Abstract It is now generally recognized that in order to make significant advances in accident prevention, the focus of industrial firms must shift from assessing the risks of existing production and manufacturing systems to discovering technological alternatives, that is, from the identification of problems to the identification and design of solutions. Encouraging the industrial firm to perform an inherent safety opportunity audit (ISOA) to identify where inherently safer technology is needed, and a technology options analysis (TOA) to identify specific inherently safer options, will advance the adoption and design of primary prevention strategies that will alter production systems so that there are fewer inherent safety risks. Successful approaches require both technological and managerial changes. Firms must have the willingness, opportunity, and capability to change.