Construction and agriculture remain the most dangerous industries, the HSE said as it released the latest details for the number of people killed at work in 2009/10.
A total of 19 workers were killed at work in the North West between 1 April 2009 and 31 March 2010, according to the Health & Safety Executive. This is compared to an average of 27 work-related deaths in the past five years in the region, and 23 fatal injures in 2008/09.
The HSE said details of the incidents in which North West workers died were not being released as the figures were only provisional at this stage and out of respect for the families of those that died.
Across Britain, the number of people killed at work fell to a record low with 151 workers dying at work in 2009/10, down 15% on the previous lowest total of 178 in the year before.
David Sowerby, divisional director of the HSE in the North West, said: "While it's heartening to see a reduction in the number of work-related deaths in the North West, it's simply not good enough that 19 people failed to come home from work to their families last year.
"Yet again, falls from height and incidents involving workplace transport are among the biggest killers, and companies must act now to improve safety.
"Many of these unnecessary deaths could have been avoided if simple and sensible precautions had been in place, and if workers had been involved in dealing with the risks they face.
"Once more, the agriculture and construction industries figure prominently in the North West fatalities – and we all must work hard to tackle the poor safety record in these sectors.
"For the sake of those workers who have lost their lives, HSE will continue to take an uncompromising approach to safety."