Many social accident insurance administrations have already successfully implemented Vision Zero, and can demonstrate positive results such as the reduction of work-related accidents and diseases at national, regional or sectoral level. The positive impact is not just for social security institutions, but also extends to companies that have implemented the ISSA’s Seven Golden Rules of Vision Zero for zero accidents and healthy work (ISSA, 2017) to promote safety, health and well-being at work (Figure 1). Furthermore, the international community has recognized the importance of Vision Zero on numerous occasions, including the World Congress on Safety and Health at Work. 

Figure 1. Vision Zero – Seven Golden Rules for Zero Accidents and Healthy Work

1. Take leadership – demonstrate commitment
2. Identify hazards – control risks
3. Define targets – develop programmes
4. Ensure a safe and healthy system – be well-organized
5. Ensure safety and health in machines, equipment and workplaces
6. Improve qualifications – develop competence
7. Invest in people – motivate by participation

Experiences of ISSA member institutions in Europe

As the demand for robust prevention systems grows, workers' compensation boards and occupational health and safety institutions have begun to implement Vision Zero or add the principles of Vision Zero to their existing prevention approaches. The ISSA has been guiding the transition of its members toward these new practices in various forms. The ISSA Guidelines on Prevention of Occupational Risks (ISSA, 2019) offers a roadmap to establish a functioning and committed prevention service within occupational accident insurance. Starting with a clear mandate, prevention activities should be support insured companies through specific services, ranging from technical site visits and consultations to medical support, strategic support, and information campaigns.

The ISSA, its members, the Special Commission on Prevention and the International Prevention Sections have organized numerous Vision Zero and prevention events. These include webinars, Vision Zero Days, Vision Zero Summits, a special session at the World Social Security Forum 2022 in Morocco, several sessions at the World Congress on Safety and Health at Work 2023 in Australia, and a dedicated session at the Regional Social Security Forum for Europe 2024 in Portugal that focussed on good practices.  

Regional networks and monthly themes (FIOH, Finland)

The Finnish Institute for Occupational Health (FIOH) has established a Vision Zero Forum (Finnish Institute for Occupational Health 2024a and 2024b). The Forum is composed of regional prevention networks and helps facilitate participation in national events despite long distances and cost constraints. These networks aim to foster collaboration and knowledge sharing among members at regional level. Meetings are held every six months, featuring visits to workplaces to exchange insights on safety, health, and well-being practices while building connections between organizations.

The main objectives of this initiative were to decentralize activities, facilitate closer collaboration among local workplaces, and create a platform for sharing best practices. By setting up regional networks, the Forum aimed to make participation more accessible and enhance cooperation among members. This approach aligns with the ISSA Guidelines on Prevention of Occupational Risks, emphasizing the importance of adapting strategies to local contexts. Targets were set to establish a network in each of the 17 regions and the Helsinki Metropolitan Area within 2–3 years, and the goal was achieved by 2023 despite challenges posed by the COVID-19 pandemic.

The evaluation of the initiative indicates positive outcomes, with members citing networking opportunities, site visits, and knowledge exchange as key benefits. The establishment of regional networks has facilitated ongoing communication and sharing of good practices among Vision Zero Forum members, both formally during meetings and informally outside of official gatherings.

The three indispensable factors for replicating this good practice are:

1. Needs-based approach: Regional activities must align with the specific needs of participating workplaces to ensure relevance and engagement.
2. Forum-level coordination: Sustaining the networks requires ongoing coordination and support to organize meetings and provide guidance on discussion topics.
3. Willingness to share: Participants must be willing to share best practices and be open to new ideas from other workplaces, as collaboration is fundamental to the Vision Zero approach.

However, potential risks include the emergence of competition between companies, which could impact transparency and hinder the sharing of best practices. Mitigating this risk requires fostering a culture of cooperation and emphasizing the collective benefits of knowledge sharing for all members.

The Finnish Vision Zero Forum provides networking opportunities to its members, and up-to-date knowledge on safety, health, and well-being. These materials are used by the workplaces in their occupational safety communication and in making safety-related issues visible at the workplace. The “Monthly Theme” has been one of the most used contents that the Vision Zero Forum provides.

Finland has noticed a decline in occupational accidents in the companies that actively participate in the Vision Zero Forum, and better prevention performance in these companies compared to other companies (Figure 2). 

Figure 2. Average accident rate – Vision Zero Forum companies vs. All Finland

Prevention of fatal and serious accidents (BGHW, Germany)

The German Social Accident Insurance Institution for the Trade and Logistics Industry (Berufsgenossenschaft Handel und Warenlogistik – BGHW) has implemented targeted prevention measures aligned with the 7 Golden Rules of Vision Zero, to reduce the number of fatal and serious accidents in its sector (German Social Accident Insurance. 2024a). The BGHW recognized the need to identify high-risk hazards as early as possible and conducted extensive analysis of fatal and serious accidents over several years. This has led to the identification of recurring situations and potential preventative measures.

