An example of Early Injury Intervention: An Athletic Trainer & CEIS helps a maintenance employee improve his posture to decrease neck and shoulder fatigue from his tasks.

Leading a team of passionate, forward-thinking healthcare practitioners in the early days of workplace wellbeing was nothing short of exhilarating. We didn’t just follow the rules—we challenged them, exploring new ways to keep people safe, healthy, and thriving on the job. A recent conversation with a former colleague from those days reminded me of the impact of that work and inspired me to put my reflections into this article. For EHS leaders and practitioners committed to redefining occupational health, I hope it sparks fresh ideas and bold approaches.

After that conversation with my former colleague, I found myself contemplating the challenges we faced, solutions we developed, and memories from that time. What struck me most was not just what we accomplished, but what it meant—to me personally, to the young professionals I worked alongside, and to the organizations and workers we served. Ten years later, with the perspective of continued growth in the field of industrial safety and the evolution of early injury intervention into mainstream practice, I decided it was time to revisit and reinterpret that work. This article is my attempt to document why it mattered then, why it matters now, and what lessons it offers for the future.

For decades, safety professionals and occupational health providers worked in silos. Safety sought to prevent accidents, while medicine treated injuries once they had already occurred. The result was a costly and incomplete system where too many employees slipped through the cracks.

Early intervention filled this gap. By embedding healthcare expertise, educated on the environment, directly in the workplace, we transformed a reactive cycle into a proactive system—one that not only prevented injuries but also reshaped how organizations thought about their responsibility for worker well-being.

As Vice President of Operations at ATI Worksite Solutions, I had the privilege of leading a team of over 300 healthcare professionals who were pioneering a new approach to protecting workers in industrial environments. We recognized a gap between traditional reactive injury management and proactive prevention programs. Out of this realization, we helped advance a model of early intervention that has since reshaped the way companies think about occupational safety, health, and employee wellbeing.

From the Athletic Field to the Factory Floor

Our method was rooted in the idea of adapting the unique expertise of Certified Athletic Trainers to the workplace. These professionals—specially trained as Certified Early Intervention Specialists™ (CEIS™)—blended sports medicine, ergonomics, safety, psychology, and injury prevention science into one role. Instead of waiting for injuries to occur, they engaged workers in real time, on the floor, through encounters: one-on-one coaching, injury triage, safe lifting techniques, stretching programs, wellness education, and ergonomic improvements.

The impact was powerful. By being visible, approachable, and trusted, CEIS™ professionals fostered an early reporting culture where employees no longer felt they had to “work through” discomfort until it became a recordable injury. Instead, minor issues could be addressed before escalating. As we described in our paper:

“The frequent presence of the Athletic Trainer among the workforce builds rapport… employees begin to trust the Athletic Trainer as an expert in early intervention and realize they now have an effective alternative to working until the pain becomes disabling.”

Why Early Injury Intervention Works

Traditional EHS systems, while vital, often leave a timing gap. Reactive tools—like accident investigations—teach us after harm has occurred. Proactive tools—like training and audits—look toward the future. But what about the critical “now” moment, when pain first appears or risk is first observed? That’s where early intervention fits.

By responding within hours of discomfort emerging, early intervention specialists help workers reverse injury progression. Instead of weeks of rehabilitation and restricted duty, employees often returned to full function in days.

For example, when comparing two industrial sites—one with a full-time CEIS™ and another with only part-time coverage—Workers’ Compensation claim costs decreased by 50% in just four months at the full-time site. The results were so compelling that the part-time site quickly transitioned to full-time support.

Examples of How Early Injury Intervention Works

I’ll never forget a machinist at a major automotive manufacturer who came to our on-site specialist with early signs of shoulder strain. In a traditional system, he likely would have “worked through it” until the injury required medical treatment and lost time. Instead, within minutes he was coached through stretches, posture changes, and light task modifications. Within days he was back to full strength—never entering the workers’ comp system, never losing wages, and never missing a beat in his career

