The movement for improved workplace safety and the desire for creating more effective injury prevention initiatives have evolved over the past century. The results are evident as injury and fatality rates in the US have declined significantly, and especially since World War II. As recent as the 1980's most safety initiatives focused on prevention utilizing the 3 E's of engineering, enforcement and education. Employers who embraced these fundamental elements showed marked improvement. Safety was considered in facility and equipment design, the design of work procedures and work systems, training of workers, and through adherence to proper safe work procedures. Hazard identification, job safety analyses, hazard control procedures, machine guarding, measuring and monitoring environmental contaminants, job instruction training, personal protective equipment, safety inspections, incident investigations, and more were all part of a well-rounded safety program.

A portion of the early success of the safety movement was due to the pioneering work of H. W. Heinrich, through his book "Industrial Accident Prevention: A Scientific Approach", first published in the 1930's. From the publishing of this book through today, Heinrich likely has had more influence than any other individual on the work of occupational safety practitioners. Heinrich was highly influential in perpetuating two important concepts that still today drive most safety initiatives: that unsafe acts of workers are the principle causes of occupational accidents, and that reducing accident frequency will achieve an equivalent reduction in injury severity. More on this influence later.

With the enactment of the OSH Act in 1970, the safety movement in the US gained strength through broad regulatory requirements. Providing a safe place to work was now the law of the land. Enforcement looked beyond an organization's policies, work procedures, worker training, safety rules, and focused on compliance with regulatory standards. As employers became aware of OSHA standards and the cost of citations for failure to comply, they hired SH&E professionals to conduct compliance audits, find and correct deficiencies, and ultimately avoid fines. OSHA and its enforcement powers had a positive effect on safety in the US, reportedly reducing fatalities since 1970 by 65% and disabling injuries by 67%.

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