The whole-school approach can be considered as the ‘Gold standard’ of mainstreaming OSH into education. Research conducted by the European Agency has come to the conclusion that approaches that cover various fields of action at schools are best suited the integration of safety, health and well-being into education programmes and for sustainably improving prevention culture. Such holistic approaches include the different fields of actions of which mainstreaming actions can consist of: integrating OSH and risk education into school curricula; training of students, teachers and school management representatives; introducing risk management at school level; and active participation of the students in the risk management. Holistic approaches also take account of mental health and well-being of other stakeholders at school.
Once successfully implemented, the whole-school approach becomes more than the sum of its parts: Ideally prevention culture becomes integral to the school and all its stakeholders. From the mainstreaming point of view it represents the objective of the mainstreaming activities and combines management and educational approaches.
The article gives an overview of the holistic approach in the context of the general idea and political programme of mainstreaming OSH into education. It will furthermore describe key success factors and challenges and give examples of and links to good practice cases.
Mainstreaming OSH into education
Mainstreaming OSH into education can be described as an integrated educational approach which lies at the intersection of health promotion, risk education and the safety of the learning and working environment. It does not refer to education of a certain level, but rather that OSH can be integrated into pre-school, primary, secondary and tertiary education.
Various actions can be typically found under the mainstreaming label:
- Integrating OSH in the curriculum: Integrating OSH in the curriculum can either be part of a nationwide programme or a decision of the single pre-school, school or university management. Any educational facility can decide on integrating safety and health issues in the curriculum, e.g. modules on safety in physical education, safe handling of dangerous substances, safety in handicrafts or engineering lessons or general issues such as safe manual handling or workplace ergonomics. Preferably, such modules should be compulsory for all pupils and students.
- Creating a safe and healthy working and learning environment: Creating a safe working and learning environment is fundamental for each mainstreaming project. Learning from good practice is essential. Vice versa, safety and health education lacks credibility when it is done in an environment that demonstrates the opposite while a safe and healthy school environment underlines that health and safety is taken seriously by the stakeholders.
- Training the trainer: Training the trainer is also considered to be a crucial part within safety and health education. The teachers and trainers have a key position in the whole process as they are the main multipliers. They need to communicate the message and be role models for the students. Safety culture does not only rely on education and skills but also heavily on values and attitudes. In order to positively influence the attitudes of the youngsters it is important to address the teachers first.
- Involvement of the students: Involvement of students and young workers is seen as best practice which helps them to develop the confidence to challenge more experienced colleagues and management representatives (“empowerment"). It is recommended to establish a two-way dialogue that ensures the young workers can address their issues and provides them with feedback. The so established dialogue shows them that they are taken serious.
- Taking health promotion measures (see also chapter 1.2.)
Health promoting schools
Among the first activities on creating a healthier school environment was an initiative which derived from the WHO’s programme on health promotion. The programme started with the Ottawa charter in the 1980s and lead to the funding of the European Network of Health Promoting Schools (ENHPS) in 1991. The network aimed at fostering the introduction of health promotion in the educational system and is now established as Schools for Health in Europe (SHE) Network.
The approach shifted from mainstreaming health education at the very beginning of the activities, to introducing health promotion at schools and finally to becoming a holistic approach that aims at improving the quality of education (learning and teaching) by creating a comprehensive culture of safety, health and social well-being in schools. In doing so, schools become “good schools", also referred to as “good and healthy schools". The good and healthy schools are in the focus of the “Anschub"-programme, an initiative for promoting sustainable school health and education.
As a holistic approach, the whole-school approach includes and combines the different fields of actions of which mainstreaming actions can consist of, such as including OSH into school curricula; training of students, teachers and school management representatives; introducing risk management at school level; and active participation of the students in the risk management. They also take account of mental health and well-being of the stakeholders at school.
