It has been well published that employment within the construction industry, particularly in manual roles, is a dangerous occupation. Within the United Kingdom (UK) some 2.2 million people are employed within this sector and during the last 25 years, over 2,800 people have died with many more injured or suffering ill health as a result of this occupation. Further to this, many more people have indirectly been killed or suffered injury or ill health by poorly designed and constructed workplaces. As a consequence, much research on occupational health and safety within this sector has been undertaken to establish root causes of accidents and ill health. One attributor identified by research is ineffective consideration of health and safety by construction designers during the design development stages. Legislation via the Construction (Design and Management) Regulations 2007 (CDM2007) has been introduced in the UK to provide clear responsibilities on construction designers towards occupational health and safety. This responsibility requires construction designers to consider the impact of their design on the health and safety of those affected by the construction and end use, including end users, maintenance staff and future demolition workers. However, recent research has repeatability shown that CDM has not achieved the desired effect and that many construction designers are failing to fulfil their statutory designer duty obligations as defined by CDM2007 This research explores the established link between poor design and accident causation and the reported failures of construction designers to effectively manage their legal and moral obligations by considering health and safety implications of their designs. It uses data from existing studies, interviews, focus groups, online forums, questionnaires and case study observations, using a mixed method approach, targeting registered Architects. The research uncovers a number of underlying barriers that potentially hinder designer consideration of Health and Safety, proposes a number of influencing factors that act as triggers for design team involvement and suggests a framework to utilize these factors. The developed framework, called STAGE, establishes a series of structured design reviews throughout the design and construction phases of a project and provides tools to encourage and support collective consideration of health and safety risks. This method supports development of a safety culture with focus on collective knowledge sharing and encouragement of holistic and pre planned structured safety reviews. As pointed out by Walker (1989), disasters of all kinds occur with monotonous regularity in humanly devised systems. This impresses upon us the fact that good design is not simply a question of taste or style; it is literally a matter of life and death.

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The United Kingdom (UK) construction industry is one of the worst industries in the UK in terms of health and safety (H&S) performance. Numerous injuries, deaths, dangerous occurrences and work related illnesses are reported annually in the industry, and these are associated with huge economic and social costs which make the need for H&S improvement inevitable. The pursuit of improvement has triggered studies into construction accident causation which have emphasised the need to pay attention to underlying accident causal factors which emanate from the pre-construction stage in order to have sustained improvement in H&S. Construction project features (CPFs), such as nature of project, method of construction, site restriction, procurement method, project duration, level of construction, design complexity, and subcontracting, which are organisational, physical, and operational characteristics of projects emanating from pre-construction decisions fall in this category of underlying causal factors. However, despite the significance of underlying causal factors to H&S, not much attention by way of research has been given to CPFs. As a result, insight into how CPFs influence accident occurrence, the degree of their inherent potential to influence accident occurrence (i.e. their potential to cause accident) and their associated degree of H&S risk (i.e. the likelihood of accident occurrence due to CPFs) remain elusive in the extant construction H&S literature. This research was thus undertaken to empirically investigate the mechanism by which CPFs influence accident occurrence and assess their degree of potential to influence accident occurrence and their associated H&S risk. Adopting a mixed method approach, the accident causal influence of CPFs was investigated. Following a conceptualisation of how CPFs influence accident occurrence based on systems models of accident causation, a qualitative inquiry involving semi-structured interviews with experienced construction professionals was undertaken to provide empirical verification of the conceptualised view. Subsequent to the qualitative inquiry, a questionnaire survey was undertaken to elicit relevant data from experienced professionals in construction management roles to enable the assessment of the degree of potential of CPFs to influence accident occurrence and their associated H&S risk. From the analysis of data, it was found that CPFs, emanating from pre-construction decisions, influence accident occurrence by their inherent introduction of certain associated H&S issues (which can be termed as proximal accident factors) into the construction phase of projects to give rise to accidents. There are also causal interactions between CPFs and the proximal factors which can reduce or increase the presence of proximal factors. CPFs have varying degrees of potential to influence accident occurrence which can generally be high or moderate and is influenced by: the extent to which their proximal factor(s) is common (in other words prevalent) within them; and the degree of potential of the proximal factor(s) to influence accident occurrence. Where CPFs apply on a project, they are generally associated with medium risk or high risk. Whereas with medium-risk CPFs some risk control measures would suffice in mitigating risk, with high-risk CPFs substantial measures are required. As a consolidation of the research findings, a toolkit, called CRiMT, has been developed. CRiMT provides H&S risk information regarding CPFs and it has the potential of assisting pre-construction project participants in managing the accident causal influence of CPFs from the early stage of project procurement. In view of the findings, the accident causal influence of CPFs should thus not be ignored or underestimated in construction project delivery. Pre-construction project participants, especially those whose decisions determine CPFs, ought to take into consideration the H&S effects of CPFs when making decisions which determine CPFs. Also, pre-construction project participants ought to plan and implement commensurate risk control measures in the early stage of projects to eliminate or mitigate the H&S risk posed by CPFs.