Encouraging Employees to Wear Approved PPE – and What to Do if They Don’t

Holly Denny
Upon review of some National Institute for Occupational Health and Safety (NIOSH) resources, PPE – or personal protective equipment – appears to be among the least effective means of hazard exposure prevention, literally landing at rock bottom on NIOSH’s Hierarchy of Controls pyramid.1 But if you think that means PPE isn’t important, think again. It should be remembered that PPE’s ground-level position in the NIOSH pyramid isn’t indicative of its fundamental value, but rather it illustrates the priority of using PPE alone compared to more direct interventions, like eliminating the offending hazard altogether. In many industries, a complete removal of certain hazards, such as noise or harmful chemicals, isn’t yet possible. For employees working around these hazards, the remaining tiers of the NIOSH pyramid – including the use of appropriate PPE – play a crucial role in minimizing exposure, preventing certain illnesses and injuries, and safeguarding their long-term health and wellness.

So, what’s an employer to do if an employee forgets or refuses to wear PPE and then sustains an exposure injury? And how can employers avoid this situation in the first place? According to Arlene King, vice president of onsite strategic initiatives at Concentra®, it all starts with a comprehensive safety plan and strong enforcement policies.

Set the stage for safety

As an employer, one of your first questions regarding PPE may be who is at fault for an injury if an employee doesn’t wear the provided PPE. As King explains, “Preventing the injury by ensuring the appropriate, consistent use of PPE can keep that question from ever having to be asked – and that should be the employer’s priority.”

This may seem like an uphill battle for some employers, but there are numerous strategies and solutions that can effectively boost PPE compliance in the workplace and even trigger a favorable shift in employees’ attitudes toward PPE overall.

At the foundation of an effective PPE compliance plan, King states, is the thoughtful design and implementation of safety guidelines and, perhaps more important, firm enforcement procedures. For example, employers can include PPE usage requirements in their company-wide safety policies and outline something as weighty as disciplinary action as a potential consequence of  policy violation. This tactic may initially be perceived by some employees as threatening or forceful, but the objective is far from sinister and, in fact, quite the opposite: demonstrating the gravity of PPE usage in keeping employees safer, healthier, and capable of doing their jobs for longer. Employers should take steps to specifically communicate this message, educating employees of the importance of workplace PPE, and letting employees know that disciplinary action is never the goal.

To wear PPE, or not to wear PPE: that is the question

Despite an employer providing the necessary PPE and mandating its use, employees still have to make the conscious choice before each shift to wear their PPE – and, unfortunately, they often don’t. In a survey conducted at the American Society of Safety Engineers (ASSE) conference in 2010, 98 percent of respondents reported having seen their employees working without the required PPE.2 Motivating employees who don’t regularly or consistently wear their PPE may involve something as simple as identifying potential reasons why they may not already be doing so. It is often assumed that employees who don’t wear their provided PPE are being stubborn or negligent, but there may be another factor at play.3 Perhaps the PPE is uncomfortable, or maybe it no longer fits correctly. There is also the possibility that an employee may never have been trained properly on how to use, wear, or maintain their PPE. Some employees may not have been educated on the hazards of their job and the importance of using PPE.

Many of these hurdles to PPE compliance can be solved by partnering with an experienced occupational health care provider like Concentra. At Concentra, we provide a comprehensive line of services and educational resources regarding PPE usage to ensure employees are medically fit to use their recommended PPE, that the provided PPE meets standards required by the Occupational Health and Safety Administration (OSHA), and that PPE fits comfortably and appropriately – a major factor in an employee’s decision on if and when to wear their PPE.4

Nothing will come of nothing

The Centers for Disease Control and Prevention (CDC) recommends that employers take a proactive role in monitoring employee safety by conducting routine safety audits to ensure PPE is being used when and where it is indicated and to identify cases of PPE non-compliance.5 Regular safety checks also serve as a reminder and an incentive for employees to continue using their PPE or, if necessary, to have their PPE adjusted or replaced.

