More and more persons are exposed to hypoxia while working at altitude, e.g. when working for cable cars or ski areas in the Alps, for business in South America or Asia, as airline crews, or in rooms with reduced oxygen pressure for hypoxia training or fire protection. Unfortunately, the different countries have a multitude of regulations for occupational health and safety concerning hypoxia -most of them with major deficiencies and a significant lack of knowledge about hypoxia and possible specific risks. So far, no national regulation differentiates the different types of hypoxia and the environment, both having significant influence on the specific risk profile of employees and consequences for occupational health and safety.As the world's umbrella body for preventive medicine at altitude / hypoxia, the Medical Commission of the Union Internationale des Associations d'Alpinisme (UIAA MedCom) recently established a recommendation to enable the national bodies to establish knowledge-based pragmatic procedures for occupational health and safety [1]. The most important message is as follows: Any environment with oxygen concentration of 14.0% or more or an altitude of 3,000 m or less is safe for any non-acclimatized person without severe cardiopulmonary disease (10 g/dl) and an exposure limited to a few hours (one work shift). These environments include most alpine cable cars, ski areas, aircrafts flying on long-range distances, most towns or villages where businessmen might go to, and rooms for fire protection. For longer exposure (sleep at high altitude) or higher environments the persons should be acclimatized or exposed for a short time only. Details how to manage health and safety in such environments are given.