Under a cooperative agreement between NIOSH and the Iowa Department of Public Health, a survey was conducted to characterize the occupational disease surveillance activities of the 50 states, New York City, and the District of Columbia. The latter two entities were considered to be "states" in the data presented below. In response to questions on the reporting requirements for the six sentinel diseases, lead (7439921) poisoning, silicosis, asbestosis, mesothelioma, coal workers' pneumoconiosis, and byssinosis, 16 states answered that all six diseases were reportable. Lead poisoning was reportable in 28 states, and the other diseases listed above were reportable in 23, 22, 21, 19, and 17 states, respectively. In all, 32 states had either mandatory or voluntary reporting requirements for occupationally contracted diseases. Reporting was required of private physicians, hospitals, laboratories, nursing home administrators, labor unions, and employers. In response to questions on where the gathered information was located, it was found that individual case reports and, in seven states, summaries of case reports, were the largest sources of information. Some occupational or industry information was coded on death certificates in 31 states, and the parents' occupation was listed on birth certificates in 14 states. A central cancer registry was maintained in 32 states, but in only 18 of them were the occupational histories listed (always or sometimes). Only seven states maintained occupational disease registries other than cancer. Thirty three departments maintained a file of machine readable workers' compensation claims, but only 24 of them analyzed the data. Only four departments used hospital records to collect occupational information.