Safety Science 163 (2023) 106131

Contents lists available at ScienceDirect

Safety Science
journal homepage: www.elsevier.com/locate/safety

Benefits and challenges relating to the implementation of health and safety

leading indicators in the construction industry: A systematic review
Rantsatsi Ndaleni Phinias
Private Bag X 021, Vanderbijlpark 1911, South Africa

A R T I C L E I N F O A B S T R A C T

Keywords: Organisations have used both Health and safety (H&S) lagging and leading indicators as part of the measures
Qualitative and quantitative indicators taken to manage H&S. However, in recent years researchers have advocated strongly for the use of leading in­
Construction hazards dicators over lagging indicators. While the use of leading indicators to improve H&S performance is well
Control measures
documented. However, there is no systematic literature reviews of the benefits and challenges relating to their
Worker involvement
Occupational health and safety
implementation in the construction industry. This study aims to provide an overview of leading indicators as well
as to identify the benefits and challenges relating to the implementation of leading indicators in the construction
industry. Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) procedure is used to
conduct a systematic literature review. Scopus and Google Scholar produced a total of 335 articles. Based on the
inclusion and exclusion criteria, 34 articles were considered relevant for review. Content analysis was applied,
and the study identified eight benefits (identification of construction accidents, measurement and monitoring,
prevention of construction accidents, early warning system, increase compliance with H&S legislations, ano­
nymity and confidentiality, predictions and control measures) and eight challenges (training and communica­
tion, leadership and commitment, time and cost, effectiveness and uncertainty, varying definitions, dominance of
quantitative indicators, convenience and worker involvement and participation) relating to the implementation
of leading indicators. Study findings are critical for increasing construction practitioners and researchers
knowledge and understanding of benefits and challenges relating to the implementation of leading indicators.

1. Introduction
Construction industry is known for causing injuries to workers. These
injuries have been many and serious (Musonda et al., 2021; Rantsatsi
et al., 2021). Despite this, the construction industry has seen some im­
provements in health and safety (H&S) performance. This is because
various strategies have been implemented to manage H&S. New ap­
proaches have been considered for improving construction methods and
design and for safeguarding the H&S of workers (Costin et al., 2019).
Other approaches include introducing H&S culture (Musonda et al.,
2021), behaviour-based safety program (Li et al., 2015), H&S manage­
ment system (Wachter and Yorio, 2014) and collaboration (Rantsatsi
et al., 2023). These approaches are aimed at improving site working
conditions, delivery of projects and ensuring that every worker returns
home safe. Other measures implemented by construction organisations
to manage H&S include the use of lagging and leading indicators. Both
indicators have received attention in the literature. Recently, the use of
lagging indicators has been criticised for investigating what has
happened (Lingard et al., 2017) and focusing on recurrences. Thus,
providing a rear mirror view. Lagging indicators are described by acci­
dents and associated with reactive actions (Xu et al., 2021), delayed
response (Poh et al., 2018) and failures (Oswald, 2020: 12). This is
related to losses and accidents that have already occurred. According to
Sinelnikov et al. (2015) lagging indicators are criticized for focusing on
failures and may even encourage under reporting of incidents which
reduces reliability of incident data (Xu et al., 2022). The lagging in­
dicators continue to be unable to provide explanations for negative
outcome (Xu et al., 2021) and existing safety conditions (Xian et al.,
2022). Despite their shortcomings, lagging indicators can successfully be
used to draw comparisons across projects or organisations (Hinze et al.,
2013; Lingard et al., 2017: Oswald, 2020) and are easy to collect, un­
derstand (Oswald et al., 2018) and helpful for identifying trends (Lin­
gard et al., 2017; Oswald, 2020).
On the other hand, the significance of both leading and lagging in­
dicators as key components of effective H&S management system have
been highlighted by Hinze et al. (2013) and Oswald et al., 2018) and
both are necessary for H&S improvement (Liang et al., 2018; Reiman
and Pietikäinen, 2012). H&S leading indicators refer to the measures or

E-mail addresses: ndalenir@vut.ac.za, rphinias123@gmail.com.