Here is another example of how early intervention is effective in the industrial environment. An employee has back pain from lifting boxes frequently throughout his 8-hour day. As soon as he feels pain or discomfort he contacts the Athletic Trainer to come assess him or the trainer spots his unusual body motion and inquires as to his level of discomfort. The Athletic Trainer has an encounter with the employee within hours of the onset of pain. The employee is given some instructions on pre-established job-specific stretches that are posted within his department, as well as some tips on safe lifting techniques and body mechanics. The employee is reminded that icing would prevent worsening of his discomfort. The employee may be placed on protective limitations to prevent the condition from worsening to the point he can no longer perform the essential functions of his job. Daily follow up occurs from the Athletic Trainer to monitor improvement or detect the need for referral to traditional healthcare professionals for formal assessment and treatment. If the employee is compliant with the recommendations given, he should start to feel better within 24-48 hours and should continue with any job method modifications, stretching exercises and rest cycle recommendations from the Athletic Trainer in the upcoming days or weeks. The reversal of injury progression is verified and allows the introduction of a pre-established strengthening regimen that will allow the employee to increase tolerance to the physical stressors of the job that the injury originated from.

These examples illustrate the power of early intervention: small informed actions, taken early, prevent long-term harm for both employees and employers.

Agile Safety for a Changing Workplace

The workplaces of the 21st century are fast-moving, lean, and often stressful environments. Early intervention methods proved agile, adapting to real-time needs in a way that aligned with modern business pressures. They reduced costs rather than added to them, supported aging workforces, and met rising expectations for safe, meaningful work.

One global manufacturer of container glass found the results so striking that they expanded the program to multiple sites, including several in California where workers’ compensation costs were historically high. Within just 12 months, they saw a 92% decrease in workers’ compensation direct spend across their California sites.

The outcomes were clear:

• Recordable injuries were reduced.
• Claim frequency and severity were reduced.
• Commercial health insurance costs decreased.
• Health screening participation and employee morale increased.

In short, early intervention created safer workplaces, healthier employees, and measurable business value.

My Contributions to a Developing Field

While the clinical expertise resided in the healthcare professionals we placed on-site, my role as Vice President of Operations was to design, scale, and institutionalize early intervention as a discipline in occupational health and safety. This work not only delivered immediate results for clients but also helped establish a new professional field at the intersection of occupational medicine and safety.

Defining and Professionalizing the Model

I contributed directly to the evolution of the Certified Early Intervention Specialist™ (CEIS™) framework, helping shape how athletic trainers could adapt their sports medicine expertise into industrial environments. This included building training structures, compliance protocols, and integration pathways that blended clinical care, ergonomics, OSHA regulatory requirements, and EHS management.

Scaling and Delivering Results Across Industries

I guided the national expansion of early intervention programs into aerospace, automotive, glass, food, pharmaceuticals, and distribution sectors. Each implementation was tailored to unique operational risks, labor structures, and cultural expectations. Under my operational leadership, ATI Worksite Solutions transformed early intervention from a promising idea into a proven, repeatable, and scalable system that organizations could rely on for consistent performance.

Leveraging Deep Heavy Industry Experience

A critical differentiator of our success was the ability to integrate early intervention seamlessly into the realities of demanding industrial environments. Drawing on my extensive experience protecting employees in heavy industry settings—including aerospace, metals, glass, and chemical production—I ensured that our programs were not only clinically sound but also operationally relevant. This gave my team the advantage of deep contextual knowledge, enabling them to fully align their efforts with production demands, workforce dynamics, and safety-critical operations. The result was maximum impact in keeping employees safe, healthy, and able to contribute to the mission of their organizations.

Data-Driven Outcomes and ROI Validation

One of my central contributions was embedding rigorous measurement and business case validation into early intervention. I championed the use of performance metrics, client sentiment and return-on-investment analytics, showing clients tangible outcomes such as:

• 50% reduction in Workers’ Compensation claim costs within four months at pilot sites.
• 92% decrease in workers’ compensation spend across California operations for a global glass manufacturer.
• Reductions in OSHA recordables, improved wellness participation, and measurable gains in morale and productivity.

By making outcomes visible, I ensured that early intervention was not seen as a “soft” wellness initiative, but as a core business strategy that aligned with corporate cost, productivity, and compliance goals.

Integrating Occupational Safety and Medicine

Historically, safety and medicine operated in silos: safety professionals focused on preventing incidents, while occupational medicine treated injuries after the fact. My work demonstrated that the two could be seamlessly integrated through real-time, on-site intervention. This approach not only reduced injuries but also reshaped organizational culture—creating early reporting environments where prevention became part of daily operations.

Alignment with NIOSH Total Worker Health®

The philosophy behind early intervention aligned naturally with what later became mainstream under NIOSH’s Total Worker Health® (TWH) approach. TWH emphasizes policies, programs, and practices that integrate protection from work-related safety and health hazards with promotion of injury prevention, well-being, and overall worker health.

