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There were 1,424 serious workplace injuries recorded in Wales last year compared to 1,638 in 2008/9.
However, the estimated number of people suffering from work-related illnesses rose by 19,000 from 45,000 in 2008/09 to 64,000 last year.
Although there was a rise in the number of people who were fatally injured at work in Wales in 2009/10 - seven, up from a record low of five the previous year - there has been a step change improvement in recent years.
Terry Rose, HSE Director for Wales, said: "Although serious injuries at work in Wales have reduced, these figures show that there are still numerous cases where the health and safety of workers is still not being taken seriously. The fact that seven people failed to come home from work in Wales last year because of avoidable safety failings is a terrible tragedy.
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"It is not trivia. Employers have a legal duty to protect their employees. Health and safety needs to be at the very heart of the business and not seen as an add-on, tick-box exercise at best or an unnecessary burden at worst.
"Last year in Wales we secured convictions for 31 breaches of health and safety law by companies and individuals. We will continue to target those who fail to meet the standards that employees have a right to expect."
Across England, Scotland and Wales, 28.5 million working days were lost to injury and ill health last year.
National workplace fatal injuries fell from 179 in 2008/09 to a record low of 152 in 2009/10, and there was a reduction of more than 11,000 in the number of workplace injuries classified as serious or incurring more than three days absence from work.
Comparison with international data still shows Britain to be one of the safest places to work in the EU.
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