https://doi.org/10.1016/j.ssci.2023.106131
Received 24 November 2022; Received in revised form 22 February 2023; Accepted 2 March 2023
Available online 17 March 2023
0925-7535/© 2023 The Author(s). Published by Elsevier Ltd. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-
nc-nd/4.0/).
R.N. Phinias
activities that are implemented to either predict future H&S perfor­
mance or prevent future accidents. Various scholars have highlighted
the benefits of using H&S leading indicators for preventing future ac­
cidents, while others have argued that these indicators can be used to
measure activities and actions that may determine future accidents or
predict future H&S performance (Hinze et al., 2013; Poh et al., 2018)
and are associated with positive safety actions (Oswald, 2020). These
indicators are considered critical for providing early warning signals and
identifying problem areas (Agumba and Haupt, 2012). This is helpful in
proactively preventing accidents from occurring. Several scholars have
conducted systematic literature review on leading indicators (Neamat,
2019; Alruqi and Hallowell, 2019; Xu et al., 2021). However, no single
study has provided a systematic review of benefits and challenges
relating to the implementation of leading indicators. This study aims to
provide an overview of leading indicators as well as to identify the
benefits and challenges relating to the implementation of leading in­
dicators in the construction industry.
2. Methodology
Literature review is usually conducted to provide evaluation and
analysis of previous studies. According to Tranfield et al. (2003) sys­
tematic review provides replicable, scientific and transparent process.
Systematic literature was conducted using Preferred Reporting Items for
Fig. 1. Procedure of systematic literature review of the implementation of health and safety leading indicators in the construction industry.
2
Safety Science 163 (2023) 106131
Systematic Reviews and Meta-Analyses (PRISMA) to achieve study
objective. PRISMA is appropriate for conducting systematic review and
can be used in any field. PRISMA has been used previously and Ahamad
et al, (2022) and Couto da Silva and Amaral (2019) used it in H&S
studies. For improving accuracy, replicability, and transparency,
PRISMA was chosen over other procedures. The study followed the four
stages of PRISMA as depicted in Fig. 1.
2.1. Search strategy and study requirements
This section describes the identification, screening, eligibility and
inclusion stages. The keywords were used to conduct search on Scopus
and Google Scholar databases. The two databases were used because
they have research data on different fields including construction H&S
field studies. Two databases were chosen to increase the chance of
finding relevant publications (Ahamad et al., 2022). The search used
words such as ‘’Systematic review’’ Systematic literature review, ‘’
Health and safety’’, Leading indicators’’, ‘’Active’’, ‘’Passive,’’ ‘’Bene­
fits’’ ‘’Challenges‘’ Construction industry’’ were used to increase the
chances of discovering the relevant papers. The search was conducted
between March and November 2022. The last search was performed 15
November 2022. The Google Scholar produced 211 and Scopus 124
results. This resulted in total of 345 papers including 10 from other
source using reference lists. Studies that met following inclusion criteria
R.N. Phinias Safety Science 163 (2023) 106131

were included (a) articles published between 2012 and 2022; (b) studies Table 1
that explored H&S leading indicators; (c) only articles with full text; (d) reviewed articles on health and safety leading indicators in the construction
only peer reviewed articles written in English, and (e) only articles industry.
focused on construction industry. The following exclusion criteria were No Study focus Authors/Year Country Journal/ source of
set (a) books, conference papers and technical reports; (b) articles publication
without the name of the author or year of publication; (c) articles 1 Identify health and Agumba and South Mediterranean
investigation H&S issues that said nothing about leading indicators, and safety performance Haupt (2012) Africa Journal of Social
(d) any articles that explored leading indicators outside the construction improvement Sciences
indicators for small
industry. This study outlined the inclusion and exclusion criteria to
and medium
ensure a review of the best available data (Tranfield et al., 2003). After construction
removing duplicates, the number of papers was 166. The study screened enterprise
all 166 papers based on the inclusion and exclusion criteria. Screening 2 Measuring, Hallowell United Journal of
process excluded 95 papers. Full text articles assessed for eligibility were monitoring, and et al. (2013) States of construction
responding to safety America engineering and
71. Full text articles excluded were 37. Articles included in qualitative leading indicators (USA) management
synthesis were 34 (see Fig. 1). 3 Select and rank of Janackovic Serbia South African
PRISMA guidelines were followed to ensure data quality. Peer occupational safety et al. (2013) Journal of
reviewed journal articles were included in this review in order to in­ indicators based on Industrial
fuzzy AHP: A case Engineering
crease validity and reliability of the findings. Thus, books, conference
study in road
papers and university dissertations were excluded. The study sought to construction
extract meaningful data from identified articles. Full text was for iden­ companies
tified articles, and consideration was subject to inclusion criteria. The 4 Enhancing Rajendran USA Practice Periodical
author independently screened articles and extract data, while the in­ construction worker (2013) Struct. Des.
safety Constr. 18 (1),
dependent person verified the findings of the author based on the study
performanance using 45–51.
objective. Any discrepancies were dealt with, and appropriate changes leading indicators
made. This was done to remove researcher bias or any errors. Addi­ 5 Discuss leading Hinze et al. USA Journal of Safety
tionally, data extraction was conducted based on the study objective and indicators of (2013) Science
construction safety
summarized information was entered into the Tables 1 And 2.
performance
Excel spreadsheet was used to track the study focus, authors, publi­ 6 Present interlocked Biggs and Australia Journal of Safety
cation date, country, and journal. 34 articles were selected for data projects in safety Biggs (2013) Science
extraction. Articles published in management or social sciences journals competency and
were also considered if they met the study objectives and inclusion and safety effectiveness
indicators in the
exclusion criteria. Only peer reviewed articles were considered as rec­
construction sector
ommended by Ibrahim and Belayutham (2019). 7 Investigating safety Masood et al. Pakistan Sci Int
performance (2014)
3. Findings and discussion indicators on
construction projects
8 Provide a framework Shen and USA Journal of
All 34 articles were analysed using content analysis method to syn­ for near-miss data Marks (2015) Construction,
thesise the literature. This section presents four main findings of the collection and Engineering and
study. Firstly, year and source of publication were reported and com­ visualisation within Management
parison with previous studies was made to establish if there were any a BIM platform
9 Develop leading Guo and Yiu New Journal of
new information. Secondly, countries of origin were reported and
indicators to monitor (2015) Zealand Management
comparison with previous studies was made to establish if there were the safety conditions Engineering
any new information. Thirdly, research areas emerging from the review of construction
were reported and recommendations were made for any new informa­ projects
10 Predictive validity of Salas and USA Journal of
tion emerging from the review. Finally, benefits and challenges relating
safety leading Hallowell Construction,
to the implementation of H&S leading indicators were identified and indicators: empirical (2016) Engineering and
new knowledge was established to fill the gap identified. assessment in the oil Management
and gas sector.
3.1. Publication year and source of publication 11 Investigate the Teizer (2016) Germany Journal of
critical time window Construction
for pro-active Innovation
Table 1 presents the years in which articles were published and construction
sources of publication. Only articles published between 2012 and 2022 accident prevention
were included in the review. Table 1 shows that between 2012 and and response
12 Uncover time Lingard et al. Australia Journal of Safety
2017, only 11 articles were published and between 2018 and 2022 over
dependent (2017) Science
23 articles were published. The number of articles published have relationships and
doubled during this period. High contribution could mean that re­ explore causal
searchers are recognising the usefulness of leading indicators for relationships
improving H&S performance. Table 1 shows that researchers used between indicators
13 Using a pressure- Guo et al., Australia Journal of
different journals to publish their work. Journal of Safety Science (JSE) state-practice model (2017) Construction,
contributed seven articles, Journal of Construction Engineering and to develop safety Engineering and
Management (JCEM) contributed six articles, Journal of Construction leading indicators for Management
Management and Economics contributed three articles and other jour­ construction
projects.
nals contributed one article each. Both JCEM and JSE contributed more
14 Develop a composite Liang et al. China International
articles than any journal. Similar to study by Shaikh et al. (2020) which safety performance (2018) Journal of
reported that JCEM (14) and JSE (7) contributed to most of the papers (continued on next page)
reviewed. Thus contributing 14 and 7 articles respectively.

