This document provides valuable guidance for developing a range of state-based public health programs occupational illness and injury prevention. It is an update of a 1995 publication and was prepared by members of the Occupational Health Surveillance Workgroup of the Council of State and Territorial Epidemiologists (CSTE). The minimum recommended state-level approaches in the Guidelines describe public health activities in occupational injury and illness prevention that can be performed at a minimal cost using existing staff and data. The comprehensive state-level approaches suggest areas for expansion as resources become available. Occupational injuries and illnesses are preventable. The first step to prevention is to know the how, why and when of the health condition. The Guidelines highlight the fundamental importance of public health surveillance data or, to use the term from Institute of Medicine, "assessment" as one of the three core functions of public health practice. State health departments have been practicing disease surveillance for the past 100 years. It is something we do well. Strong, state-based public health surveillance systems for occupational diseases and injuries are needed to provide critical data not available in national data systems. Advances in available electronic health data systems in the past ten years have greatly expanded opportunities for state-based occupational health surveillance activities. In some ways occupational injuries and illnesses are easier to address than other preventable conditions because often the risks can be controlled through better engineering design rather than requiring individual behavior change. However, like other aspects of public health, there can be complex social interplay that may impede effective prevention. The second section, "policy development," describes minimum and comprehensive activities to address and mobilize social forces to promote occupational safety and health. Finally, in accord with the third core function of public health - "assurance" - the Guidelines describe a range of state-level approaches to occupational injury and illness prevention, many of which are now possible because of the near universal accessibility of information and communications tools through the Internet. Furthermore, successful prevention strategies that have been developed by a core group of state programs for over 10 years can readily be shared with all states.