Table 3 Cost of Best Practices Program Implementation

In 1970, the OSH Act was promulgated with the intent focus “to assure so far as possible every working man and woman in the Nation safe and healthful working conditions” (29 U.S. Code 671). The question of how to accomplish that goal has been the subject of discussions throughout the SH&E community long before the act was passed. Over the years, practitioners and researchers have suggested that an effective way to prevent and control occupational injuries, illnesses and fatalities is to design out or minimize hazards and risks early in the design process (Lin, 2008; NIOSH, 2006, 2010; Schulte, Rinehart, Okun, et al., 2008). Looking at early efforts beginning in the 1800s, this belief was typified by the widespread implementation of machine guards, boiler safety practices and controls for elevators, followed by more efforts such as lockout/tagout controls and improved ventilation. Following passage of the OSH Act, many efforts, including the Safety and Health Awareness for Preventive Engineering (SHAPE) program (www.cdc .gov/niosh/topics/SHAPE), the issuance of the Process Safety Management of Highly Hazardous Chemicals Standard (29 CFR 1910.119), the OSHA Alliance Roundtable on Design for Construction Safety (www.design forconstructioninsafety.org), and NSC’s Integrating Safety Through Design Symposium and its Institute for Safety Through Design were all undertaken to encourage prevention during the design process (Schulte, et al., 2008). Despite this level of activity, a need for a national comprehensive approach to address worker safety and health issues by designing out potential hazards at the beginning phases of a project remained. In July 2007, NIOSH launched the Prevention Through Design (PTD) national initiative to establish such a comprehensive approach (NIOSH, 2012). The initiative’s broad mission is “to prevent or reduce occupationally related injuries, illnesses, fatalities and exposures by including prevention considerations in all designs that affect individuals in the occupational environment” (NIOSH, 2010). With the assistance of diverse stakeholders spanning the industrial sectors and educational disciplines, PTD was defined as: