Construction industry is one of the major contributors towards Malaysian economy and socio-economy. It is an important
industry gearing Malaysia towards developed nation status. However, fatalities in this industry are a crucial problem. Number of
fatalities in this industry is the highest compare to other industries registered in Malaysia. The contributing factors can be separated
into immediate (human and worksite elements) and underlying (management and external). Occupational safety and health (OSH)
management is a challenge in the construction industry due to its hazardous nature. A framework of construction OSH management
consisting of policy, process, personnel and incentive elements were tested. 13 respondents from 13 residential projects comprising of
high-rise and low-rise in Pulau Pinang were interviewed. It was found that the immediate factors are being more recognized by the
respondents compare to the underlying factors. Human element is perceived as the most significant contributor, while the external
element is the least significant. In terms of construction OSH management, process and personnel elements are the most significant in
developing an effective OSH management programme.