AbstractThere are many studies that focus on Prevention through Design (PtD) for construction workers and developing formalized PtD processes for construction projects. However, few studies have aimed at developing a formalized PtD process for mechanical/electrical/plumbing (MEP) worker safety. A formal process for implementing PtD for MEP worker safety is badly needed because MEP work onsite and during operation and maintenance (O&M) can lead to injury and death. To address this knowledge gap, our research team aimed to create a formalized PtD process for MEP safety and developed case studies that detail how the process can be implemented in the field. The formalized process and case studies would then be used in an implementation guide created specifically for the industry. This project was completed through expert interviews, six case studies, and ongoing discussion and review by an Industry Advisory Council. Using these methods, the team identified factors for implementation success and developed a formalized PtD process specific to the MEP worker context. The process consists of five phases: (1) hazard identification, (2) risk assessment, (3) design review, (4) implementation, and (5) learning. We anticipate that this study will contribute to the field of PtD research through creating one of the first formalized PtD processes for MEP construction and O&M worker safety, and through a cross-case analysis of the six PtD cases that indicated not only the importance of stakeholder engagement and cross-disciplinary dialogue, but that effective PtD implementation can occur even outside of a collaborative project delivery context at any point during design and construction.