The holistic approach combines single activities on teaching safety, mainstreaming OSH into the school curriculum and making the school environment safer and healthier and combines management and educational approaches. In addition, the whole-school approach aims at mainstreaming related educational (and management) issues such as social patterns, sustainability and environmental aspects. It successfully brings together stakeholders from school management, teaching staff, pupils / students with parents and local authorities.
Thus, the whole-school approach is more than the sum of its parts: It provides education and training in a context that guarantees health and well-being for pupils both at school and in the way the school prepares them for their lives in society and in the working world.
The good school approach (see chapter 1.2) represents a “paradigm shift" which means that prevention and safety culture becomes an integral part of the school’s operations and the school life of all its stakeholders. This means that education not only influences positively the safety and health performance of the stakeholders like school management, teachers, parents and students, but vice versa, safety and health positively influence the working and learning performance. Finally, safety and health have become means of promoting quality in education. Or in simpler words: ‘If you feel better, you work and learn better’ (Peter Paulus).
As already mentioned, the whole-school approach combines different actions and methods that are presented under the heading of mainstreaming OSH into education. This means, that the scope is wider and that the whole-school approach does not only address risk education but also management and safety and health promotion of all stakeholders at school. This also means that the approach does not only address students but also teachers, management representatives and parents.
It also means a change in the methodology: The whole-school approach aims at activating all stakeholders. Pupils and students as well as further parties can actively participate in general procedures, the safety and health management, and in the culture of the education institution itself. Positive attitudes and experiences towards participation and engagement in OSH are key components of a good safety culture. Such attitudes can be developed in schools through actively involving pupils / students in safety management. This can be done in schools of primary, secondary and tertiary education when the maturity level of the target group is taken into consideration when starting the initiative.
Pupils no longer play a passive (learning) role but they experience ownership of their environment and how it is managed. Hence they feel more motivated to play their part in school safety and health. By their active participation a corresponding system of safety and health management and promotion, where stakeholders of different levels interact and contribute, becomes reality within the learning and working environment, as the following illustration shows:
By combining and further developing the different fields of actions of mainstreaming OSH into education, the whole-school approach can be characterised by a set of innovative features:
- The school management profits from new ideas which are brought in by students and teachers. Management representatives receive more support for safety and health management and health promotion.
- OSH responsibilities can be used as a means of supporting and promoting risk education at the same time.
- Pupils / students also benefit from participating in the management as they develop skills in risk assessment, safety management and health awareness which are usually not covered in the curriculum.
- Also teachers become active and participate in OSH management processes. They can also be trained as certification auditors and get the opportunity of gaining new knowledge in safety and health as well as in the use of new teaching methods.
- All stakeholders at school profit from better health and safety awareness and the prevention of ill-health and accidents.
- Employers profit from the broadened skills of the pupils / students and a more positive approach towards safety and health of the future employees.
Demands for policy makers and the framework
The whole-school approach is a holistic and cross-cutting approach which brings together education, accident prevention, occupational safety and health, public health, and sustainable development. There are opportunities for synergies, interaction and joint approaches but also challenges which usually consist in the transversal policy making and networking. Often issues of education, occupational health, public health and sustainable development are under different auspices (e.g. different ministries and policy-makers) that follow different political agendas and that do not necessarily share the same priorities. In addition, federalism and regionalism must be respected in some EU Member States. For example, in Germany or Belgium, unlike other EU Member States, education is not under the authority of the national government but expression of the sovereignty of the Federal States.
Policy-makers and experts can also support the whole-school approach by programmes and campaigns that raise awareness of health at school. They can help to bring together specialists from the different fields of expertise and establish networks and foster the exchange of ideas and information. They can also support the development of tools which are needed to implement an integrated approach at schools. Like the approach, the tools also need to be cross-cutting, going beyond legal prescriptions of risk education and safety and health at schools. Ideally, they combine aspects of risk education, OSH management and health promotion. The prevention of bullying and harassment to both staff and pupils is an important field of action and a particular area of overlap between mental health promotion and OSH in schools.
