Project Summary/Abstract Michigan State University in conjunction with the Michigan Occupational Safety and Health Administration (MIOSHA) and the Michigan Department of Health and Human Services has been conducting state-based occupational injury and illness surveillance since 1988. This proposal will continue and expand this activity. This proposal will fund activity to generate the occupational indicators, data on elevated blood leads, and specific non-fatal injuries (e.g. burns), ten special projects and expanded surveillance programs for: (1) occupational lung disease; (2) acute work-related pesticide injuries and illness; (3) acute work-related acute traumatic fatalities. Since initiation of multi-source surveillance, cases of work-related asthma, cases of acute pesticide poisoning, cases of silicosis and other lung diseases, elevated blood lead levels, and both acute fatal and non-fatal traumatic injuries have been confirmed. This case-based surveillance has initiated follow- back enforcement MIOSHA inspections in the worksites. These inspections have included interviews of fellow workers. The confirmation process, workplace inspections and fellow worker interviews will be continued. There has been 100% reporting from the 134 acute care hospitals in the state. A quarterly newsletter (four/year for 31 years) has been written and mailed out to approximately 3,300-targeted physicians and health care professionals. Two hundred and three annual reports and 51 hazard alerts have been disseminated. The above active outreach to encourage reporting and educate employers and employees about hazards will be continued as will presentations and display booths at medical meetings, publishing papers in the medical literature, postings on our website (oem.msu.edu), Twitter, and Facebook, the NIOSH Science Blog and through the medical licensing board. We will continue to work with NIOSH, CSTE, other states, trade organizations and unions. Evaluation of the effectiveness of our effort to improve working conditions will also continue. Innovations in this application including expanding our educational outreach, and ensuring that we address the hazards of vulnerable populations and minorities, as well as temporary workers and youth follow back. New activity planned includes expanding surveillance to include exposure surveillance, additional nonfatal traumatic injuries, projects on under-reporting, evaluation of MIOSHA inspections for following up reported cases and projects on special populations and industrial sectors.