Michigan State University in conjunction with the Michigan Department of Community Health and the Michigan Department of Labor and Economic Growth has been conducting state-based occupational safety and health surveillance since 1988. This proposal will continue and expand this activity. This competitive supplement proposal will fund surveillance programs for two specific conditions: (1) work-related fatal injuries and (2) work-related noise induced hearing loss (NIHL). The state has had NIOSH funded surveillance projects since 1988. With this funding occupational disease reporting has increased from less than 100 reports a year prior to 1988 to 15,000-20,000 reports a year. The state has had NIOSH funded projects in work-related NIHL from 1992 to 2000 and 2002 to date and work-related fatal injuries since 2002. Michigan conducted work-related fatal injury surveillance with state funds from 2000 to 2002 and continued surveillance without NIOSH funds for work-related NIHL from 2000 to 2002. Since initiation of surveillance, 605 work-related fatal injuries and 24,706 cases of work-related NIHL have been confirmed. Sixty-six fatality investigations and 122 NIHL follow back industrial hygiene inspections have been conducted. The confirmation process, industrial hygiene inspections and fatality investigations will be continued. A website with all the material prepared has been and will be maintained in the future. Seventy-nine fatality summaries, 6 hazard alerts, one quarterly newsletter (total 30 different newsletters) on NIHL and 2 annual reports per year (total 16 different reports) have been written and distributed to approximately 4,000 targeted health and safety and health care professionals. Active outreach to encourage reporting of NIHL will be continued. Additional activity that will continue will include presentations and display booths at medical and health and safety meetings, publishing papers in the medical literature and working with other state organizations such as the medical and audiology licensing board to publicize Michigan's occupational disease reporting law. Active dissemination of material derived from work-related fatal injuries and preventive intervention will continue to be an integral part of our program. Evaluation of the effectiveness of our effort to improve working conditions will also continue. In addition to the above basic surveillance, we will be expanding our outreach, followback and evaluation activity. New activity planned for NIHL includes: expanding our use of workers' compensation data, projects on under reporting, evaluation of OSHA inspections for following up reported cases, and a strategic plan for hearing loss. New activity planned for work-related fatal injuries includes: a project to address fatalities in temporary employees, and involvement of engineering students.