Objectives Occupational health services (OHS) are an important resource within employers’ preventive occupational health and safety management (OHSM). The aims of this study were to investigate employers’ utilization of OHS in preventive OHSM and identify decisive contextual, structural and/or processual conditions in ensuring successful collaboration with OHS in preventive OHSM.

Methods A total of 122 organizations within the Swedish welfare sector (education, social services and healthcare), of which 112 had access to OHS, responded to a quantitative survey on the organization and management of their preventive OHSM. Responses were investigated using both conventional descriptive analysis and configurational analysis.

Results Only a third of the participating organizations utilized OHS to a high or very high degree within their preventive OHSM. Factors for successful collaboration with OHS within preventive OHSM included having a contract that made it possible to use OHS and having established routines for involving OHS in the early phases of preventive measures, especially when managing external demands and complex challenges.

Conclusions The utilization of OHS within preventive OHSM is limited, and increased utilization may improve the ability of employers to successfully implement OHSM. The successful organization of OHSM practices and the OHS contract were key factors in a successful collaboration with OHS. Working together in preventive OHSM may also strengthen social capital for all stakeholders, which could further enhance collaboration.

Key terms health and safety management; occupational health and safety; occupational health service; OSH; performance; prevention

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