This paper examines the contributing factors in construction accidents, drawing on focus group research and detailed studies of 100 individual accidents. The research identified that problems arising from workers or the work team were involved in 70% of accidents, workplace issues in 49%, shortcomings with equipment (including PPE) in 56%, problems with material suitability and condition in 27%, and deficiencies in risk management in 84%. A model is proposed to illustrate how originating managerial, design, and cultural factors shape the circumstances on-site, leading to acts and conditions that result in accidents. The model emphasizes the need for sustained improvement in construction safety by addressing the underlying influences. Key recommendations include integrating safety across the project team, prioritizing risk management over PPE, improving engagement with risk management, benchmarking safety practices, learning from failures, and disassociating safety from bureaucracy. The research highlights the need for widespread improvement in understanding of safety and risk management in the construction industry.This paper examines the contributing factors in construction accidents, drawing on focus group research and detailed studies of 100 individual accidents. The research identified that problems arising from workers or the work team were involved in 70% of accidents, workplace issues in 49%, shortcomings with equipment (including PPE) in 56%, problems with material suitability and condition in 27%, and deficiencies in risk management in 84%. A model is proposed to illustrate how originating managerial, design, and cultural factors shape the circumstances on-site, leading to acts and conditions that result in accidents. The model emphasizes the need for sustained improvement in construction safety by addressing the underlying influences. Key recommendations include integrating safety across the project team, prioritizing risk management over PPE, improving engagement with risk management, benchmarking safety practices, learning from failures, and disassociating safety from bureaucracy. The research highlights the need for widespread improvement in understanding of safety and risk management in the construction industry.