The developers of the good school model and participants in the ENHPS documented that the existence of policy support (in the case of ENHPS called “national support centres") helped to further develop and to spread the health promotion in schools.
Initiatives by policy-makers: examples
At the European level, the whole-school approach is part of the political agenda on mainstreaming OSH into education. As the EU lacks educational law making competence, it has been promoted mainly by OSH policies. Since 2000 mainstreaming OSH into education has been a goal of the OSH strategies and was actively promoted by the European Agency for Safety and Health at Work (EU-OSHA) with campaigns and publications. But also the Leonardo programme (now Erasmus plus) has been used to provide funding for educational projects that aimed at mainstreaming OSH. Starting as a Leonardo-project, the European Network on Education in Occupational Safety and Health (ENETOSH) became a success. An overview is provided in the article on mainstreaming OSH into education.
In November 2012, ENETOSH, EU-OSHA, the International Labour Organisation (ILO), the International Social Security Association (ISSA) and the US National Institute for Occupational Safety and Health (NIOSH) jointly established a working group for the international dissemination of the whole-school approach (WhSA working group). The group wants to “improve the quality of education and educational establishments by the means of health and safety, mainstream the whole-school approach internationally, consolidate the already existing material concerning mainstreaming OSH into education, improve the link between good practice and research within the field and support countries during their process of the integration of OSH into education according to their needs." The working group has set up task groups on the development of material and on the development of a strategy as well as a think tank on the development and transmission of values by a whole-school approach.
Also on a national basis there are known examples of successful cooperation of policy-makers. In Germany the Statutory Accident Insurance (BUK, now DGUV) supported the development of the “Good Healthy School", a whole-school approach, in cooperation of the ministries of education of the Federal States (Länder) of Germany. In Ireland, the mainstreaming OSH into education programmes have been successfully embedded in the national OSH strategy. The national Health and Safety Authority (HSA) closely cooperates with the Department of Education and Science and associated organisations. Thereby HSA combines activities on the promotion of risk education with teacher training and the promotion of safety management. Further examples are known from Finland where several tools have been developed to help educational establishments to develop programmes. The initiative also includes a certification criteria and evaluation tools.
Key success factors and challenges
The whole-school approach is closely related to the idea of mainstreaming OSH into education. Hence the prerequisites for successful realisation and implementation of mainstreaming OSH projects in practice should be taken into account. For an overview please consult Mainstreaming OSH into education. However, the whole-school approach is a more complex task which may require special attention with regard to some details:
- Identify and address all groups before starting the project: The full commitment and the timely inclusion of policy makers, school management, teachers, parents and other stakeholders is crucial. The success of the approach is closely connected to the timely inclusion of and the support by the mentioned stakeholders and target groups. All cases presented in the case study report of EU-OSHA point out that a successful partnership is a key factor for successful integration of health, safety and well-being. This can also include professional associations or trade unions who often can provide helpful support.
- Demonstrate leadership and close cooperation: Successful school projects require initiative and engagement from a school’s management staff, as the key driving force is internal. The initiative steering committee should fully demonstrate its commitment to a safe and healthy school environment. The message can better be implemented in class the more stakeholders show that they support the ideas behind the initiative. It is of importance for teachers who are the multipliers and as well as for pupils who learn from positive role models.
- Set strategic goals and make a thorough planning taking account of the school environment before starting the action: A thorough analysis of the situation that takes account of time constraints and numerous obligations and commitments of the stakeholders is beneficial. Many projects fail because they are too ambitious and do not respect time constraints as a consequence of a heavy curriculum. The definition of milestones and long-term goals helps to motivate the participants. The different stages of project planning in mainstreaming OSH into education projects are described in an E-Fact of EU-OSHA.