3
R.N. Phinias Safety Science 163 (2023) 106131

Table 1 (continued ) Table 1 (continued )

No Study focus Authors/Year Country Journal/ source of No Study focus Authors/Year Country Journal/ source of
publication publication

indicator that Occupational and include leading

integrates the Environmental indicators
leading and lagging Health 26 Analyse construction Shaikh et al. Australia International
indicators safety performance (2020) Journal of
specifically for the indicators Building
safe contractor Pathology and
selection Adaptation
No Title Authors/Year Country Journal/ source of 26 Explore safety in the Forteza et al. Spain Rev. la
publication construction (2020) Construction
15 Present a critical Oswald et al. Australia Journal of industry: accidents
review of the use of (2018) Engineering, and precursors
safety performance Construction and 27 Focus on approaches Oswald Australia Journal of
indicators in the Architectural to the measurement (2020) Construction
construction Management of safety in Management and
industry construction Economics
16 Investigate empirical Alruqi et la. USA Journal of Safety 28 Present and organise Hallowell USA Journal of
relationship between (2018) Science safety prediction et al. (2020) Construction
measures of research into four Management and
construction safety major families, based Economics
climate dimensions upon the information
and safety that an analyst uses
performance to make a prediction
17 Present a machine Poh et al. Singapore Journal of 29 Explore the Quaigrain and Canada International
learning approach to (2018) Automation in relationship between Issa (2021) Journal of
develop leading Construction leading and lagging Construction
indicators indicators of Management
18 Propose a decision Karakhan USA Journal of disability
making framework et al. (2018) Construction, management
that can be utilized Engineering and performance
to evaluate safety Management No Title Authors/Year Country Journal/ source of
maturity of publication
construction 30 Conduct a systematic Xu et al. United Journal of Safety
contractors literature review on (2021) Kingdom Science
19 Use the internet of Costin et al. USA MDPI safety safety leading (UK)
things to collect (2019) journal indicators and
quantifiable data accident causation in
which can trigger an construction
actionable response 31 Explore what and Xu et al., UK Journal of Safety
in real time based on how safety leading (2022) Science
established indicators can be
thresholds implemented to
20 Investigate the most Neamat Iraq Advances in improve safety
common list of (2019) Science, management in the
leading and lagging Technology and construction
indicators Engineering industry
Systems Journal. 32 Introduce a leading Bhagwat et al. India International
21 Present a review and Alruqi and USA Journal of indicator-based (2022) Journal of
meta-analysis of Hallowell Construction, jobsite safety Occupational
safety leading (2019) Engineering and inspection method to Safety and
indicators Management measure the Ergonomics
22 Evaluate a Manjourides USA American Journal project’s safety
subcontractor pre- and of Industrial performance
qualification Dennerlein Medicine 33 Investigate safety Xian et al. Malaysian Journal of Positive
assessment (2019) leading indicators for (2022) School of
procedure informed Malaysian Psychology
by various leading construction
indicators industry
23 Utilising Versteega Canada Journal of Safety 34 Develop a safety Haji et al. Iran International
construction safety et al., (2019) Science leading indicator (2022) Journal of Civil
leading and lagging measurement tool Engineering
indicators to using BIM
measure project
safety performance
24 Present methods of Hallowell USA Journal of 3.2. Country of origin
safety prediction: et al., (2019) Construction
analysis and Management and
integration of risk Economics
Table 1 identified the countries in which articles were published.
assessment, leading USA contributed 13 articles, Australia contributed six articles, UK and
indicators, precursor Canada contributed two articles and South Africa, India, Malaysian,
analysis, and safety Iran, Spain, Iraq, Serbia, Germany, Singapore, Pakistan, China, and New
climate.
Zealand contributed one article each. USA has greater contribution to
25 Use safety Liu et al. USA Journal of
prequalification (2019) Environmental the subject of leading indicators. Developed countries provided 28 of 34
surveys to identify and Occupational articles resulting in 82% contribution. This was the case in previous
approaches that Health Policy study by Shaikh et al. (2020) which evaluated safety performance