Consider an employee who works around airborne contaminants that may be dangerous when inhaled. When the employee was first hired, a respirator questionnaire and medical evaluation were performed, and the employee was cleared for tight-fitting respirator use. An OSHA-approved respirator was provided, the fit was confirmed, and the employee was properly trained on how to use and maintain the respirator.

Over time, the employee decided to grow a beard and subsequently began wearing glasses. Now, the beard makes it uncomfortable to wear a respirator mask, and the new glasses are constantly fogging up – making it difficult to work. Because of this, the employee rarely wears a respirator anymore. Even when worn, it does not provide adequate protection due to a poor fit and seal.

During a routine floor safety check, an operations manager notices the employee working around hazardous materials without their respirator. After a discussion regarding the uncomfortable fit and other concerns about the respirator, the employee is educated on steps they can take – like shaving their beard, for example – that will allow the employee to resume wearing PPE, remain compliant and – most importantly – protect the employee’s health and safety. Ultimately, the employee decides to shave the beard and undergoes a new respirator fit test while wearing glasses, and they are once again able to work comfortably, effectively, and safely. Without the routine safety audit that was performed, the employee may have continued working for years without critical PPE – something which could potentially result in illness, injury, claims, and poor outcomes for all parties.

To further support employers’ efforts in PPE compliance and injury/illness prevention, Concentra can help to customize a medical surveillance plan based on your local, state, federal, and OSHA-mandated guidelines, with screenings and surveillance available for a wide range of exposure hazards, such as:

  • Asbestos
  • Beryllium
  • Heat
  • Lead
  • Noise
  • Silica
  • Many others

When evidence of an elevated exposure is identified through comparative medical surveillance with Concentra, employers can make necessary modifications to the employee’s PPE or job duties in order to discourage the potential development of an acute, chronic, or even life-threatening condition.

What’s in a claim?

While doing everything “right” can certainly diminish the likelihood of illness or injury associated with an employee not wearing their PPE, these situations may still arise, with OSHA estimating that up to one million injuries could have been prevented with proper PPE use in 2010 alone.6 These incidents leave employers understandably wondering, “what happens next?” 

As Dr. Maja Jurisic, vice president, medical director of Concentra strategic accounts, explains, “Workers’ compensation is, for the most part, considered a ‘no-fault’ system,” meaning there is no burden of blame. Even when an employee acts negligently by refusing to wear PPE and goes on to become hurt or ill related to hazardous exposure, employers will almost always be responsible for the resulting claim.7 Like most things, there are some exceptions to the rule – such as when the employee sustains an injury while committing a crime at the workplace or while under the influence of drugs.8 There are also some instances of workers’ compensation claims being denied on the basis of employee negligence, after which time they may go on to be evaluated by a workers’ compensation judge.9 Still, this is rare, with most injuries related to PPE non-compliance ultimately resulting in a compensable claim.

With this in mind, King’s direction to focus on preventing exposure-related injury and illness by boosting PPE compliance through education, awareness, safety audits, and medical surveillance with an occupational health provider like Concentra bears repeating. To learn more about how Concentra’s occupational health experts can support your organization’s efforts to encourage PPE use, keep your employees safe and healthy, and address employee injuries should they occur, contact us today.


  1. Hierarchy of Controls. The National Institute for Occupational Safety and Health. Last reviewed August 11, 2022.
  2. Workers Are Risking Injury By Not Wearing Safety Equipment,” by Sandy Smith. EHS Magazine. August 17, 2010.
  3. Why Your Workers Aren't Wearing Their PPE. Grainger. Accessed February 13, 2023.
  4. How to deal with some workers who refuse to wear PPE. HSE Network. May 4, 2020.
  5. Auditing and Feedback of PPE Use. CDC. Accessed February 1, 2023.
  6. Why Workers Don’t Wear PPE & How Can You Motivate Them,” by Badar Javed. Safety First. October 12, 2022.
  7. If an Employee Does Not Use Safety Equipment, Can They Still Recover Workers’ Compensation Benefits?” Hansford Law Firm. October 14, 2019.
  8. Will Workers’ Comp Cover Employee Negligence? Peterson Insurance. January 31, 2019.
  9. Division of Workers’ Compensation. State of California Department of Industrial Relations. Last reviewed 2023.