Family members, trade unionists and civic dignitaries from all over the North East attended a moving service in Hartlepool for Workers' Memorial Day.
Around 40 wreaths in memory of those who have been killed, injured or made ill in the workplace were laid at a new memorial in Church Square.
The annual service once again emphasised the message to remember the dead and to fight for workers' rights to ensure their safety.
A number of high profile people spoke and laid wreaths including Frances O'Grady, General Secretary of the TUC union; Amy Murphy, President of USDAW, which represents shop and distribution workers; plus Hartlepool MP Mike Hill and members of Hartlepool Borough Council.
The first wreath was laid by the family of Jason Burden, from South Shields, who died aged 19 in an industrial accident in Sunderland in 2011.
Organiser Edwin Jeffries, President of Hartepool Trades Union Council, said: "They are high profile speakers but every worker is also high profile when it comes to their safety.
"Today is about remembering those who died or have been injured at work and a dedication to ensure proper health and safety regulations are in place.
"Nobody should go to work and not expect to go home at the end of it."
The day's theme this year was dangerous substances – get them out of the workplace. The long-term lung condition asbestosis from workplace exposure is said to be responsible for more than 100,000 deaths worldwide.
Workplace stress is also responsible for millions of lost days and is linked to deaths from heart disease, cancers and suicide.
Trade union speakers said the movement was key to ensuring employers take health and safety seriously and to stand up for workers.
Ms O'Grady said in the service in Christ Church: "I believe that every single worker has a human right to go to work and be safe and not to suffer ill health or distress or mental ill health through the work that they do."
She said the town's annual event is "a credit to Hartlepool" and praised the effort of Mr Jeffries for making it happen.
MP Mike Hill, a former Unison official, said the day brings the community together and it sends out a strong message for workplace safety that he pledged to take to Parliament.
Dave Anderson, former Unison President, said: "Today reminds people how important health and safety is.
"It's appalling the way in which people have allowed health and safety to almost become the butt of a joke.
"People who are responsible for people's lives need to up their game and recognise that health and safety is in everybody's interest."