4
R.N. Phinias Safety Science 163 (2023) 106131

Table 2 that considers multiple interdependent factors to assess maturity of

Benefits and challenges of implementing of health and safety leading indicators construction contractors. The framework identified leading and lagging
in the construction industry. indicators together with other five factors that should be used to eval­
Item Benefits Sources uate safety performance. The authors suggest that evaluating safety
Identification of Liu et al. (2019); Versteega et al. (2019)
performance by considering only leading and lagging indicators might
construction hazards not be enough.
Measurement and Liu et al. (2019) Agumba and Haupt (2012); Third area was about the use of technological resources or tools to
monitoring Poh et al. (2018). Janackovic et al. (2013) develop leading indicators. Technological tools or resources such as
Prevention of Lingard et al. (2017); Hinze (2013)
machine learning or building information modelling (BIM) was used to
construction accidents
Early warning system Xu (2021); Guo and Yiu, (2015); Shaikh et al. develop leading indicators (Poh et al., 2018). BIM can be used to
(2020); Janackovic et al. (2013) improve visualisation, communication, integration, and H&S perfor­
Increase compliance H&S Manjourides and Dennerlein, 2019: 322 Xu mance (Zhang et al., 2015). Despite these benefits, review reveals that
legislations et al., (2022) only three studies used technological resources to develop leading in­
Anonymity and Hinze et al., 2013: 25
confidentiality
dicators. Thus, more research should explore the use of technological
Predictions Hallowell et al. (2020); Hinze et al. (2013); applications or resources in identifying effective leading indicators.
Alruqi et al. (2018) The fourth area was about the classification of leading indicators into
Control measures Liu et al. (2019); Versteega et al. (2019) Hinze active and passive indicators. Leading indicators can be grouped into
et al. (2013)
active and passive leading indicators (Hinze et al., 2013; Haji et al.,
Challenges
Training and Liu et al. (2019) Hinze et al., (2013) 2022). As such, Hinze et al. (2013) further indicate that active leading
communication indicators requires short period to be changed while passive do not.
Leadership and Liu et al. (2019) Hinze et al. (2013) Review reveals that only one study focused on the active leading in­
commitment dicators and passive indicators were only discussed. There is need of
Time and cost Versteega et al. (2019)
more research focusing on active and passive leading indicators.
Effectiveness and Versteega et al. (2019); Lingard et al. (2017);
uncertainty Manjourides and Dennerlein (2019) The fifth area was about the use of quantitative and qualitative in­
Varying definitions Hinze et al. (2013), Poh et al. (2018), Lingard dicators. Review shows an over-reliance on quantitative leading in­
et al. (2017) and Xu (2021) dicators as a measure of choice. Hence, there is an inclination to focus on
Dominance of Oswald (2020); Biggs and Biggs (2013)
the quantity than quality of indicators. It is argued that qualitative in­
quantitative indicators
Convenience Xu et al. (2022) and Hinze et al. (2013) dicators can provide useful insights (Oswald, 2020). The reliance on
Worker involvement and Liu et al. (2019) and Khaikh et al. (2020) quantitative indicators may be because they are perceived as being more
participation objective and may offer consistent interpretation (Hinze et al., 2013).
However, focusing on qualitative indicators may offer new insight into
the effectiveness of leading indicators.
indicators in construction. Similarly, a systematic review on factors of
Final area was about the relationship between the lagging and
collaboration by Rantsatsi et al. (2020) reported that developed coun­
leading indicators. Only four studies, Versteega et al. (2019), Lingard
tries provided more articles than developing countries. Low contribu­
et al. (2017), Rajendran (2013) and Manjourides and Dennerlein (2019)
tions by developing countries could mean H&S leading indicators
investigated the relationship between lagging indicators and leading
subject is underdeveloped in these countries or maybe researchers
indicators on construction projects. These studies could not provide
choose to publish through other platforms such as conference
conclusive results regarding the relationship of the indicators. According
proceedings.
to Oswald (2020) and Xu et al., (2021) the relationship between lagging
and leading indicators remains unclear. Hence, leading indicators have
3.3. Research areas been adopted without critical analysis (Lingard et al., 2017).

