A continuous all embracing registration of acute, in-patient and out-patient visits at hospitals and primary health care centres, has been conducted since 1978 in Skaraborg County in western Sweden. A special focus has been directed at accident cases which account for 20% of the total number of acute visits. The accidents have been divided up by environment: home, work, traffic and other. Cases of work-related accidents have been mapped out in more detail with the help of standardized and structured surveys via telephone interviews, information from hospital records, and death certificates. This study aims at achieving increased understanding and knowledge about the accident pattern in the working environment in a municipality. This mapping of cases of work-related accidents in a defined population is also a part of evaluation of an intervention programme. Such a comprehensive community-oriented intervention programme has never been reported before. A total of 20 440 inhabitants in the municipality were registered in health and medical care centres over a six-year period because of injuries. Out of this total, 3 729 or 18.2% occurred on the job. A significant over-representation of work-related accidents existed for men, those in the 16–34 year age group, and those in manufacturing or farming. High incidences of industrial accidents were concentrated in the months of August through November. The most common types of injuries were to the eyes, or from crushes, falls, cuts, or punctures from sharp or piercing objects. In reference to accident frequency, type of injury, degree of severity, hospitalization, or sick-listing, there was no significant difference found to exist between accident cases in firms with occupational health and those without. A comparison of our registration system for work-related injuries with the central official statistics of Sweden reveals a substantial under-reporting of work-related accidents in the latter. Consequently, a need exists for the registering of accidents on the local level as a base-line for the intervention programme as well as the evaluation of the effects.