New directions for healthy working environments (HWE) policy: A qualitative systematic review of attempts to reframe occupational safety and health (OSH)

‘Healthy working environment’ (HWE) describes an ambitious research and policy agenda for occupational safety and health (OSH). It signals a shift from a narrow focus on the avoidance of immediate workplace physical harms towards a wider concern with the longer-term occupational, social, and environmental contributors to physical and mental health and wellbeing. We examine how researchers and policymakers define this aim and what policy instruments they recommend. We then focus on the European Union to examine who may be responsible for making, implementing, or influencing the design of each instrument.

A qualitative systematic review (2025–26) to identify academic journal articles (Web of Science) and grey literature reports (Policy Commons) on HWE and OSH policy and policymaking, then snowballing to identify key academic and policy reference points. We draw insights from policy theories to inform an inductive approach that identifies key policy problem, policy mix, and policy process themes in the HWE literature.

HWE represents ambiguous aspirations for policy change. This ambiguity exacerbates uncertainty about which policy instruments should be used, and who should adopt them. EU research highlights hard regulations to enforce minimum OSH standards but soft guidance to encourage HWE innovation, contributing to the sharing of responsibilities between state and non-state organisations. Organisational research highlights greater scope for HWE change among large companies in sectors that reward innovation.

HWE signals an ambitious but ambiguous definition of OSH. In the EU, it symbolises the rhetorical pursuit of higher ambitions but lower substantive state intervention. There is some evidence of organisational innovation, but not on a scale consistent with EU ambitions.

Academics and policymakers use the term ‘healthy working environments’ (HWE) to widen how we think about occupational safety and health (OSH). They encourage more attention to mental health, the longer-term impact of work on health, the avoidance of physical and emotional exhaustion and development of new measures to improve wellbeing, while ensuring inclusive workplaces, and adapting to the economic, social, and technological impacts on work.

In that context, we present three main findings. First, we find a strong rhetorical emphasis on the case for HWE: access to a safe and healthy working environment should be a human right backed by enforced regulations, healthy workplaces boost productivity and economic growth, and trade unions enable meaningful worker engagement in the design and delivery of work.

Second, it is difficult to translate this broad agenda into specific policy instruments and assign responsibility for influencing, making, and delivering HWE policy. HWE models may favour high or low levels of state intervention, prioritise health or the economy, and seek to support or enforce organisational change. Approaches may be top-down to harmonise policy or bottom-up to favour innovation and learning.

Third, we find a growing gulf between higher EU HWE ambitions and limited state capacity to support and implement policies. HWE now expands the scope of OSH but in a longer-term context where the scale of national inspections is falling, the role of trade unions and worker representation is diminishing, and the private market for OSH services has grown. This trend accentuates country-wide differences in OSH cultures, in which only some countries oversee high levels of intervention to support HWE. It also puts a lot of faith in organisational innovation to deliver ambitious HWE policies, even though only large companies in some sectors may be in the position to invest.