This review identified six main research areas. First area was about
the identification of leading indicators. Identified articles provided va­
riety of leading indicators intended to improve H&S performance.
Summarised list of leading indicators include, regular meetings, op
management, Training, provision of H&S budget, provision of tools and
equipment, inspection, hazard identification, pre-task planning
meeting, toolbox talk, audits, contractor prequalification criteria, site
walkways, management commitment, safety observation, near miss
report, safety climate, worker safe behaviour, negative random drug test
results, client engagement, designer engagement, contractor engage­
ment, worker involvement, mock emergence drill, stop work authority,
housekeeping and safe working procedure. This review reveals that pre-
task planning meeting, toolbox talk, audits, near miss report and site
inspections and training were the most used leading indicators. These
findings support the work of Xu et al. (2021) that identified 16 leading
indicators. Similarly, Xian et al. (2022) determined that frequency of
toolbox meetings was one of the indicators implemented by Malaysian
construction organisations.
Second area is about conceptual frameworks for developing leading
indicators. Xu et al. (2021) developed a leading indicators framework
that considers accidents. Their argument was that effective safety
leading indicators framework should identify the situations that might
cause accidents. Meaning that the framework should be informed by the
causes of the accidents. Karakhan et al., (2018) developed framework
3.4. Benefits and challenges relating to the implementation of leading
indicators in the construction industry
This section outlines the benefits and challenges identified through
content analysis from 34 articles as described in table 1.
3.4.1. Benefits relating to the implementation of leading indicators in the
construction industry
3.4.1.1. Identification of construction hazards. Leading indicators can
help in the identification of existing and potential construction hazards.
Hazard identification is an important element of effective H&S program
and for establishing safe working environment, that reduces harm to
construction workers. Study by Sinelnikov et al. (2015) revealed that
leading indicators are used for anticipation and elimination of risks and
are also used to provide information (Reiman and Pietikäinen, 2012).
This information is useful for identifying H&S problems. H&S indicators
are important in accident prevention strategies (Zhang et al., 2015) and
may be used to identify root causes of incidents (Liu et al., 2019). Hence,
Identification of hazards are used to reduce the likelihood of accidents,
while identification of root causes is used to prevent recurrences.
3.4.1.2. Measurement and monitoring. Leading indicators provide

