The Equipment Paradox: Explaining Differential Personal Protective Equipment Adoption Patterns Through Injury Experience and Perceived Threat in Informal Sector Welders

Background Despite universal awareness of welding hazards, personal protective equipment (PPE) compliance among informal‐sector welders is strikingly heterogeneous across equipment types, a pattern we term the equipment paradox. We examined distinct PPE adoption profiles and their predictors among informal welders in the Gambia. Methods Cross‐sectional analysis of 271 welders in Brikama. Latent class analysis (LCA) identified PPE adoption profiles using eight binary indicators: safety goggles, welding helmets, face shields, respirators, work suits, earmuffs, rubber gloves, and insulated gloves. Multinomial logistic regression examined demographic and occupational‐injury predictors of class membership. Results LCA identified three classes. Class 1 (selective compliance, 61.3%) showed near‐universal goggle (98.2%) and high rubber‐glove use (72.3%) but very low compliance with respirators (3.6%), helmets (9.6%), and earmuffs (1.2%), the equipment paradox in concentrated form. Class 2 (universal compliance, 29.5%) showed near‐perfect compliance across all items (mean 7.86/8). Class 3 (moderate compliance, 8.9%) showed intermediate, inconsistent patterns and the highest respiratory‐symptom burden (75.0%) despite low respirator use (46.9%). Welders with ≤ 10 years’ experience had higher odds of universal compliance (adjusted OR = 0.21 for the reverse comparison, p = 0.001), and each additional year of age increased universal‐compliance odds (aOR = 1.05, p = 0.032). Prior injury experience did not predict class membership. Conclusions The equipment paradox is driven by occupational socialization during apprenticeship and equipment‐specific barriers (comfort, thermal load, and perceived efficacy) rather than by accumulated injury experience. Interventions should target apprenticeship curricula and equipment‐specific barriers, particularly for respiratory protection.