The most dangerous construction tasks are trenching and excavation related works, resulting in accidents among construction employees. The study assessed health and safety risk associated with excavation cave-in. Delphi method of data collection was employed in the administration of questionnaires, among six academics and seven construction professionals in Cape Coast Metropolis. Findings from the study show that adequate measures were put in place by the contractors to minimize cave-in.  The employed safety measures with high response rate are: heavy equipment should be kept away from trench edges, appropriate training on shoring should be provided to all workers and trenches should be inspected on regular basis, and at the start and end of each shift. While the employed safety measures with low response rate are attributed to, trench evaluation should be rigorous when there was heavy down pour and shoring of trenches should be carried out by specialists.  Further findings indicate that all the construction sites applied one or two of the installation preventive systems, namely shoring and sloping the ground. These installation preventive systems fall within the minimum criteria for a good system. Preventive system for excavation works are employed by the firm, was considered by the experts to have reached consensus with IQD cut-off (IQD ≤1) score set. Contractors and construction professionals must ensure that preventive measures for cave-in safety should be also applied to areas with potential risk within the site, to prevent any unforeseen dangers.

Keywords: Atmospheric Risk; Fatalities; Hazards; Installation; Preventive Systems.