Our early intervention model anticipated this integration by:

• Bringing together safety and health disciplines into one role at the point of work.
• Promoting wellness alongside injury prevention, with CEIS™ specialists addressing nutrition, stretching, strengthening, and healthy lifestyle coaching.
• Building a culture of health where employees trusted the system enough to report early, and organizations could respond in real time.

In many ways, the CEIS™ framework was an early embodiment of the Total Worker Health vision—creating workplaces that didn’t just prevent injuries but actively supported longer, healthier, and more satisfying careers.

Advancing the Profession and Thought Leadership

Beyond operations, I worked to establish early intervention as a recognized field. This included:

• Authoring research and professional papers, including Early Injury Intervention Methods Bridge the Gap Between Reactive and Proactive Injury Prevention Systems. (Presented at ASSP’s SAFETY2015 in Dallas TX)
• Presenting at national forums and safety congresses, raising awareness and influencing adoption among EHS leaders.
• Mentoring professionals and building interdisciplinary teams, ensuring the sustainability and growth of the CEIS™ model, a proven and reliable method to bring holistic wellbeing to industrial workforces.

Developing the Next Generation of Leaders

One of the greatest joys of my time leading ATI Worksite Solutions was not only advancing early intervention in industry, but also developing the remarkable healthcare practitioners who made it possible. Many were just beginning their careers when they joined our team. I had the privilege of mentoring them as they grew—not just as medical and occupational safety professionals, but as leaders capable of shaping entire workplace cultures.

We spent countless hours together learning how to translate clinical expertise into meaningful impact on the factory floor, how to build trust with industrial workers, and how to understand the unique pressures faced by plant leaders. I emphasized the importance of being reliable, capable, and indispensable to our client organizations. In short, we were not simply providing a service; we were becoming strategic partners in creating safer, healthier, and more productive workplaces.

The five years I spent leading operations at ATI Worksite Solutions were transformative—not only for the industry, but also for all of us on the team. Watching these young professionals flourish has been one of the most rewarding aspects of my career. Many have gone on to make significant contributions of their own. One especially proud example is the founding of the Industrial Athletic Trainers Society by a former member of our team—a powerful testament to the momentum and influence of this work.

In mentoring them, I learned as much as I taught: that the future of our profession depends on empowering the next generation with both technical expertise and the confidence to lead with purpose. Their success continues to multiply the impact of early intervention across industries, and their legacy is as much a part of this story as mine.

The Full Impact of a Holistic Approach: Creating Safer Jobs and Fostering Well-being

For decades, organizations treated occupational safety and health (OSH) and employee well-being as separate domains. Traditional OSH—what most simply call “safety”—was focused on health protection: preventing accidents, exposures, and injuries. Meanwhile, wellness and health promotion programs emphasized health enhancement: encouraging nutrition, exercise, and lifestyle improvements outside the core safety system.

The A-ha moment came when forward-thinking companies began asking: What if these two streams weren’t separate? What if safety and health promotion were integrated into a single, holistic system of care for employees?

The Power of Integration

Research by Loeppke et al. (2015) demonstrated that integrating health protection and health promotion delivers measurable benefits beyond what either can achieve alone. The two fields reinforce one another, creating a whole greater than the sum of its parts:

• Improved safety outcomes: Workers who are healthier overall are less likely to suffer musculoskeletal injuries, fatigue-related errors, or chronic disease complications that impair safety.
• Enhanced health outcomes: A safer workplace reduces physical and psychological stressors that otherwise undermine wellness efforts.
• Cultural transformation: When organizations treat health and safety as inseparable, they create a Culture of Well-being—where employees feel valued not just for their output, but as whole people.

From Compliance to Culture

Traditional safety systems often emphasize compliance—meeting OSHA or regulatory standards. Integrated systems go beyond compliance to embed health and safety into daily work practices, leadership priorities, and organizational values.

• A lockout-tagout procedure is health protection.
• A stretching and ergonomics coaching program is health promotion.
• But when combined—ensuring equipment is safe while also preparing employees’ bodies for safe operation—they form a seamless protective web that reduces both acute accidents and long-term strain.

This shift reframes the safety profession itself: from “preventing harm” to “creating the conditions for people to thrive.”