- Set up a steering team: As the whole-school approach also combines elements of risk and health education, safety and health management, health promotion and sustainability, it is considered to be advantageous to set up a steering team which receives advice by specialists from the three fields of expertise (see above: the background and the model of the whole school approach).
- Look for public support: Getting public support for the initiative will probably help to up-scale the project. However, progress can also be made without. The initiative needs then probably to be adapted in scale, in time or objectives. A stepwise approach and the definition of milestones help to change the school environment.
- Identify synergies: Communicate the opportunities and synergies that are possible. For example, if you plan a health and safety management, synergies between different management systems can be used (e.g. with a pre-existing quality or environmental management). It is easy to start an OSH management system if there are other management systems in place.
- Take advantage of better education and better health as a win-win-situation: The core strength of the good healthy school model is that the safety and prevention contribute to the improvement of the working and learning conditions of teachers and students. Educational success goes hand in hand with positive health effects and a better social climate. The win-win situations help raise the interest of the teaching staff who are often under time pressure.
Good practice: Case studies and impact
As already mentioned, OSH can be mainstreamed into pre-school, primary, secondary and tertiary education facilities and so can the whole-school approach. On the ENETOSH website a broad range of good practice case studies from different educational environments are presented in a data base.
ENETOSH actively promotes the model of the “Good Healthy School" which was developed in Germany and which can be integrated in any kind of school or day-care establishment. The Good Healthy School originated in health promotion which is the centre of its approach. The basic assumption of the model is that it needs healthy students and healthy teachers in order to create a healthy educational environment. The main actors of the approach are the school management and the teachers by promoting health and safety actively, covering general health promotion, safety promotion, occupational safety and accident prevention, emergency response and emergency management and the integration of health and safety in education. Under the Good Healthy School Approach new concepts for teacher and management training have been developed.
On the EU-OSHA web site and in the report on the whole-school approach various good practice models can be found that range from pre-school to vocational or university level. The following examples are only some from the EU-OSHA report  that may illustrate that several paths lead to Rome:
- Källby Gård is a Swedish primary school for pupils aged 1 to 12 years. Källby Gård focuses on the provision of a secure and safe learning environment for pupils. The example includes the active involvement of pupils in the risk assessment and also invites the parents to participate actively. It also includes environmental aspects and an accident and near miss reporting system.
- At the Bourne College in the UK the social climate was identified as the key for creating a safer and healthier environment. Hence a programme on the improvement of the social climate and the prevention of psycho-social risks was set up. The whole initiative was based on the active participation of the pupils and was steered by a ‘school change group’ which included representatives from pupils, parents, carers, teachers and administration.
- HTL Donaustadt is the example of a vocational school in Vienna, Austria that included OSH management into the already existing environmental management system. Road safety and OSH became part of the vocational training and education curriculum. Students were also invited to participate actively in the assessment of working conditions and occupational risks.
- The Dublin Institute of Technology in Ireland succeeded in promoting risk awareness and health and safety culture as an integral part of education. The student’s union was included in the development of a safety induction programme.
EU-OSHA states that despite the fact that various examples of mainstreaming OSH into education can be found at university level  it seems that a “whole university approach" is harder to find than in other levels of education. Examples are most likely to be found in practical laboratory work where OSH legislation regarding the use of dangerous substances applies immediately. Students can carry out own risk assessments before starting their practical session. Reason for the difficulties of whole university approaches may lie in the size of universities which can easily count 30,000 and more students and the independency and heterogeneity of their departments, including engineering, sciences, social sciences, humanities and many more. An approach focussing on single university departments may be a step in the right direction.
While generally Eurostat figures on workplace accidents of young people show a downward trend since 2002, it is not possible to determine the precise influence of OSH/risk education because many factors can influence the figures. The standardised incident rate for young workers is still higher than for the average worker by the factor 1.3 to 1.4 : While the average accident rate per 100,000 workers in the EU27 was 1,820 in 2011, it was 2,440 for workers between 18 and 24.