5
R.N. Phinias
opportunity to monitor and review measures implemented to improve
H&S. Hinze et al. (2013) argue that these indicators are there to monitor
construction safety process as well as to initiate proactive actions to
correct the weakness detected. There are also critical for monitoring and
assessing performance (Sinelnikov et al., 2015). Similarly, Lingard et al.
(2017) indicate that regular measurement of safety performance pro­
vides information required for evaluating the effectiveness of H&S ac­
tivities. These indicators are seen as tools for monitoring H&S system
(Swuste et al., 2016) and for facilitating continuous learning (Xu et al.,
2022). Hence, information gained from these tools can be used to
measure and evaluate the H&S interventions. On the other hand, leading
indicators are praised for their ability to monitor and review H&S per­
formance (Poh et al., 2018). According Agumba and Haupt (2012) they
can be used detect problem areas and serve as a basis for decision
making (Janackovic et al., 2013). Furthermore, their frequency differs
depending on the situation. According to Liu et al. (2019) evaluation can
be done periodically or annually to check whether the program is on
track to achieve its objectives. Finally, leading indicators can help to
track progress and evaluate the quality and suitability of H&S programs.
3.4.1.3. Prevention of construction accidents. Leading indicators often
help to prevent construction accidents before they occur. For instance,
study by Lingard et al. (2017) indicated that the number of toolbox talks
conducted led to decrease in the number of injuries. Another study
established that one of the benefits of leading indicators is prevention of
risks and losses (Sinelnikov et al., 2015). Thus, with leading indicators,
new or existing intervention can be modified to prevent accidents from
occurring. However, the implementation of H&S program does not only
prevent construction accidents but can also contribute to project success
(Buniya et al., 2022). As such, the benefits of leading indicators go
beyond H&S objectives.
3.4.1.4. Early warning system. Early warning system can help to provide
early signs of potential failures of H&S program. It can also help orga­
nisations to detect and address problems before they cause accidents
(Sinelnikov et al., 2015). Given, their proactive nature, leading in­
dicators provide early warnings of potential negative outcome (Xu et al.,
2021; Guo and Yiu, 2015) and upcoming H&S related issues (Shaikh
et al., 2020; Janackovic et al., 2013). As such, provide information about
the status of construction H&S (Guo and Yiu, 2015) before accidents
happen (Sinelnikov et al., 2015) and can also be used to institute correct
actions. On the other hand, Hallowell et al. (2013) highlight that leading
indicators are measured on monthly basis. It is understood that these
leading indicators are implemented based on time, for example daily,
weekly, monthly, or yearly. Thus, early warning signals can be given
either daily, weekly, monthly, or annually to correct the situation.
Finally, is it noted that early warning system remains ineffective without
top management support and lack of supportive H&S culture (Sinelnikov
et al., 2015). Hence, top management commitment is necessary.
3.4.1.5. Increase compliance with health and safety legislations. It is
argued that merely complying with H&S legislations and standards may
not be enough to reduce injuries (Manjourides and Dennerlein, 2019).
With implementation of leading indicators, organisations can fulfil the
H&S legislation requirements. However, their implementation should go
beyond legal compliance (Xu et al., 2022). For example, H&S legisla­
tions require the reporting, investigation and recording of accidents and
completion of inspection or audits. By conducting audits, organisation
can provide a means of checking regulatory requirements and ultimately
improving H&S compliance and worker safe behaviour. According to
Swuste et al. (2016) managers can use audit results as a tool to identify
accident signals.
3.4.1.6. Anonymity and confidentiality. Anonymity and confidentiality
provide ways of protecting the identity of individuals being measured. In
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Safety Science 163 (2023) 106131
some cases, effectiveness of other indicators may depend on whether the
identity of affected workers is revealed or not (Hinze et al., 2013). For
instance, the identity of top management site walkabout as part of their
key performance indicators may be disclosed, while the identity of those
reporting near misses may be protected. According to Hinze et al. (2013)
the former is done to ensure accountability, while the latter is done to
encourage workers to report incidents. The protection of the identity
may encourage workers to report incidents and prevent worker vic­
timisation while, disclosure of persons responsible for implementing
interventions in response to incidents may promote sense of commit­
ment and accountability. Although, this review demonstrated that an­
onymity and confidentiality could not be applied in all situations, for all
categories of construction workers or for all leading indicators, but there
was a potential benefit in promoting anonymity and confidentiality.
Guaranteeing anonymity and confidentiality may encourage greater
participation in leading indicators program.
3.4.1.7. Predictions. According to Hallowell et al. (2020) safety pre­
diction uses information from the past to predict future safety events.
Information gained from leading indicators (for example, site walks,
audits, training, and meetings) can be used to predict future incidents. In
a study by Hallowell et al. (2020) leading indicators were identified as
one of the examples considered for estimating probabilities of future
events. These events may involve injuries, accidents, illnesses, losses or
any high-risk activities or trades. According to Alruqi et al. (2018)
leading indicators are one of the methods used to predict construction
safety performance. Similarly, it is known that some leading indicators
predict future accident rates (Hallowell et al., 2019; Hinze et al., 2013).
Findings by Lingard et al. (2017) tend to contradict the assumption that
leading indicators measured at one point in time can predict safety
outcomes at a subsequent point in time. The potential of leading in­
dicators for predicting and preventing negative outcomes is what mo­
tivates organisations (Sinelnikov et al., 2015). However, Sinelnikov
et al. (2013) note that new leading indicators should be chosen based its
predictability. Since, they provide information that can be used for
predicting future situations, whether negative or positive (Reiman and
Pietikäinen, 2012). However, Swuste et al. (2016) note that leading
indicators ability to predict major accidents seems to be futuristic.
Recent study indicates that no consensus on leading indicators capa­
bility for predicting future performance (Liu et al., 2019). Finally, H&S
professionals use leading indicators to make H&S decisions (Sinelnikov
et al., 2015). As problems are detected early, then solutions can be
provided to prevent future occurrences.
3.4.1.8. Control measures. It is widely acknowledged that leading in­
dicators are used to establish the effectiveness of H&S measures
(Sinelnikov et al., 2015) and can also be used to describe how effective
the safety process is (Hinze et al., 2013). As such, leading indicators
measure fundamental parts of the project or organisation H&S culture
(Hinze et al., 2013) and they can establish if control measures are
adequately functioning (Swuste et al., 2016). Further, they are helpful in
assessing the effectiveness of H&S initiatives (Sinelnikov et al., 2015).
Based on the results of leading indicators, relevant measures can be put
