Sector specific skills in occupational safety and health (OS&H) are crucial for being able to contribute to good work environment and decrease today's high levels of sick absences. Large manufacturing companies are due to tradition good at OS&H and can serve as an interesting context for investigating the knowledge level in the area today, and needs for the future. For this purpose a case study was performed in this sector as a co-operative inquiry, including 10 OS&H professionals (engineers and ergonomists) employed at in-house and external occupational health services (OHS). Professional experiences, good examples from practice and current research were shared jointly within the inquiry. The results show needs to work more preventively than today comprehending aspects as system understanding, integrated work teams, participation, a clear role in change projects plus skills in risk assessments. Skills in how to conduct well-functioning dialogues with stakeholders were also on the agenda.