After 1900, the increasing numbers of work-related injuries experienced in modern factories resulted in the passage of state workers' compensation acts (essentially no-fault insurance systems) to pay injured workers limited disability and health benefits. Although these programs filled an acute need by providing some support for the injuries workers experienced at work, they were primarily designed to protect companies from tort liability that had begun to be assessed when injured workers took their cases to the civil courts.

The first national legislation to protect the health of U.S. workers was the Walsh-Healey Public Contracts Act of 1936, which required federal contractors to comply with health and safety standards; at the same time, the Social Security Act funded the establishment of industrial hygiene programs in many states. Concern over a ''spreading epidemic of occupational injuries and disease" (Bingham, 1992:1325) led to the passage, in 1969, of the Coal Mine Health and Safety Act (MSHA) and, in 1970, of the Occupational Safety and Health Act (OSH Act), giving the federal government broad responsibility for worker health and safety. The 1970 OSH Act established an employer's general duty to provide a healthy and safe work environment and "...to furnish to each of his employees employment and a place of employment which are free from recognized hazards that are causing or likely to cause death or serious physical harm...." Today, debate is most frequently centered on defining "recognized" hazard and "serious physical harm," with employers generally arguing for narrow interpretations and workers arguing for broad ones.

Companies appear to focus most of their attention on control or prevention of injury risks since the negative impacts of injuries are easily and directly measured in terms of production delays and the costs of workers' compensation. Much less attention is devoted to preventing chronic diseases, such as occupational cancer, since the latency of these diseases results in little direct evidence of costs at the time the risks are incurred. During the 1970s and 1980s, many larger companies developed medical or nursing units to provide health-related services to workers, and only a few developed comprehensive occupational health and safety programs targeting prevention. The recent trend toward "lean" companies has resulted in a reduction or elimination of many such programs.