in place to prevent accidents. Similarly, Hinze et al., (2013) notes that
advantage of leading indicators is that changes can be made to safety
process before injuries occur. This can help to encourage safe behaviour
(Sinelnikov et al., 2015) and help management to make relevant de­
cisions to avert the adverse event. Finally, according to Reiman and
Pietikäinen (2012) leading indicators influence control measures. Be­
sides, identifying gaps in H&S system and leading indicators can suggest
new control measures.
R.N. Phinias
3.4.2. Challenges relating to the implementation of leading indicators in the
construction industry
3.4.2.1. Training and communication. Communication and training
were identified as an important factor for implementing leading in­
dicators (Sinelnikov, et al., 2015; Hinze et al., 2013). Training and
communication of leading indicators is required at levels within the
construction projects to get the support or buy in of every worker. Or­
ganisations should inform every worker about specific leading in­
dicators that they intend to measure (Sinelnikov et al., 2015) and
reasons behind their implementation (Hinze et al., 2013). Training
should be given to workers on leading indicators program and organi­
sation should communicate how workers could get involved (Buniya
et al., 2022). This can happen during formal H&S induction training,
toolbox talk or during daily task risk assessments. Providing relevant
communication and training about leading indicators would facilitating
easy implementation and workers’ understanding and cooperation. For
instance, organisation can state that no worker will be treated unfairly
for reporting incidents. Providing education and training on leading
indicators can help to raise awareness among workers and management.
According to Hinze et al. (2013) the reasons for implementing leading
indicators should be communicated to those affected or potentially
affected. This is to increase awareness and get the support of everyone.
Proper training and communication can raise the level of understanding
and implementation. This will help everyone to contribute the devel­
opment and implementation of any H&S program (Liu et al., 2019). The
information gained should be disseminated within the project and
considered for future projects. This is because poor implementation of
leading indicators may be caused by lack of knowledge and training.
Lack of awareness among H&S staff can affect the implementation of
leading indicators (Sinelnikov et al., 2015). This may discourage
workers and management from participating in implementing leading
indicators. Like any other H&S program, the implementation of leading
indicators requires training and communication across the organisation
or project environment. Those implementing them should have good
knowledge and understanding.
3.4.2.2. Leadership and commitment. Besides training and communica­
tion, study by Sinelnikov et al. (2015) identified lack of leadership
commitment as the main barrier to the implementation of leading in­
dicators. Hence, implementation of leading indicators requires leader­
ship and commitment. This includes assignment of responsibilities and
resources for running the program. Without these resources, the
implementation becomes challenging (Hinze et al.,2013). Since re­
sources are provided by top management, its commitment becomes
critical. Although, top management does not get involved in day to day,
their leadership and commitment are central to the program imple­
mentation. Study by Sinelnikov et al. (2015) confirmed the importance
of leadership commitment for implementing leading indicators. For
instance, top management can demonstrate leadership and commitment
through identifying key leading indicators and monitoring H&S per­
formance leading indicators. Conversely, lack of leadership and
commitment may make the implementation of leading indicators a
difficult job. Therefore, communicating and training top management
on leading indicators can help to increase their awareness, support and
commitment (Sinelnikov et al., 2015). Finally, prioritising of leading
indicators by top management can encourage the whole organisation to
accept and implement them (Sinelnikov et al., 2015).
3.4.2.3. Time and cost. One of the challenges relating to the imple­
mentation of leading indicators is about the time and cost that must be
spent. It is established that implementing leading indicators requires
time, energy and money (Sinelnikov et al., 2015; Hinze et al., 2013).
Like any other program, leading indicators will take time before marked
improvement is seen (Hinze et al., 2013). There is usually a resistance to
7
Safety Science 163 (2023) 106131
adopting any H&S programs due the perception that it will cost a lot of
money and time. Similarly, according to Versteega et al. (2019) imple­
menting leading indicators requires time and costs too much money and
can be hampered by limited H&S budget (Sinelnikov et al., 2015).
However, Biggs and Biggs (2013) indicate that these indicators should
be simple and not be time consuming to implement. Finally, Sinelnikov
et al. (2015) identified competing job priorities as one of the main
barriers to the implementation of leading indicators. This perception
exists because H&S objectives is not seen in the same light as cost, time,
and quality objectives. Hence, management should set aside budget for
H&S issues such as training workers on leading indicators and allocating
time for their implementation.
3.4.2.4. Effectiveness and uncertainty. Ambiguity and uncertainty affect
implementation of leading indicators (Xu et al., 2022). Poor imple­
mentation of leading indicators may be because the organisations
struggle to see the positive effect of these indicators in their workplace
(Versteega et al. (2019). There has been evidence providing inconclusive
results around the relationship of leading indicators and lagging in­
dicators. According to Sinelnikov et al. (2015) the link between lagging
and leading indicators has been challenging for some organisations
(Sinelnikov et al., 2015). However, Hinze et al. (2013) remark that there
is no guarantee that one leading indicator can be effective in all situa­
tions. Similarly, Oswald (2020) concludes that not all leading indicators
are useful. This was confirmed in a study by Versteega et al. (2019).
Notably, Hinze et al. (2013) argue that it is almost impossible to prove
that leading indicators were the only reason that H&S performance has
improved. This is because workplace safety is affected by different fac­
tors (Oswald et al., 2018). Finally, Swuste et al. (2016) warn that leading
indicators are only effective when they are part of organisational
continuous learning process. Hence, the effectiveness and certainty of
leading indicators can be improved if they are part of organisational
process.
3.4.2.5. Varying definitions. Leading indicators are relatively new to
H&S programs (Hinze et al., 2013) compared to other measures such as
risk assessment and accident analysis. Hence, no consensus exists
regarding their definition, implementation, and effectiveness (Hinze
et al., 2013). The concept of leading indicators is somewhat unclear.
This is shown by the fact that all proactive H&S actions are defined as
leading indicators rather than according to proven causality (Versteega
et al., 2019), accuracy and reliability. Langard et el. (2017) notes that
different leading indicators definitions exist. Similarly, Xu (2021) notes
that no common agreement exists regarding definition of leading in­
dicators and no clear purpose (Poh et al., 2018). This leads to difficulty
in implementing leading indicators successfully.
3.4.2.6. Dominance of quantitative indicators. Leading indicators
involve qualitative and quantitative measurements. Quantitative mea­
