The right of worker representation has been a central tenet of occupational health and safety for over 40 years. While evidence shows that it improves health and safety at work, few attempts have been made to show how. In this plenary, a team of academics and labour representatives known as LOARC (short for Labour/OHCOW/Academic Research Collaboration) share their work examining what worker representatives actually do to achieve change. How much does it matter whether worker representatives adopt a more legal/technical approach or a more knowledge activist approach? Findings on effective worker health and safety representation styles are discussed.