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Drawing on a literature review on sentinel and alert systems for identifying new/emerging work-related diseases (WRDs) a basic typology of systems was developed. These systems differ in characteristics, ability to capture new WRDs and link with prevention. The objectives of the subsequent study of a subset of systems were to describe in-depth aims, drivers and obstacles of the systems and use of their data in practice, for prevention and detecting new/emerging WRDs.Twelve systems were chosen reflecting the different types (linked to compensation or not, aimed at all WRDs or a subset of diseases, sentinel systems, workers only or general public). Six systems were described based on desk research and six other systems were studied through interviews with different actors to gather information on the operation of the systems and the use of the gathered data for prevention.Several important themes emerged from the comparative tables, related to the design and performance of the system: visibility, reporting methods, exposure assessment, data quality, linkage to other institutions, and related to data use for prevention, alert on hazardous situations, and awareness on new/emerging diseases.Each system has its strengths and limitations, closely related to its purpose and the country that developed it. Sentinel systems seem to be best equipped for prevention and alert on new/emerging diseases. Enhancing reporting needs to balance required information and perceived reward for reporters. Embedding of systems in governmental or public health organisations is important in terms of financing, expertise and dissemination of results.