The main objectives of this exercise were to collect comprehensive data on accidents, derive preventive measures, and create practical tools for labour inspectors, companies, and employees. These efforts resulted in the development of two guides on Vision Zero in Trade and Goods Logistics (ISSA, 2023a and 2023b), where part 1 is an analysis of fatal and serious occupational accidents, and part 2 is a practical guide to prevent such accidents.

Additionally, various communication channels were utilized, including a new website, publications, interactive engagement, and social media campaigns aimed at younger employees.

While the number of fatal and serious accidents has decreased since the beginning of the study, it is still too early to assess the full impact of the activities. However, it can be stated that there has been a shift in the communication style, which is now focussing more on prevention and emphasizing engaging with stakeholders.

Punjab prevention strategy (DGUV, Germany)

The German Social Accident Insurance (Deutsche Gesetzliche Unfallversicherung – DGUV) collaborated with the Labour & Human Resource Department of the Government of Punjab, Pakistan and the German Corporation for International Cooperation (Deutsche Gesellschaft für Internationale Zusammenarbeit – GIZ), to establish a prevention culture strategy in the Punjab region. The Punjab Prevention Strategy on Safety, Health, and Wellbeing at the Workplace (German Social Accident Insurance, 2024b) is a comprehensive initiative based on the principles of the Vision Zero Strategy.

The strategy addresses the challenge of work-related accidents and diseases, aiming to reduce workplace accidents and fatalities, mitigate exposures to hazardous substances, ensure compliance with OSH legislation, and enhance competencies and knowledge among stakeholders. Key elements include promoting a Vision Zero mindset, developing a common understanding of safety, health, and well-being, and positioning Punjab as a role model for cooperation and improved working conditions. Targets, defined in a 10-year action plan, include reducing workplace accidents and fatalities by 75 per cent and decreasing exposures to hazardous substances (Figure 3).

Figure 3. Punjab’s Vision Zero 10 Year Action Plan

The strategy also focuses on capacity building, increasing the number of Vision Zero committed companies, and establishing occupational safety and health (OSH) facilities, such as an OSH Academy and a personal protective equipment (PPE) testing laboratory.

The strategy's impact is not fully evaluated, however, lessons learned highlighted the importance of stakeholder engagement, joint strategy development, and adapting approaches to local contexts for successful implementation the Labour & Human Resource Department of the Government of Punjab. By the end of 2023 the government has already successfully engaged with over 94 million people through a targeted media campaign, raising awareness and promoting Vision Zero (Figure 4).

Figure 4. Punjab Prevention Strategy 2023

National Vision Zero strategy (AAA, Luxembourg)

Luxembourg launched its national Vision Zero strategy (Association of Social Security Institutions of Luxembourg, 2024) in 2016. The strategy was initiated by the Accident Insurance Association of Luxembourg (Association d’Assurance Accident – AAA), in collaboration with the Luxembourg Employers Association (Union des Entreprises Luxembourgeoises – UEL) and the National Institute for Sustainable Development and Corporate Social Responsibility (Institut National pour le Développement durable et la Responsabilité sociale des entreprises – INDR).

The objective of the strategy is to reduce work-related accidents and occupational diseases as well as commuting accidents through cross-media campaigns, incentives for companies, and awareness-raising measures through a common and inclusive approach: Vision Zero.

Key achievements include the establishment of a trilingual internet portal (visionzero.lu), and the introduction of a system to incentivize companies to invest in accident prevention. The strategy also involves organizing yearly forums and bi-annual award ceremonies, awareness-raising activities through media, and conducting specific actions targeted at high-risk sectors.

Despite challenges posed by the COVID-19 pandemic, the strategy has shown promising results, with a 15 per cent reduction in the incidence rate of work-related accidents achieved in 2019. In 2022, there was a significant reduction in the national frequency of all accidents, exceeding the target reduction of 20 per cent (Figure 5).

Figure 5. Vision Zero in Luxembourg

Lessons learned highlight the importance of media campaigns, prevention tools like the Vision Zero 7 Golden Rules, and ongoing support and advice for companies to foster a culture of prevention. However, risks such as inadequate media exposure and lack of ongoing support for companies could hinder the successful continuation of the programme.

Youth short film competition (KRUS, Poland)

The Polish Agricultural Social Insurance Fund (KRUS) organized a short film competition to promote safety education among young people in agriculture, integrating Vision Zero principles into creative narratives (Agricultural Social Insurance Fund, 2024) . The "My Vision Zero Youth Short Film Competition" targeted students aged 13–21, and tasked them with creating short films to promote safe work practices on farms using the Vision Zero strategy and 7 Golden Rules.

