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This paper aims to analyse the extent to which health and safety action controls, results controls and informal controls affect the integration of health and safety issues into management actions, which in turn leads to improve health and safety performance. It also investigates the extent to which those health and safety control mechanisms contribute complementarily to the integration of health and safety issues.

A survey of 108 Italian non-listed firms tests a set of hypotheses based on complementarity theory and object of control framework.

Not all the health and safety control mechanisms positively influence the integration of health and safety issues into business practices and external stakeholder relations. Complementarity between health and safety control mechanisms is significant only for higher health and safety performance companies, indicating that the health and safety control mechanisms operate as a package.

The health and safety performance measure could be replaced in future research by improved inter-subjectively testable information, although collecting health and safety quantitative data is difficult. An additional limitation is the response rate.

The findings encourage companies to design and use a comprehensive set of health and safety control mechanisms to promote a healthy workplace.

The paper contributes to the management control, sustainability management control and health and safety accounting literature. The paper provides an in-depth interdisciplinary analysis of the effectiveness of different control mechanisms in the context of health and safety that hitherto has rarely been investigated despite the multiple importance of the topic.