text: **When looking at**recognised occupational diseases — not work-related diseases — as an indicator for 
  **health outcomes**of working conditions, these underwent a similar decrease to that for work accidents. 
  The outcomes for the main occupational disease groups descended, for example, hearing impairments 
  from noise at work, pulmonary diseases (from exposure to dust and chemicals), very specific 
  musculoskeletal diseases, and diseases related to exposure to hazardous biological or chemical agents. 
  However, the latest estimates of the burden of diseases from the WHO/ILO and ICOH do not show a 
  decline in work-related diseases. The figures might even considerably increase in future estimates if 
  mental diseases and illnesses from biological agents are incorporated. 
  
  Coping with a**broader variety of the workforce**— higher age, higher skills and longer education, more 
  women and more international workers — is a challenge for OSH practices in enterprises. It is a topic 
  that is tackled in a large and increasing number of preventive information and guidance documents. 
  **Preventive services, external or internal, in a private, state or mixed framework**, are functioning 
  as an important pillar of OSH; they are crucial for the implementation of good and best practices in 
  enterprises. 
  
  We can observe**more global efforts**for better OSH. Ethical considerations in supply chains are of 
  increasing importance for enterprises in international trade and many markets. International 
  organisations like the ILO, WHO, ISSA, UN, ICOH and IALI continue to develop not only objectives and 
  observation tools but also more and more action programmes to practically improve the situation globally. 