The main objective of the competition was to render occupational safety and health education engaging and modern, to promote different aspects of Vision Zero, and to encourage young people to proactively learn about OSH in agriculture. The innovative aspect was to use a film competition format, which challenged the participants to develop their technical filmmaking skills while embedding Vision Zero principles into their creative process.

Targets included reaching a broad audience of young people and receiving a minimum of 20 film submissions annually. Assessment after each competition consistently demonstrated the achievement of targets, with the number of submissions meeting or surpassing expectations each year. Prizes were awarded to films that best reflected Vision Zero principles.

Besides the film competition, KRUS has organized a wide range of prevention activities since 2019, all of which are based on Vision Zero. This has yielded tangible results, and occupational accidents in the agricultural sector has dropped by 15 per cent (Figure 6). 

Figure 6. Vision Zero prevention activities in the agricultural sector in Poland

Risk assessment in emerging economies (IOSH, United Kingdom)

The Institution of Occupational Safety and Health (IOSH) in the United Kingdom has addressed chronic workplace harm in emerging economies, particularly focusing on vulnerable groups such as shea butter producers and textile weavers in northern Ghana, fishmonger women of Lake Victoria in Kenya, and quarry scavenger widows in eastern Kenya (Institution of Occupational Safety and Health, 2024). The main difficulty faced in these contexts stems from the harsh working conditions, which give rise to societal challenges like malnutrition, child labour, and sexual exploitation, all of which require urgent intervention.

The strategy to mitigate the negative impact on workers involves creating documentaries to showcase local risk assessments and interventions led by IOSH members and partners. These documentaries aim to raise awareness globally about the unimaginable working conditions faced by these vulnerable groups and highlight the impact of collaborative efforts in improving their working lives. The innovative feature lies in the use of storytelling through documentaries to engage stakeholders and drive real change.

Quantitative and qualitative targets include showcasing the documentaries globally, charting the success of the initiative, and instigating real mechanisms to support vulnerable workers.

Chemical occupational risks programme (CNAM, France)

The National Sickness Insurance Fund (Caisse nationale de l’assurance maladie – CNAM) of France has developed a programme (“Risques Chimiques Pros”) to address the prevalent issue of chemical risks in the workplace (National Sickness Insurance Fund, 2024a) . Chemical risks constitute the second biggest cause of occupational diseases in France. They stem from exposure to hazardous chemicals, including carcinogens, present across various industries. The programme operates through a four-step online process, enabling companies to assess, plan, and monitor actions to reduce employee exposure and mitigate consequences, particularly in highly affected sectors such as automotive repair, construction, and healthcare.

The main objective of the programme is to eliminate or minimize employee exposure to chemical risks and help companies to carry out daily chemical risk prevention. The programme's success is based on several factors, including targeted company selection, a user-friendly website, and effective communication between companies and health insurance branches.

The programme's impact evaluation has revealed significant progress, with over 90 per cent of targeted companies enrolled, and more than 75 per cent developing action plans. The feedback from participating companies reported high satisfaction levels, with the majority seeing increased motivation to address risk prevention and observing reductions in chemical exposure. The potential risks during implementation may include difficulties in engaging with small businesses, ensuring compliance with preventive measures, and addressing sector-specific challenges.

To replicate this success, future iterations will focus on providing more OSH training, tailoring approaches to company size and maturity, improving website usability, and a stronger focus on various economic sectors and pollutants.

Sectoral programme for construction (CNAM, France)

In France, CNAM has also launched a sectoral programme for construction that prioritizes early intervention and risk management in construction projects (National Sickness Insurance Fund, 2024b). The main operational objective is to support and accompany the contracting authorities so that they can include prevention provisions in their calls for tenders. These provisions help to manage occupational risks on building sites in a proactive manner, because the prevention activities must already be outlined in the application for the tender. This also means that a prevention budget must already be allocated by the applicant when pitching for the construction project.

Launched in 2014 and expanded in 2018, the programme underwent a two-phase approach. Initially, it only evaluated the contractual practices of project owners regarding prevention, revealing shortcomings such as insufficient safety coordination and inadequate provision of prevention resources. Following this assessment, measures were identified and disseminated through practical guides tailored to various construction types.

By 2021–2022, the programme had supported over 810 project owners and companies on 1,160 construction projects, leading to significant occupational safety and health improvements. The requirement of having to list prevention measures in construction bids increased the prevention performance of the contracted companies substantially. Notably, the average number of prioritized prevention measures implemented nearly doubled compared to previous years, exceeding programme targets.

Lessons learned included the importance of early intervention and formalizing prevention measures throughout construction projects. To replicate these successes, sustained engagement from industry stakeholders, particularly project owner representatives, and continued on-site support from health insurance prevention experts are essential. However, challenges do persist, notably in addressing safety gaps in individual house construction projects and enhancing recognition of the crucial role of safety coordinators. Overcoming these challenges may require regulatory adjustments and increased awareness campaigns to highlight the significance of safety coordination.