Holistic Impact on Business and Workers

An integrated approach creates impact on multiple levels:

For Workers:

• Safer jobs with fewer injuries and exposures.
• Reduced stress and fatigue, leading to higher engagement.
• Improved long-term health trajectories, with lower risks of chronic disease.
• A greater sense of purpose and belonging at work.

For Organizations:

• Reduced workers’ compensation costs and healthcare spend.
• Fewer lost workdays and restrictions, driving productivity gains.
• Stronger employer brand and ability to attract/retain younger workers who expect healthy, mission-aligned workplaces.
• Alignment with frameworks like NIOSH Total Worker Health®, which are increasingly viewed as best practice.

For Society:

• Reduced burden on healthcare systems.
• Longer, healthier working lives.
• More sustainable organizations that balance profit with people and purpose.

A Culture of Well-being: The Endgame

The integration of OSH and health promotion doesn’t just prevent injuries—it creates workplaces that actively improve people’s lives. This is the true “A-ha moment”:

• Safety protects.
• Wellness empowers.
• Together, they create well-being.

And well-being is what transforms organizations. Workers in these environments don’t just avoid harm—they gain health, resilience, and satisfaction. In turn, businesses gain loyalty, performance, and long-term sustainability.

As Loeppke et al. (2015) concluded, aligning health and safety strategies yields measurable benefits. But the impact extends further: it reshapes the relationship between workers and their employers into a partnership built on care, trust, and shared success.

A Vision for the Future of Work

Drawing on broader workforce megatrends, I also advanced the case that early intervention was part of a larger transformation in how we think about health at work. At conferences such as the OSHU Pain at Work Conference, I emphasized that:

• Musculoskeletal conditions remain the leading cause of workplace disability.
• A “Culture of Safety” must evolve into a “Culture of Wellbeing”—where prevention, well-being, and human sustainability are core to business.
• Health and safety cannot remain in silos; they must be integrated into a Total Worker Health™ approach that reflects changing employee expectations and the future of work.

And increasingly, those expectations are being shaped by younger generations entering the workforce. Millennials and Gen Z don’t just want a paycheck; they want work that is healthy, meaningful, and aligned with a greater mission than enriching shareholders. They expect employers to provide safe, sustainable, and satisfying workplaces where their well-being is valued and where the company’s purpose resonates with their own values. Early intervention, integrated health models, and Total Worker Health® speak directly to this demand—making organizations more attractive to top talent while strengthening long-term resilience.

In many ways, this work represented a paradigm shift. We demonstrated that occupational safety is not just about preventing catastrophic accidents, and occupational medicine is not just about treating injuries after they occur. The real power lies in the space in between, where early intervention can change the trajectory of worker health, safety performance, and organizational resilience.

Looking Ahead – A Call to Action

The evidence is clear: early injury intervention works. It reduces injuries, improves well-being, lowers costs, and builds trust between workers and organizations. It was an early model of the integrated approach that NIOSH has since advanced through Total Worker Health®—and it has never been more relevant.

Now is the time for forward-thinking companies to:

• Break down silos between health, safety, and well-being.
• Embed prevention and intervention into daily work, not just after-the-fact programs.
• Invest in agile, human-centered systems that adapt to worker needs in real time.
• Embrace Total Worker Health® as both a business strategy and a social responsibility.
• Meet the expectations of new generations of workers, who want healthy workplaces that align with purpose, sustainability, and shared value.

The workplaces that thrive in the future will be those that go beyond compliance, beyond traditional safety, and embrace integrated models of health and performance. As leaders, we have both the tools and the responsibility to make work not only safer, but healthier, more meaningful, and more sustainable.

The next evolution of early injury intervention will be shaped by technology. AI-enabled health analytics, wearable sensors, and real-time ergonomics feedback will expand the reach of early intervention specialists and provide data-driven insights we could only imagine a decade ago.

Just as athletic trainers on the factory floor bridged the gap between safety and health, these technologies—when combined with human expertise—will allow organizations to predict and prevent risks with even greater precision. Companies that embrace this next frontier will not only protect their workforce but will also lead in building the sustainable, people-centered workplaces of the future.

The choice is in front of us: will we wait until employees are injured and disengaged, or will we build workplaces where people live longer, healthier, and more satisfied lives—while contributing to a mission bigger than themselves?

Ref: Loeppke, Ronald R., et al. (2015).  “Integrating health and safety in the workplace: how closely aligning health and safety strategies can yield measurable benefits.” Journal of occupational and environmental medicine 57.5: 585-597.