Current green design and construction practices are primarily aimed at minimizing environmental and resource impacts and improving the safety, health and productivity of a building's final occupants and the public. Rating systems, such as the U.S. Green Building Council's (USGBC) Leadership in Energy and Environmental Design (LEED) put little, if any, focus on the safety and health of the initial occupants, the construction workers or those that maintain these buildings.Yet, such rating systems and their proponents represent a largely untapped opportunity for safety and health practitioners to enlist in efforts to promote designing for safer workplaces during the building's construction and maintenance. In the U.S., the likelihood of governmental regulations that would broadly specify prevention through design (PtD) efforts in upstream construction activities is remote. Because PtD has seen international support in enhancing construction worker safety and health, innovative and creative ways to diffuse the concept in the U.S. must be developed. This article focuses on the congruencies between the green building effort as a sustainable holistic system and the safety and health of workers who build and maintain these buildings. National Occupational ResearchAgenda (NORA) Construction Sector goals, whose formulation was facilitated by NIOSH in collaboration with external stakeholders, are described as they relate to green building elements and ideologies. Motivations and methods for design professionals to participate within NIOSH PtD and a new NIOSH program, Safe Green Jobs, are described. The basic premise of the article is summed up by Gilding, et al. (2002) who say "no entity that presides over projects that experience avoidable workplace deaths, serious injuries, or illnesses can ever claim to be sustainable." For green buildings to be considered sustainable, construction safety and health concepts must be integrated into upstream considerations.