There appear to be a number of strategies, both environmental and personal, that could be incorporated into occupational health and safety programs to reduce the incidence and severity of back injuries. It will take carefully designed education delivered with persuasion to move employers to looking beyond personal causal factors to the environment. In addition, it will take financial resources and a long-term perspective for employers to see the value of investing in strategies such as environmental redesign or job analysis and preplacement strength testing. The occupational health nurse is in a key position to influence the development and management of effective injury prevention and control programs if prepared with an accurate understanding of the involved issues. Shown are examples of theoretical injury prevention tools that encourage creative problem solving by the nurse and support the concept of changing the environment in addition to trying to change behavior.