However, it can be demonstrated on the micro scale, e.g. in the evaluation of case studies, how an enhanced safety culture in schools clearly contributes to an improvement of the safety and health performance and of social interaction. Evaluations carried out in the Czech Republic showed that health promoting schools improved learning conditions of the students and the social climate for both teachers and students. Also attitudes changed towards more trust between the participants and more openness to communicate problems and to overcome them.
 EU-OSHA – The European Agency for Safety and Health at Work, ''Mainstreaming OSH into education,'' Bilbao, Luxemburg 2004, pp.118-120, 141. Available at: https://osha.europa.eu/en/publications/reports/313/view
 EU-OSHA - The European Agency for Safety and Health at Work, ''OSH in the school curriculum, requirements and activities in the EU-Member States,'' Bilbao, Luxemburg 2009, pp.14-18, 23-25. Available at: https://osha.europa.eu/en/publications/reports/TE3008521ENC
 EU-OSHA – The European Agency for Safety and Health at Work, ''Mainstreaming OSH into university education,'' Bilbao, Luxemburg 2010, pp. 148 ff. Available at: https://osha.europa.eu/en/publications/reports/mainstream_osh_university_education
 EU-OSHA – The European Agency for Safety and Health at Work, ''Training teachers to deliver risk education,'' Bilbao, Luxemburg 2011, pp. 83 ff. Available at: https://osha.europa.eu/en/publications/reports/teachers-training-risk-education_TE3111358ENN/view
 EU-OSHA - The European Agency for Safety and Health at Work, ''Involving young workers in OSH,'' E-Facts 73, Bilbao 2013. Available at: https://osha.europa.eu/en/publications/e-facts/e-fact-78-involving-young-workers-in-osh
 WHO – World Health Organisation (undated). The Ottawa charter for health promotion. Retrieved 3 March 2014, from: http://www.who.int/healthpromotion/conferences/previous/ottawa/en/
 WHO – World Health Organisation (undated). European network of health promoting schools, the alliance of education and health. Retrieved 3 March 2014, from: http://www.euro.who.int/en/health-topics/Life-stages/child-and-adolescent-health/publications/Pre-2005/european-network-of-health-promoting-schools-the-the-alliance-of-education-and-health
 SHE – Schools for Health in Europe. SHE network. Retrieved 24 Feb. 2014, from: http://www.schools-for-health.eu/she-network
 Paulus P., 'From the health promoting school to the good and healthy school: new developments in Germany.' ''The Health Promoting School: International Advances in Theory, Evaluation and Practice,'' Clift S. and Bruun Jensen, B., Copenhagen 2005, pp. 55-74. Available at: http://www.euro.who.int/__data/assets/pdf_file/0012/111117/E90358.pdf
 Anschub.de - Programm für die gute gesunde Schule e.V., ''Alliance for sustainable school health and education: Good and healthy schools in Germany,'' Gütersloh 2007. Available at: http://www.anschub.de/uploads/tx_jpdownloads/What_aims_does_Anschub.pdf
 EU-OSHA – The European Agency for Safety and Health at Work, ''Occupational safety and health and education: A whole-school approach,'' Bilbao, Luxemburg 2013, pp.4-9, 34ff., 87. Available at: https://osha.europa.eu/en/publications/reports/occupational-safety-and-health-and-education-a-whole-school-approach/view
 ENETOSH – The European Network on Education and Training in Occupational Safety and Health (undated), How to prove good practice? Retrieved 02 Feb. 2014 from: http://www.enetosh.net/webcom/show_article.php/_c-173/_nr-2/i.html
 European Commission (undated). Erasmus+, EU programme for education, training, youth and sport. Retrieved 3 March 2014, from http://ec.europa.eu/programmes/erasmus-plus/index_en.htm
