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It took over 30 years to gain enough support to produce a truly global OH and S management system standard, despite conservative estimates of 250 million occupational accidents and 160 million occupational diseases each year – worldwide over a million work-related fatalities every year. It took four years of work involving experts from 63 countries and 9 international organisations (including the International Labour Organisation and the International Trades Union Congress) to produce a draft 88% of those involved can support.The standard has been developed through a consensus-based process including 10 physical meetings (involving up to 100 people in countries spanning four continents), electronic meetings and teleconferences. Each formal iteration of the standard has been balloted, with a minimum of 75% approval needed to progress to the next stage and every comment submitted on each draft considered.The standard is likely to publish at the end of 2017 or early in 2018 and is intended to replace the current widely used OHSAS 18001 standard, which was developed by a smaller number of countries before an agreement was made for a full ISO (International Organisation of Standardisation)To what extent can standardisation help improve OH and S performance across the world? What are the barriers to use and limitations? How can we promote proactive OH and S management, particularly in relation to health and wellbeing?