An understanding of how health and safety management systems (HSMS) reduce worksite injuries, illnesses and fatalities may be gained in studying the behaviors of health and safety leaders. These leaders bear the accountability for identifying, understanding and managing the risks of a mining operation. More importantly, they have to transfer this knowledge of perception, recognition and response to risks in the mining environment to their workers. The leaders’ efforts to build and maintain a mining operation’s workforce that consistently executes safe work practices may be captured through more than just lagging indicators of health and safety performance. This exploratory study interviewed six leaders in occupations such as site-level safety supervisors, mine superintendents and/or general managers at surface and underground stone, sand and gravel and metal/nonmetal mine sites throughout the United States, with employee populations ranging from 40 to 175. In exploring leaders’ perspectives on how they systematically manage health and safety, examples such as approaches to task training, handling near-miss incidents, identifying future leaders and providing workers with feedback offer insights into how leaders translate their knowledge and management of site-level risks to others.