 ENETOSH – The European Network on Education and Training in Occupational Safety and Health, ''(self presentation leaflet),'' Dresden 2012. Available at: http://www.enetosh.net/files/186/EN_ENETOSH_Imageflyer_2012_1.pdf
 ILO – The International Labour Organisation (undated). Website. Retrieved 3 March 2014, from: http://www.ilo.org/global/lang--en/index.htm
 ISSA – International Social Security Association (undated). Website. Retrieved 3 March 2014, from: http://www.issa.int/
 NIOSH - The National Institute for Occupational Safety and Health (undated). Website. Retrieved 3 March 2014, from: http://www.cdc.gov/niosh/
 Hundeloh, H and Heinz B., ''Promoting safety – a component in health promotion in schools,'' Berlin 2002. Available at: http://www.enetosh.net/files/186/Safety-promotion5-02.pdf
 HSA – Health and Safety Authotity, ''Strategy Statement 2010-2012,'' Dublin 2010. Available at: http://www.hsa.ie/eng/Publications_and_Forms/Publications/Corporate/Strategy_Statement_2010-2012.pdf
 EU-OSHA – European Agency for Safety and Health at Work, ''Mainstreaming occupational safety and health into education,'' Facts 52, Bilbao 2004. Available at: https://osha.europa.eu/en/publications/factsheets/52/view
 ENETOSH – The European Network on Education and Training in Occupational Safety and Health (undated), How to prove good practice? Retrieved 02 Feb. 2014 from: http://www.enetosh.net/webcom/show_article.php/_c-173/_nr-2/i.html
 Eurostat (undated). Accidents at work by sex and age, standardised incident rate. Retrieved 13 Feb 2014, from: http://appsso.eurostat.ec.europa.eu/nui/show.do?dataset=hsw_mi01&lang=en
 Havlinova, M. and Kolar, M., ‘Is the social climate more secure in health promoting schools? A comparative research study.’ ''The Health Promoting School: International Advances in Theory, Evaluation and Practice,'' Clift S. and Bruun Jensen, B., Copenhagen 2005, pp. 409-422. Available at: http://www.euro.who.int/__data/assets/pdf_file/0012/111117/E90358.pdf
Buijs, G.; Jociutė, A.; Paulus, P. & Simovska, V., Better schools through health: learning from practice. Case studies of practice presented during the third European Conference on Health Promoting Schools, held in Vilnius, Lithuania, 15–17 June 2009. Available at http://www.leuphana.de/fileadmin/user_upload/Forschungseinrichtungen/zag/files/Publikationen/Publikationen/Buijs_etal_2009.pdf
Clift S. and Bruun Jensen, B., The Health Promoting School: International Advances in Theory, Evaluation and Practice, Copenhagen 2005. Available at: http://www.euro.who.int/__data/assets/pdf_file/0012/111117/E90358.pdf
ENETOSH – The European Network on Education and Training in Occupational Safety and Health (undated), Website. Retrieved 3 Feb. 2014, from: http://www.enetosh.net.
EU-OSHA - The European Agency for Safety and Health at Work, OSH in the school curriculum – Member States activities, Facts 82, Luxemburg, Bilbao 2009. Available at: https://osha.europa.eu/en/publications/factsheets/82
EU-OSHA – European Agency for Safety and Health at Work, Magazine 9, Safe Start, Bilbao 2006. Available at: https://osha.europa.eu/en/publications/magazine/9/view
EU-OSHA – European Agency for Safety and Health at Work, Strategies for training teachers to deliver risk education, Facts 103, Bilbao 2013. Available at: https://osha.europa.eu/en/publications/factsheets/103/view
ISSA – International Social Security Asscociation (undated). International Section on Education and Training for Prevention. Retrieved 23 Feb. 2014, from: http://issa.int/web/prevention-education
Volpert, W., Sensumotorisches Lernen, Frankfurt 1971.
WHO – World Health Organisation (undated). School health and youth health promotion. Retrieved 23 Feb. 2014, from: http://www.who.int/school_youth_health/en/