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Impact of Workplace Health Screening on Early Detection of Chronic Diseases among Formal-Sector Workers in Nigeria

Abstract

Chronic diseases constitute an important public health challenge and may remain undiagnosed for extended periods because many individuals do not undergo routine health assessments until symptoms become noticeable. Early detection of chronic diseases such as hypertension, diabetes mellitus, cardiovascular diseases, and other non-communicable conditions provides an opportunity for timely intervention, lifestyle modification, treatment initiation, and prevention of complications. Workplace health screening provides an important avenue for identifying health risks among formal-sector workers because employees spend a substantial proportion of their time within organized work environments where occupational health and wellness programmes can be implemented. Workplace health screening refers to systematic health assessments conducted or facilitated within the workplace to identify risk factors, undiagnosed conditions, and early signs of chronic diseases. Such screening may include blood pressure measurement, blood glucose testing, body mass index assessment, cholesterol testing, cardiovascular risk assessment, and other appropriate health examinations. Early detection refers to the identification of previously undiagnosed chronic diseases or clinically significant risk factors at an early stage through appropriate screening and assessment. In Nigeria, formal-sector workers may face occupational stress, sedentary lifestyles, unhealthy dietary patterns, limited physical activity, and competing work demands that can increase their risk of chronic diseases while also limiting their opportunities to seek routine healthcare. Workplace screening may therefore provide a convenient opportunity for identifying previously undiagnosed conditions and connecting workers with appropriate healthcare services. Against this background, this study investigates the impact of workplace health screening on early detection of chronic diseases among formal-sector workers in Nigeria. The study is anchored on the Health Belief Model, Social Cognitive Theory, and the Preventive Health Model. The Health Belief Model explains participation in health screening through perceived susceptibility to disease, perceived severity, perceived benefits of early detection, perceived barriers, and cues to action. Social Cognitive Theory emphasizes the interaction between individual knowledge, self-efficacy, workplace environment, social influences, and health behaviour. The Preventive Health Model provides a framework for understanding individuals' decisions to participate in preventive health services based on perceived risk, anticipated benefits, and barriers to action. Collectively, these theoretical perspectives provide a suitable framework for explaining how workplace health screening may influence early detection of chronic diseases among formal-sector workers in Nigeria. The study will adopt a quantitative quasi-experimental research design. Primary data will be collected from formal-sector workers in selected Nigerian organizations using structured health-risk assessment questionnaires, workplace screening records, and appropriate clinical screening tools. A multistage sampling technique will be employed to select states, organizations, workplaces, departments, and eligible workers. Where feasible, workers will be assessed before and after participation in a structured workplace health-screening programme, while a comparison group may be used to strengthen evaluation of the intervention. Workplace health screening will include appropriate assessments such as blood pressure, blood glucose, body mass index, waist circumference, cholesterol or other cardiovascular risk indicators, depending on the screening programme and available clinical resources. Early detection will be assessed using the identification of previously undiagnosed hypertension, diabetes mellitus, elevated cardiovascular risk, obesity, or other selected chronic disease indicators confirmed through appropriate clinical assessment and referral procedures. Additional information will be collected on workers' sociodemographic characteristics, occupational characteristics, previous health screening history, family health history, lifestyle practices, and healthcare utilization. Descriptive statistics will be used to summarize participants' characteristics, screening participation, detected health conditions, and referral patterns. Inferential statistical techniques, including chi-square tests, paired-sample tests, independent-sample tests, and logistic or multiple regression analysis, will be used to determine the impact of workplace health screening on early detection of chronic diseases. Where appropriate, pre-screening and post-screening detection rates will be compared. Diagnostic tests will also be conducted to assess the reliability of the research instruments, model assumptions, goodness of fit, multicollinearity, and robustness of the findings. The study is expected to find that workplace health screening has a significant positive impact on the early detection of chronic diseases among formal-sector workers in Nigeria. Workers who participate in organized workplace screening programmes are expected to have a higher likelihood of identifying previously undiagnosed chronic conditions and important disease risk factors compared with workers without access to routine workplace screening. Screening is expected to facilitate earlier identification of hypertension, diabetes, obesity, cardiovascular risk, and other selected chronic health conditions, thereby creating opportunities for timely referral, treatment, lifestyle modification, and continued monitoring. Workplace-based screening is also expected to reduce some of the practical barriers associated with accessing health assessments outside working hours. However, the effectiveness of screening may depend on workers' participation, the quality and frequency of screening, availability of appropriate diagnostic equipment, confidentiality of health information, referral systems, and access to affordable follow-up care. Consequently, screening programmes should be integrated with appropriate referral, counselling, treatment, and health-promotion services rather than functioning as isolated screening activities. The study is expected to contribute to the literature on workplace health screening, early detection, chronic disease prevention, occupational health, employee health, health promotion, preventive healthcare, and public health in Nigeria by providing empirical evidence on the role of workplace-based screening in identifying chronic diseases among formal-sector workers. The findings will provide useful information to the Federal Ministry of Health and Social Welfare, Federal Ministry of Labour and Employment, employers, occupational health departments, healthcare providers, health insurance organizations, public health practitioners, workplace wellness programmes, development partners, and policymakers regarding strategies for strengthening preventive healthcare in formal-sector workplaces. The study will also provide evidence-based recommendations for establishing regular workplace health-screening programmes, improving employee participation, strengthening referral and follow-up systems, protecting worker confidentiality, integrating health education with screening activities, and promoting early detection and management of chronic diseases among formal-sector workers in Nigeria.

Keywords: Workplace health screening, early detection, chronic diseases, formal-sector workers, Nigeria, occupational health, preventive healthcare, health promotion, employee health, hypertension, diabetes, cardiovascular risk, workplace wellness, public health.