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Health and wellbeing are the ultimate goals in life. Expenses, whether governmental or non- governmental, are often directed towards health and development. More efforts and costs are essential for sustainability and its three pillars; environment, society and economy. Cultural, political and technological factors are intermingled with these pillars. The balance between these three pillars is crucial in the nations’ goal to maintain resources for the present and future generations. Work represents a risk as well as a benefit at the same time. The aims of the modern policies and strategies of the Occupational Health and Safety (OHS) programmes are workers’ protection and profit earning as well as sustainability, considering the effectiveness, utility and benefits of those policies. The situation in big firms is rather acceptable but small and medium sized enterprises and informal sector need more effort. Globally, around 4% of GDP is lost due to the costs of work related injuries and illness with global financial losses exceeding $1250 billion. This cost is high compared with that of cancer or AIDS. The burden of occupational injuries and illness is also high when calculating Disability-Adjusted Life Years lost, or healthy years of life lost either from disability or premature death. This will hinder economic development and sustainability. So, all should be motivated towards cost effectiveness OHS programmes as a priority in their agenda. Occupational health literacy, unemployment, workers’ behaviour, high risk group workers (children, women, and elderly and immigrants workers), inequity and inequality should be considered in OHS programmes. Society, workers, payers, and providers’ perspectives must be investigated in facing challenges towards OHS and sustainability. Reallocation of resources, controlling of externalities, enforcement of regulations and encouraging of innovation are crucial elements for sustainable development and economic growth.