Occupational safety and health risks among plumbers: A qualitative study of workplace hazards, safety practices, and system-level gaps in Texas

Background: The plumbing trade exposes workers to ongoing workplace hazards that pose significant health risks. This issue is well known but remains unresolved. A key question remains: why have current safety measures, such as training programs, regulatory standards, and personal protective equipment (PPE) requirements, failed to reduce injury rates or significantly improve safety in the plumbing field. Objectives: Despite well-documented hazards in plumbing work, qualitative research examining why existing safety measures continue to fail plumbers—particularly in trade-specific U.S. contexts such as Texas—remains limited. This study examined the perspectives and daily experiences of 23 Texas plumbers to understand workplace hazards, safety practices, regulatory oversight, and potential ways to improve occupational health, contributing worker-centered qualitative evidence to a field often dominated by administrative statistics or broader construction-industry analyses. Methods: This qualitative descriptive study used semi-structured interviews (30–45 minutes) with 23 plumbers from various sectors of the Texas plumbing industry, conducted January 24 to March 1, 2025, and analyzed using Braun and Clarke's reflexive thematic analysis. Results: Thematic analysis identified seven themes, most prominently barriers to PPE use, an entrenched “get-it-done” safety culture, and gaps in policy enforcement and quality control, as well as challenges in tool and equipment safety, training adoption, and physical safety and insurance protections. These themes revealed differing views between plumbers and organizational stakeholders, examined through structural, cultural, and behavioral lenses. Conclusion: Within this qualitative sample, system weaknesses, unsafe practices, and adverse health outcomes appeared closely intertwined among Texas plumbers. Closing the perceptual gap between plumbers and employers may require coordinated efforts from both groups, offering a foundation—rather than a generalizable model—for future training, research, and policy development. Objectives: Despite well-documented hazards in plumbing work, qualitative research examining why existing safety measures continue to fail plumbers—particularly in trade-specific U.S. contexts such as Texas—remains limited. This study examined the perspectives and daily experiences of 23 Texas plumbers to understand workplace hazards, safety practices, regulatory oversight, and potential ways to improve occupational health, contributing worker-centered qualitative evidence to a field often dominated by administrative statistics or broader construction-industry analyses. Methods: This qualitative descriptive study used semi-structured interviews (30–45 minutes) with 23 plumbers from various sectors of the Texas plumbing industry, conducted January 24 to March 1, 2025, and analyzed using Braun and Clarke's reflexive thematic analysis. Results: Thematic analysis identified seven themes, most prominently barriers to PPE use, an entrenched “get-it-done” safety culture, and gaps in policy enforcement and quality control, as well as challenges in tool and equipment safety, training adoption, and physical safety and insurance protections. These themes revealed differing views between plumbers and organizational stakeholders, examined through structural, cultural, and behavioral lenses. Conclusion: Within this qualitative sample, system weaknesses, unsafe practices, and adverse health outcomes appeared closely intertwined among Texas plumbers. Closing the perceptual gap between plumbers and employers may require coordinated efforts from both groups, offering a foundation—rather than a generalizable model—for future training, research, and policy development.