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Occupational diseases cause huge suffering and loss in the world of work. While much progress has been made in addressing the challenges of occupational diseases, there is an urgent need to strengthen the capacity for their prevention in national OSH systems. With the collaborative effort of governments and employers’ and workers’ organizations, the fight against this hidden epidemic will have to feature prominently in new global and national agendas for safety and health. This report for the World Day for Safety and Health at Work outlines the current situation concerning occupational diseases and presents proposals for addressing this serious Decent Work deficit.