What is the real price to pay for not investing in occupational safety and health? Many studies have previously tackled this question by evaluating the costs of poor or non-existent safety and health at work. This report reviews a selection of these studies and analyses the estimating methods used by each. It focuses on five different types of cost – productivity, healthcare, quality of life, administration and insurance – that emerge as a consequence of poor occupational safety and health and how these costs affect four types of stakeholders – workers, employers, government and society. The report goes on to recommend how these costs should be estimated in the future to best inform policy-makers.