Not all human experiences can be expressed in words. Arts-based expressions may be useful to qualitative researchers as they can disclose people’s experiences with health, illness and disability. These expressions, which connect with non-linguistic and unexplored realms of experience, may support researchers’ efforts to honor the complexities of their lives. In our study, we explored and identified modes of expression among those sharing their experiences in health care and wellbeing research and practice. We present an inventory of human expression types based on a hierarchical classification and a literature review. The expression types which involve modes of both verbal and non-verbal knowing, show a bounty of possible ways for researchers and others to extend their study designs beyond verbalized accounts. We contend that using non-verbal expression types can assist qualitative researchers in fostering the articulation of complex experiences. As drawing upon a variety of methods in the inventory of expression types comes with new methodological bounds, researchers need to explicate their paradigmatic point of departure. It is expected that researchers, other professionals, and the general public will increase their holistic understandings of a subject’s experience by being open to a variety of expression types during data collection, interpretation, and presentation.

An authoethnography explores the lived experiences of patients being in control and self-managing their chronic illness among their families and friends. Findings show that the current health discourse narrows down people to mere patients and gives rise to tensions. This article indicates that people with one or several chronic illnesses or disabilities are first of all full citizens with needs, values, and drives seeking a meaningful life. Fair possibilities ought to exist to satisfy their needs to belong, to care for and to matter to others since these constitute an essential aspect of being human.

A significant gap exists between accident scenarios as foreseen by company safety management systems and actual scenarios observed in major accidents. Its mere existence, pointing at flawed risk assessments, is leaving hazards unmitigated, threatening worker safety, putting the environment at risk and endangering company continuity. Safety managers and regulators, attempting to reduce and eventually close this gap, not only encounter the pitfalls of poor safety studies, but also the acceptance of “unknown risk” as a phenomenon, companies being numbed by inadequate process safety indicators, unsettled debates between paradigms on improving process safety, and inflexible recording systems in a dynamic industrial environment. The immediacy of the stagnating long term downward major accident rate trend in the Netherlands underlines the need to address these pitfalls. The main conclusion is that safety management can never be ready with hazard identification and risk assessment.

Misunderstandings due to language problems are emerging as an underlying causal factor in a wide variety of occupational accidents. Implicated in this are language proficiency and literacy, but also readability of instructions. Coupled to these is the fact that the global workforce holds more migrant workers than ever before, and there are a growing number of multi-lingual shop floor environments, especially in the transportation and health care sectors. The term ‘language problem related accident’ (LPRA) is proposed here. This article reviews LPRA trends in industry, especially in the process industry and construction industry. Proposals are made about how to better manage the safety risks associated with LPRAs. LPRA information was gathered via a literature survey using search-terms related to LPRAs. This search included the governmental resources in Europe, the USA, Australia, several Far East countries, and Africa. Both the information found and the difficulties encountered while gathering this information were analysed and validated by interviews with experts. Causal information about LPRAs is partial at best: 21 access difficulties are identified. Their resolution will create opportunities for further safety improvement. The main proposals made here relate to public information systems, company safety management, regulatory inspections, accident investigation activities and safety science research.

Since the nineteen sixties, after the successive introductions of safety equipment, standards, inherently safe process designs, sophisticated safety management systems and a suite of process safety indicators, all that remains to be slayed in ‘safe work’ would seem to be the person centered part. The presence of major hazard and risk control via well-established safety management systems in the process industry offers a unique opportunity to add safety via nudges. Psychology and behavioural economics have already entered the safety science realm. Behaviour-based safety emerged in the early nineteen eighties and is in need of an upgrade. Where conscious behaviour according to unwritten cultural rules and written instructions are not enough for safety, additional manipulation of unconsciously made choices might be used. This principle, which is called a ‘nudge’ towards desirable behaviour, is already being applied in e.g. traffic control, public space, politics, energy saving, health care and trade practice. Nudging may have uncertainties about its feasibility and magnitude of its effects, might be developed specifically for certain application areas, might raise ethical concerns and – hence – requires investigation of its application boundaries. The potential of improving safety this way resides in the human error domain and may not only reduce hitherto unaffected unsafe behaviour but also increase rule compliance on legislation, procedures and codes of conduct. This article explores ‘safety nudges’ and proposes a new safety management tool for influencing behaviour of workers in safety controlled environments in the process industry. Based on currently available evidence, a set of 9 nudge types and an implementation approach are proposed.

This longitudinal case study centres around a ‘narrative’ compiling 13 years of regulatory experience with risk assessment in practice of major hazard control of Dutch Seveso companies. The narrative is written by the first author, retired as an inspector mid-2016. The concept ‘narrative’ was reviewed, debated and methodically interpreted by the second author. The narrative story considers risk assessment as the current basis for successful prevention and sound safety management, in line with current thinking. An inventory of risks for society, workers and environment, originating from a company that is eligible to receive a licence to operate, is essential for the regulator's decision-making. It needs to cover all risks since acceptance of incomplete assessments imply implicitly accepted, yet uncontrolled, danger. Risk inventories in practice tend to be elaborate yet incomplete. Shortcomings identified via assessment by the regulator, are mainly found in the areas of known but ignored danger, lacking evidence for chance and effect, lacking underpinning of the completeness of the inventory and lacking checks whether as yet unknown danger of various types could be threatening safety. This study has three results: an exploration of current thinking about risk based regulatory approach as described in literature, an experts' narrative on pitfalls in regulatory practice and an analysis leading to new insights about incomplete risk assessments. Conclusion is that progressing towards validation of company risk assessments by the regulator would require more uniformity of company risk assessments, a standard regulator appraisal method and, as an additional safeguard, a systematically performed completeness check.