surements are used more frequently than qualitative. For instance,
quantitative indicators provide objective information such as the num­
ber of audits, percentage of training while qualitative indicators can
explain the quality of audits conducted. Oswald (2020) notes that
quantitative indicators have been dominant and that there are no clear
qualitative indicators for capturing relevant information. Majority of
indicators provided are quantitative (Hinze et al., 2013). According to
Xu et al. (2022) quantitative measurements are easy to understand and
manage. The use of quantitative indicators provides limited information
(numbers) and often does not allow for deeper understanding. Xu et al.,
(2022) argue that this may encourage over-reporting which may not
lead to H&S improvements. Conversely, qualitative indicators are based
on experiences and perspectives (Oswald, 2020). While the use of
qualitative measurements may allow lived experiences and meaning to
be attached to leading indicators. Oswald (2020) argues that qualitative
aspects should be included into how H&S is measured on construction
R.N. Phinias
projects. Hinze et al., (2013) recommend that qualitative measures
should also be used. This is because quantitative indicators tend to
measure how often an event occurs and fails to establish how effectively
it is undertaken (Biggs and Biggs, 2013). Further, the use of qualitative
measurements can help to explain why and how a situation exists
(Oswald, 2020). Hence, the qualitative information gained can be used
to explain the quality of site inspections or site walk. According to
Hallowell et al. (2020) leading indicators should measure both the
quantity and quality of H&S management activities taken to prevent
injuries. Because measuring quantity of H&S management activities
does not provide any information on quality (Swuste et al., 2016).
Hence, both quantitative and qualitative indicators are necessary to
establish the frequency of event (number of site walks) and explain the
quality of safety management activity (site walk report).
3.4.2.7. Convenience. Availability and quantification of leading in­
dicators often influence the choice or implementation of leading in­
dicators. Xu et al. (2022) found that construction organisations often use
leading indicators which were easy to collect and quantify. Hinze et al.
(2013) caution that leading indicators should not be used because they
are inexpensive and easy. Xu et al. (2022) observe that leading in­
dicators were chosen based on convenience. The use of these indicators
may hamper learning and improvement in H&S management. There­
fore, leading indicators should be chosen based on their potential for
improving H&S not only because they are readily available, inexpensive,
and easy to collect and quantify.
3.4.2.8. Worker involvement and participation. Like any other program,
leading indicators is bound to fail due to lack of worker involvement and
participation. Hence, organisation committed to implementing leading
indicators should seek workers involvement and participation. Accord­
ing to Khaikh et al. (2020) worker involvement in H&S related activities
can increase workers contribution to H&S. Thus, involvement of
workers should occur when leading indicators are established, imple­
mented and evaluated. Involvement and participation in H&S decision
making encourages workers responsibility for actions (Costin et al.,
2019). Leading indicators program should be designed in such way that
facilitates workers’ feedback. However, for workers to embrace any H&S
program, top management commitment is necessary (Buniya et al.,
2022).
This study is limited to 2012 and 2022 and Scopus and Google
Scholar databases, therefore, other time period and publications may
have different benefits and challenges not captured in this review. Non-
English articles have been missed since only English articles were
considered in this study. This article considered only peer reviewed
articles and non-peer-reviewed papers could have been missed.
Although this review could not find clear evidence for the benefit of
anonymity and confidentiality in all situations, but this does not un­
dermine the potential value of anonymity and confidentiality in imple­
menting leading indicators. Hence, future studies could investigate the
potential of anonymity and confidentiality in all situations.
4. Conclusions
Understanding the benefits and challenges relating to the imple­
mentation of leading indicators is critical for achieving zero accident in
the construction industry. This is the first review of benefits and chal­
lenges relating to the implementation of leading indicators. The purpose
of the review was to provide an overview of leading indicators as well as
to identify the benefits and challenges relating to the implementation of
leading indicators in the construction industry. The study identified
eight benefits (identification of construction accidents, measurement
and monitoring, prevention of construction accidents, early warning
system, increase compliance with H&S legislations, anonymity and
confidentiality, predictions and control measures) and eight challenges
8
Safety Science 163 (2023) 106131
(training and communication, leadership and commitment, time and
cost, effectiveness and uncertainty, varying definitions, dominance of
quantitative indicators, convenience and worker involvement and
participation) relating to the implementation of leading indicators.
However, it has been established that there is no consensus on the
definition of leading indicators and the review further indicates that
there is no consensus on their effectiveness and ability for predicting
future H&S performance consistently. The information provided in this
study is crucial for construction organisations and H&S professionals
who intend to implement leading indicators as part of the H&S initia­
tives aimed at preventing construction accidents and predicting H&S
performance. Contributions of this paper include: a systematic approach
adopted in this study, an overview of H&S leading indicators and
identification of benefits and challenges relating to the implementation
of leading indicators. It is suggested that if implemented, have the ability
to drive H&S performance. It was established that pre-task planning
meeting, toolbox talk, audits, near miss report and site inspections and
training were the most used leading indicators. The implementation of
these leading indicators is not only limited to construction phase, but
applies through project stages. These indicators can be implemented by
construction workers such as construction managers, supervisors,
workers and H&S professionals. Study findings are critical for increasing
construction practitioners and researchers knowledge and understand­
ing of benefits and challenges relating to the implementation of leading
indicators. The review identified six research areas that should be
explored to broaden our understanding and improve the efficacy of
leading indicators on H&S performance. The use of technologies and
active and passive leading indicators should be explored more. There is a
need to investigate relative importance of the identified benefits and
challenges relating to the implementation of leading indicators.
CRediT authorship contribution statement
Ndaleni Phinias Rantsatsi is responsible for conceptualisation, data
acquisition and curation, writing- original draft, writing review and
edition, formal analysis, methodology.
Declaration of Competing Interest
The authors declare that they have no known competing financial
interests or personal relationships that could have appeared to influence
the work reported in this paper.
Acknowledgement
Author wishes to acknowledge Mrs Rachel Sithole for verifying the
findings.
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