The Eastern Carolina Safety and Health School was established in 1995 as a joint project among East Carolina University faculty, representatives of local industry, and members of the North Carolina Department of Labor. It was the result of a suggestion made by Charles Jeffress, then current Deputy Commissioner of Labor and Director of NCOSH, to Drs. Mark Friend, Jim Kohn, and Dan Sprau, faculty members of East Carolina University. An initial meeting was held at Rock Springs Equestrian Center to determine the course and shape for the school.

Ralph Dudley, safety director at Burroughs Wellcome, hosted the second meeting at his plant, and was elected president of the first board. Upon his leaving to assume a position in another state, Linwood Smith, safety director at T.A. Loving Company, assumed the role of president. The first Eastern Carolina Safety and Health School was held at the Sheraton Hotel in New Bern in the spring of 1996, and was deemed a huge success. Estimates were that nearly three hundred people were in attendance at the first school. The site for the annual School has since moved to the Sheraton Hotel at Atlantic Beach.

The theme of the first and all subsequent schools has been "Treasure Hunting for Safety". Attendees have been treated to guest speakers from local industry as well as from state and federal government. Key speakers in previous schools have included Charles Jeffress, past Assistant Secretary U.S. Department of Labor and previous head of OSHA; Cherie Berry, North Carolina Commissioner of Labor; and Thomas Krause, president of Behavioral Safety Associates in Ojai, California and a leader in the field of behavior-based safety.