A total of 50 people were killed in workplace accidents last year in the State, according to the Health and Safety Authority's annual report.
The Authority said there had already been 26 deaths so far this year and warned business and employers to take steps to protect staff or face legal action.
HSA chief executive Tom Beegan said a change of priorities was needed to instil a new culture of health and safety in every workplace.
"We still think safety is not the priority that it should be.
People seem to disregard it in a way that we are not happy about," he said.
Mr Beegan said there was absolutely no proof to support the excuse that HSA regulations placed an unnecessary financial burden on small business.
"This is a cost that's totally within the control of business. So we are saying we'll do what we can, we will simplify the bureaucracy, we will reduce the paper work but at the end of the day this is about behavioural change and this must be led from the top." he said.
Mr Beegan said 1.4 million working days were lost in 2003 due to work injury or illness, while the annual cost to the economy of workplace accidents and work related ill health is about €1.6 billion.
The HSA figures for 2004 showed there were 50 fatalities in 2004, compared to 70 in 2003.
Farming and fishing were the most dangerous sectors with 16 deaths, followed by construction with 15 fatal accidents.
A total of 11,382 inspections were carried out with 45,000 calls to the HSA information line.
Male workers incur twice as many injuries as females. 70 per cent of injuries occur in the 20 - 44 age group.
Workers in the Mid-East counties of Kildare, Meath and Wicklow were most likely to suffer injury.
Workers in the West - Galway, Mayo and Roscommon were most likely region to suffer illness.
Mr Beegan also said new legislation was being passed through the Oireachtas with special provisions for self-employed workers and small firms to tighten regulations.
"I am very concerned that the lessons have not been learned and that people are dying needlessly simply because proper measures have not been taken to ensure workplace safety," Mr Beegan said. "It is simply not acceptable that any worker could lose their life by just turning up for work and carrying out their job.
The report, launched as part of World Health and Safety Day, revealed the country's worst accident blackspots were Cork with four deaths, and Donegal, Dublin, Louth and Wexford with three deaths in each county.