Artificial Intelligence for safe and healthy work in the construction industry (BG Bau, Germany)

The German Social Accident Insurance Institution for the building trade (Berufsgenossenschaft der Bauwirtschaft – BG Bau) recognizes the significance of Artificial Intelligence (AI) for the public sector and took a pioneering role in utilizing the potential of AI in social insurance (German Social Accident Insurance, 2024c). Through the "AI-based support for targeted accident prevention" project, funded by the Federal Ministry of Labour and Social Affairs (Bundesministerium für Arbeit und Soziales – BMAS), an AI open-source application was developed. The BG BAU developed the AI application to not only predict which companies are likely to have deficiencies in workplace safety and health but also to prioritize those who are at the highest risk level. The project plan included analysis, data collection, AI model development, testing, implementation, and change management, following the ISSA Guidelines on Prevention of Occupational Risks.

Trained with approximately 10 million data entries, the application tells the BG Bau OSH consultants, which companies are potentially at risk of having an accident in the near future. An onsite visit can then be arranged to provide advice to the company, based on the AI analysis of collected data, and hopefully prevent severe and fatal accidents.

Results showed that 83 per cent of the OSH consultants agreed with the AI recommendations, this significantly improved efficiency and reduced preparation time. The AI application correctly identified companies with high consulting needs in 58 per cent of cases, compared to 35 per cent without AI. By combining AI predictions with OSH consultant experience, the success rate increased to 64 per cent. This targeted approach allowed for the efficient allocation of resources, particularly benefiting small and medium-sized enterprises (SMEs).

Key factors for replicating this success include stakeholder involvement, maintaining decision authority with supervisors, and continuous feedback for AI improvement. Risks include ensuring compliance with data protection laws, addressing potential biases in data leading to discrimination, and ensuring an adequate quantity and quality of data for AI model training.

Summary of results

Table 1 summarizes the results these institutions have been able to achieve by using a proactive prevention approach, the ISSA Guidelines and the Vision Zero methodology.

Critical success factors

Participation, stakeholder dialogue, and networking

The successful implementation of prevention measures depends on active participation and dialogue with all actors involved to agree on a common approach.

In Finnland, FIOH managed to engage many companies in regional networking activities, revolving around the topic of prevention. This resulted in an active commitment and hence a broad acceptance of the Vision Zero approach. In Luxembourg, AAA engaged in a high-level stakeholder dialogue with the social partners at national level who all committed to support and promote the jointly adopted national Vision Zero strategy. In Germany, the BGHW activities enjoy a broader support because of strong stakeholder commitment.

Communication, knowledge sharing, and media

All the presented good practices include an element of knowledge sharing through communication. In Poland, the film competition organized by KRUS provided incentives (prizes) to participants. It also reached over 1’400,000 people via the organization of events and media campaigns. German DGUV’s project with Punjab, Pakistan reached 94.59 million people via Vision Zero workshops, print media, digital media (incl. SMS) and radio campaigns. Also, BGHW, AAA, CNAM and IOSH used media to raise awareness and inform about their prevention projects.

Strategies, data analysis, and technical innovation

The most efficient way to reduce the number of accidents is by targeting the sectors where most accidents and incidents occur. Therefore data-analysis and the development of strategies to tackle high-risk sectors is of great importance. The AAA, BGHW, CNAM, DGUV/Punjab’s Labour and Human Resource Department, FIOH and others have analysed the national accident statistics, identified the high-risk sectors, and have developed strategic plans to address the occupational risks. The BG Bau has also made use of technology and its AI application analysed 10 million data entries and can now predict with acceptable accuracy where the next accident is going to happen. CNAM’s strategy to include prevention requirements in the bidding process of construction projects is also based on strategic data analysis in a high-risk sector.

Final remarks

ISSA member institutions in Europe have made progress in prevention and promoted prevention in other regions of the world. ISSA tools including Vision Zero, the ISSA Guidelines and related activities have supported these efforts.

Each of the good practices described in this article exemplifies innovative approaches and collaboration to improve occupational safety and health. By addressing specific challenges and tailoring strategies to local contexts, these practices contribute to safer, healthier and more productive workplaces. By focusing on actions and results, they have demonstrated the importance of adapting strategies to local contexts and fostering a culture of prevention. They have  created a healthier and safer working environment. The analysis of the success factors shows that, while participation, stakeholder dialogue, and networking, as well as communication, knowledge sharing and media remain the main ones, data analysis and technical innovation are success factors for good practices on prevention.

The ISSA continues to support social security institutions and other prevention stakeholders through its various knowledge and networking activities, including the Vision Zero and ISSA websites.

References