The Massachusetts Department of Public Health’s Occupational Health Surveillance Program (OHSP) is proposing to build on its extensive experience and network of partners to continue and enhance the Expanded Program for occupational health surveillance and prevention. The overarching aim of the program is to reduce the incidence and severity of work- related injuries and illnesses and improve worker health in Massachusetts. This proposal has strong support from state agency leadership and has leveraged additional state and federal resources to supplement its core surveillance funding. Work-related injuries and illnesses are preventable. While Massachusetts has made progress in improving worker health and safety, work-related injuries and illnesses remain a significant public health threat. One to two workers are fatally injured each week in Massachusetts. For every fatality, there are an estimated 890 nonfatal injuries and illnesses reported by employers, amounting to over 86,000 work-related injuries and illnesses per year. Previous studies have demonstrated that the true number is much higher. As has been demonstrated recently with COVID-19, this burden falls disproportionately on low wage workers, primarily immigrants and workers of color, who are often employed in more dangerous jobs. Work-related injuries and illnesses have serious health and economic costs for workers, their family, employers, and society. While the full costs in Massachusetts have not been calculated, over $1.26 billion dollars were paid in Massachusetts Workers’ Compensation benefits in 2018. The purpose of this proposal is to continue and enhance OHSP’s Fundamental Project and three of its currently funded Expanded Projects to meet the identified needs of the state. OHSP proposes broadening the scope of the Fundamental Project to provide more cross- project coordination and intra-departmental collaboration on complex evolving issues, such as COVID-19 and health equity. The proposal builds on our commitment to underserved workers by using a health equity framework to guide our work. This proposal will expand OHSP’s ability to use health informatics and to collaborate with partners in order to identify and respond to unsafe work conditions and ameliorate their impact on the health and quality of life of workers. OHSP proposes to continue and enhance its three Expanded Projects on worker fatalities, health care workers, and work-related respiratory diseases. Ultimately, the proposed Expanded Program will lead to reductions in hazards in MA workplaces, improved worker health, and lower costs.