In response to reports of bursitis of the knee, fluid buildup requiring knee aspiration, skin infections of the knee and a variety of knee symptoms reported by carpet layers, NIOSH issued the recommendations contained in this NIOSH Alert. Approximately 100,000 carpet layers were noted to be employed in the United States. Carpet layers make up less than 0.06% of the United States workforce, but they file 6.2% of all workers' compensation claims for traumatic knee injury, a rate that is 108 times that expected in the total workforce and the highest rate of any occupation reporting such claims. An evaluation of claims revealed that both the use of the knee kicker and kneeling were risk factors associated with a high frequency of knee disorders. Carpet layers were observed to spend the majority of their work time of their knees, but they seldom used protective knee pads. A safe alternative to the knee kicker was indicated to be the power stretcher, which helped eliminate impact trauma to the knee. Recommendations were provided and included the use of knee pads and the power stretcher, proper training of carpet layers, and conduction of further research to develop installation methods that further reduce the physical stress and knee trauma suffered by carpet layers.