, concern, etc.).
4. Mixed (n = 48) – accounts for more than half of the sample (53.9%) and includes studies that address both deliberative and affective/subjective aspects, although they may only partially cover each dimension.
5. Unclear (n = 7) – includes articles whose contributions are not clearly defined.
    

This breakdown of content makes it clear that the absence of a commonly agreed upon, scientifically grounded tool to define and assess risk perception greatly limits the comparability of studies.

Only seven out of the 89 articles examined both the deliberative and affective dimensions of risk perception in accordance with the appropriate definition and standard evaluation suggested by Wilson et al. (2019). Among these, four articles use a standardized tool: the CoWoRP scale. This is a questionnaire designed to survey risk perception in the construction sector. The questionnaire evaluates 13 items covering the deliberative dimension (with two separate subscales for probability and severity) and the affective dimension (in terms of worry and feelings of safety).
These dimensions are assessed separately across different scenarios (for example, the perceived probability of suffering negative consequences from working on a moving lifting platform; the perceived severity of potential negative outcomes from working on an unstable stepladder; worry about negative consequences of poorly placed cables on the floor; feeling unsafe due to potential negative consequences of walking on uneven mats or rugs), rather than evaluating all dimensions for the same hazards.

It should be noted that the resulting risk perception index combines various components of risk perception related to very different hazards, which often require very different preventive practices. This is an important consideration when aiming to develop effective field-based training interventions.

Risk Perception and Safety Behaviors

The second focus of the review concerns the relationship between risk perception and safety behaviors.

The majority of articles (63%, n = 56) examine safety behaviors in connection with compliance with safety rules and protective barriers.
Conversely, 17% (n = 15) of the articles assess safety behaviors from the opposite perspective, focusing solely on risk-taking behaviors (for example, non-compliance with safety rules).

The remaining articles evaluate behavioral intentions (4.5%, n = 4), accident/injury experiences (4.5%, n = 4), or a mix of different categories.
In total, only 67 articles clearly assess the association between risk perception and actual behavior. Of these, 55% report a positive and significant association between higher risk perception and the adoption of safer behaviors. Only 6% of articles report a negative and significant association—that is, higher risk perception is linked to less safe behavior.

A null effect is reported in 25% of the articles, while 13% present mixed results (for example, a significant positive effect for a specific behavior but not for others, or for a sub-dimension of risk perception).

The Role of Other Factors, Including Cultural and Organizational Aspects

This third perspective in the literature review aims to determine whether and how other factors may be involved in the relationship between risk perception and safety behaviors.

The findings mainly highlight facilitating factors at the individual level (such as personality traits, motivation, expertise, etc.). Only two articles evaluate variables at the organizational level, particularly the enabling effect of safety climate and working conditions. It is worth noting that when these organizational factors are found to be effective, they influence safety behaviors more strongly than risk perception itself.  

Key Takeaways

Interest in the topic has clearly increased over the past five years.

However, the publications still tend to be of relatively low methodological and theoretical quality, due to the lack of a common conceptual framework. The analysis revealed a wide variety of methods used to assess risk perception, many of which are of limited quality. Definitions of risk perception—and even of safety behaviors—are often missing or incomplete, addressing only one facet of the topic. Only 7 of the 89 articles assessed the three sub-dimensions of risk perception proposed as unifying by Wilson.
This methodological and theoretical weakness undermines the effectiveness of field interventions and workplace training.

Despite these shortcomings, a positive association between risk perception and safety behaviors is found in most of the articles. Frontline workers who perceive work-related hazards are more likely to adopt safe behaviors, while those with low risk perception are more likely to neglect self-protection. Training workers to recognize hazards and perceive risks is therefore a promising direction for improving safety behaviors.

Nevertheless, the presence of null effects and mixed results in nearly 40% of the articles highlights the need to further explore this relationship, although this may be due to the heterogeneity of the measures used to assess both risk perception and safety behaviors.

Organizational and cultural facilitating factors influencing risk perception and its relationship to safety behaviors remain poorly explored. Only 11 out of 89 articles have studied these aspects. Organizational factors such as safety climate and working conditions have received little attention, while the roles of group dynamics, peer relationships, and leadership within work teams are almost always overlooked. This is clearly a shortcoming, as contextual and social elements of the work environment are likely to be highly relevant. For example, if the safety climate within a team is poor (e.g., when a worker is allowed to not wear appropriate personal protective equipment; when the manager and/or colleagues fail to address clear safety violations; and/or if the team leader does not prioritize safety), a worker may come to view the work environment as less risky and thus feel less inclined to adopt safe behaviors (Christian et al., 2009; Fang et al., 2020).

Similarly, a perceived lack of managerial commitment to safety (Hansez & Chmiel, 2007) or difficulties in obtaining safety equipment may lead workers to view safety as an irrelevant part of their daily job. Moreover, work environments that promote “macho” cultures (e.g., emphasizing strength and toughness, emotional control, and courage as expressions of masculinity) may lead workers to view risks in fatalistic terms or as exciting challenges to be faced (Stergiou-Kita et al., 2015).

It is therefore essential to better understand the role played by all these contextual factors and social dynamics in shaping risk perception and compliance with safety rules among workers.