Despite gradual improvements in safety technology over the course of the last century, work related fatalities, injuries and ill-health still represent a major and unacceptable burden on both society and the economy in most countries. The failure of employers to properly discharge their legal duties to prevent this harm to their employees, provides strong ethical and pragmatic reasons why people at work should have rights to adequate representation of their health and safety interests. This book considers the practice of such worker representation on health and safety at work. Drawing on ten case studies from the UK construction and chemicals industries, it critically analyzes existing statistical data, brings together a wide range of international materials, and examines the extent to which existing arrangements deliver results. It finds that whereas worker representation can improve health and safety, the preconditions for this are only present in a minority of workplaces. Proposals are made to redress the weaknesses of the currently dominant regulatory model.