The bureau conducts preoccupancy inspections for migrant labor camps and conducts other inspections to ensure compliance with applicable agricultural safety and health standards.

The East and West Compliance Bureaus conduct inspections of North Carolina businesses to ensure compliance with applicable workplace safety and health standards. The OSH Complaint Desk processes work-related safety and health concerns.

The bureau provides free on-site consultation upon employer request to help employers comply with workplace safety and health standards. The bureau also administers the Safety and Health Achievement Recognition Program (SHARP) that recognizes small to mid-size businesses that establish and maintain effective safety programs. 

The bureau coordinates and conducts various outreach programs such as safety and health schools and workshops, speaking engagements, training events, and booth displays. The bureau reviews the federal standards for state adoption, coordinates state-specific rulemaking activities, distributes OSH publications, and provides written, electronic or telephone interpretive guidance to employers and employees and processes variance requests. The bureau also administers library services and two recognition programs, the Carolina Star Program and the Safety Awards Program, that acknowledge businesses with exemplary safety and health programs. 

The bureau provides statistical data about North Carolina employers and produces several annual statistical documents and reports. PSIM manages inspection and investigative case file disclosures and file archiving. The bureau is also responsible for managing the OSH Inspection Targeting System.